- Universal pager 0737 (paging uses)
- VAD coordinator cell number: (608) 516-0348 (pass around phone)
- Can assess them like any other patient except pulses will need to verified by Doppler
- Call VAD coordinator with any concerns
- CT scans, ultrasounds, CXR, KUB are acceptable diagnostic tests
- May externally shock or pace like a standard patient
- Do not do chest compressions without discussion with Heart failure team
- Do not take down sterile driveline dressing
- No MRI
- All are on coumadin. INR goal is variable based on patient and/or device.
- All are on ASA. Heartware requires 325mg. HeartMate II is usually 81mg.
- Pt may be on usual heart failure cocktail variety (Beta blocker, ACE inhibitor, diuretic, potassium supplement)
II. Vitals Signs
- Blood pressure
- 99.9% of patients will NOT have a palpable radial pulse
- BP needs to be obtained by Doppler and BP is assessed/monitored as MAP pressure = (NOT systolic)
- Doppler pressure
- Supplies: BP cuff with sphygmo + doppler
- Put on the BP cuff
- Gel on the patient's arm
- Turn on Doppler and find the brachial pulse (like any other pulse)
- Pump up the BP cuff to about 100mmHg and slowly decrease pressure
- First sound you hear = MAP
- Preferred MAP is 60-80 mmHg
- Heart Rate
- HR itself is NOT different
- Can tolerate slow VT 130-170 bpm (some patients may know they have it and others do not)= maybe awake and alert and talking to you
- Can tolerate Afib unless really fast but usually have palpitations
- Still treat medically stable arrhythmias causing symptoms
- May treat unstable arrhythmias like any other patient- cardioversion and/or defibrillation
- Respiratory Rate: No change
- Pulse Ox- dampened waveform but should be close to accurate if finger has good circulation
- When you listen to their chest- will hear a mechanical hum. This is normal.
- Mechanical hum may mask heart tones but in some patients may hear S1S2 (which means the native heart is ejecting).
- Can still see JVD, palpate edema
- Pulses by palpation are difficult (arms and feet)
- Abdomen- sterile dressing covering exit site of the VAD. Please do not take this down without talking with a VAD coordinator.
- Will see the device components
IV. Device Components
- Each device’s components are DIFFERENT.
- All have a pump (surgically implanted usually LV to aorta for LVAD)
- Computer- sends setting information to the pump which causes it to run
- Power- battery (run time is device dependent)
If you are interested in more information about your patient’s specific VAD, more information is available on uwhealth.org.
Ventricular Assist Device (VAD) Resources