ventricular assist device-vad/lifevest
VAD
Care/Treatment:
- Family and caregivers can answer most questions.
- Family may have the patient's home hospital on the phone to use as a resource (if so, stay in Scope of Practice and have home hospital, contact Base Hospital if necessary).
CPR:
- ONLY if unresponsive, apneic, pulseless and a “red heart” alarm in (turbine non-pulsatile) VAD (ask family). Most types of VAD’s do not allow for CPR.
- 02, IV as indicated.
- Vitals: note that some patients may not have a palpable pulse or BP (are awake and talking).
- Paramedics may operate hand pump.
- Take all related VAD equipment to hospital with patient.
- Cardiac Monitor, 12 Lead, Defibrillation and AED are all indicated per normal protocols.
Medications:
- No ALS drugs are contraindicated (unless family states otherwise).
- Patient may be on “blood thinners”. Do not administer ASA with CP.
- No IO for LVAD patients.
Special Notes:
- Pulmonary Edema with hypotension and “red heart” alarm in 1st generation (displacement pulsatile): hand pump is indicated.
- Fluid challenge with caution (Contact Base).
- Pump failure can present as Cardiogenic Shock: hypotension, syncope, LOC or ALOC, Pulmonary Edema.
- Patient can still experience dysrhythmias—treat per protocols with BHC.
- May also have an AICD implanted.
- Chest compressions and chest trauma can disrupt internal mechanics/connections of the VAD.
- VAD’s are 1st generation (pulsatile displacement pump) or 2nd generation (non-pulsatile turbine).
LifeVest
LifeVest (Automatic External Defibrillator):
- Initiate CPR unless the vest device is broadcasting “press the response button,” “electric shock possible, do not touch patient,” or “bystander do not interfere.”
- If needed, remove the LifeVest and monitor / treat the patient with the standard monitor / defibrillator.
- To remove the LifeVest pull out or disconnect the battery, then remove the vest.
- Take the vest, modem, charger, and extra battery to the hospital