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Download Community Preparation for Caring for Ventricular Assist Device
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Community Preparation for Caring for Mechanical Circulatory Device Patients University of Wisconsin Hospital And Clinics Ventricular Assist Device Program Mechanical Circulatory Support Device Overview • MCDSs are devices to support the failing heart (one side or both) • Most MCDS patients are anticoagulated with Coumadin and Aspirin • All MCDSs have: – Pump (implanted inside the patient’s chest) – Computer to control the settings/ display VAD performance readings – Power source: batteries or console connected to AC power •Components •VAD readings •Care Overview •Emergency Care Thoratec TLC-II • Can be used for RV, LV or both • Can be implanted or paracorporeal • Pulsatile VAD (can hear it running) • Sterile dressing over cannula exit sites • Each VAD has 2 mechanical valves Thoratec TLC-II VAD Components Inflow cannula Outflow cannula Thoratec TLC-II Control Panel Thoratec TLC-II Care Overview • Can palpate a pulse • Need to assess if pump if running: listen for mechanical valve clicking and the noise of console working (BOTH NEED TO BE HEARD) • Blood pressure: – Keep SBP< 140 – Non-invasive blood pressure cuffs will work Thoratec TLC-II Care Overview (cont’d) • EKG conduction is not affected and arrhythmias maybe tolerated including VT/ VF – Most of these patients have an ICD/ pacer. Some patients’ ICDs are off to avoid inappropriate shocks. – Most VAD patients tolerate the arrhythmias and may have little symptoms for period of time. • Assess for patient’s tolerance of situation (if able). Ask for symptoms: lightheadedness, shortness of breath, palpitations, bloating, pain (anywhere), fever, chills, diaphoresis Emergency Care- Thoratec • √ VAD stopped (listen for valve clicking and console running). If stopped significant risk for clot inside MCDS and thromboembolize. • NO CHEST COMPRESSIONS • Defibrillation- STANDARD METHOD • Heparin bolus if VAD stopped (contact attending cardiac surgeon) • Hand pumps can be used in case of console failure. RVAD needs to be pumped < then LVAD.
