LVAD AWARENESS for Paramedics/EMT/EMS Ambulance Companies. 911 PROTOCOL?

[LVADone]

A 911 call is made. A male patient collapses and seems too sluggish to move. An Ambulance is immediately dispatched to the location. The paramedics arrive and finds the patient sitting on the floor with his wife by his side. The male is conscious and answers the questions the paramedics ask.

He states he became dizzy and passed out. The patient continues to say that he has a Left Ventricular Assist Device (LVAD) implanted and grafted to his heart. The LVAD helps pump oxygen-enriched blood that his damaged heart can not do. The male patient also claims that due to the design of the LVAD, basic equipment WILL NOT detect his Blood Pressure nor Pulse. Special Dopler equipment will detect his vitals.

http://api.ning.com/files/UlNjvG5vp...BxvKB5U9vYh01jHjmXa1k4/HeartMate2THORATEC.jpg

It appears that the patient has lost color and is sweating. What next? There is a titanium heart/blood pump implanted to his heart. If needed, are chest compressions dangerous for this patient? The answer is YES! It can cause the LVAD to dislodge from the heart and the the patient can internally bleed.

I am a 47 yo male with an LVAD implant. I DONT HAVE the conventionally found Blood Pressure and i do not have a Pulse, However i am alive and well
I am trying to raise awareness of LVAD 911 PROTOCOL and to obtain more info from you the experts on how to spread this crucial topic. It is predicted that the LVAD will be as common as dialysis.

WHAT are your questions and or experiences?

I started a blog:

http://www.FromTheBottomOfMyLVAD.blogspot.com

showing the "Day In The Life Of AN LVAD RECIPIENT"

Thanks for your Help and interest.
Josh Morris

PS my son is EMT in NYC

 

[reaper]

I applaud you for taking the time to do this. It may enlighten a lot of people in EMS that have no knowledge of LVAD use. I have treated many LVAD Pt's. The first one did have me spinning, not knowing what to do. Research is a great thing. They are becoming more popular and EMS needs to know how to deal with them.

Thanks again for taking the time to contribute.

 

[LVADone]

I applaud you for taking the time to do this. It may enlighten a lot of people in EMS that have no knowledge of LVAD use. I have treated many LVAD Pt's. The first one did have me spinning, not knowing what to do. Research is a great thing. They are becoming more popular and EMS needs to know how to deal with them.

Thanks again for taking the time to contribute.

Thanks for that BUT the applauds go to you and this EMT community/ 1st responders that save lives... day in and day out!!!

THANK YOU

 

[trevor1189]

Very interesting post, I'm sure 90% of the EMS community would be flustered on a patient like this. Interesting post.

 

[EMSLaw]

Very interesting post, I'm sure 90% of the EMS community would be flustered on a patient like this. Interesting post.

Yes, I'm quite sure many of us would be, and I will include myself in that.

I read the blog, and it's very interesting. I'm glad this is something that I now know about.

My question is - what is the treatment protocol here? If someone with one of these was found unconscious, they would be pulseless by definition, leading to potentially fatal CPR. At least now, I know what an LVAD looks like, so I'd know to be concerned, but how could we tell if the patient was unconscious because he fell and hit his head, as opposed to being in cardiac arrest?

 

[LVADone]

Yes, I'm quite sure many of us would be, and I will include myself in that.

I read the blog, and it's very interesting. I'm glad this is something that I now know about.

My question is - what is the treatment protocol here? If someone with one of these was found unconscious, they would be pulseless by definition, leading to potentially fatal CPR. At least now, I know what an LVAD looks like, so I'd know to be concerned, but how could we tell if the patient was unconscious because he fell and hit his head, as opposed to being in cardiac arrest?

One of my "discharge agreements" from the hospital was that my Hospital MUST speak with my local:

Fire Dept

Ambulance Corp (covering 911 calls in my nieghborhood)

Police Dept

This way when my address pops up, they already know of my implant and already know what to do as the hospital sent them information.

My concern is if an LVAD patient is enjoying his day in another community and collapses... what can/will the paramedics do there. Its probaby a safe bet for LVAD recipients to carry a "User Manual" with them until this LVAD is a common household word like Dialysis...;-)

thanks

 

[LVADone]

Very interesting post, I'm sure 90% of the EMS community would be flustered on a patient like this. Interesting post.

So true 90% would be uninformed but its not their fault. Local hospitals that have the LVAD program should disseminate info to all 1st responder agencies in their nieghborhoods as well as the corporations that manufacture the LVAD (there are a few) should release info on their websiites for you folks.

I am in the process of receiving How to revive and secure a LVAD recipient. Once i do, i will it post here.

The FDA approved this LVAD on 2 classes:

Bridge To Transplant

Destination Therapy

Therefore The LVAD will be a common thing in our everyday world very soon; saving the lives of 10s of thousands of people. It will be as common as Dialysis

thanks...

PS... i guess its not a good idea to drive the ambulance like you stole it when there is a Patient in the back ...huh?

 

[Seaglass]

I know very little about them. Look forward to learning more. In the meantime, I have a few quick questions:

How long is the battery life away from the base unit?

If your home experiences power failure, will the disconnection alarm still work to alert you?

Can the system you wear tolerate severe heat/cold, getting wet, etc.?

 

[firetender]

Edgar Allan Poe would understand!

You brought up a great topic that makes me wonder:

Edgar Allan Poe, one of our finest American writers, had epilepsy. It drove so much of his writing, and a consistent fear for him was that he would be in a neighboring town where no one knew him, suffer a seizure, be taken for dead and buried. (He actually had a system installed in his coffin so he could let the medics know they goofed!)

It's be great if more people like yourself would post here, letting us know of those anomalies of treatment or disease medics might encounter and where. Maybe there should be a thread specifically dedicated to this so everyone on this site could have easy access.

More than anything, Thank You for your appreciation, and blessings to you and yours.

 

[amberdt03]

We have a patient with an LVAD in my fire district. A nurse from Baylor is going to come and do a class for us. I won't be able to attend unfortunately do to me having school that day. But I do plan on going to the house and when the family is able to, teach me about it.

 

[LVADone]

I know very little about them. Look forward to learning more. In the meantime, I have a few quick questions:

How long is the battery life away from the base unit?

If your home experiences power failure, will the disconnection alarm still work to alert you?

Can the system you wear tolerate severe heat/cold, getting wet, etc.?

How long is the battery life away from the base unit?

I am lucky as i have the "new" lithium batteries that lasts 12-14 hours... however my batteries have lasted 18+ hours. When i leave the house i must bring 2 spare batteries.

The older Acid/lead batteries last approx 4 hours. When recipients with this style batteries leave the house, they must bring 4-6 spare batteries.

If your home experiences power failure, will the disconnection alarm still work to alert you?

In the event of a power outage, the Power Base Unit (PBU) has a back up battery inside and provides power. The alarms still work and and loud enough to wake up the dead

Can the system you wear tolerate severe heat/cold getting wet etc?

The system Controller worn around the waist CANNOT withstand the elements as it is a computer that actually monitors and regulates the LVAD... this LVAD spins its pump (for me) 8,600 rpms... other recipients have a higher rpm. So rain, coldness and heat at long lengths of time... especially by the oven in the kitchen should be avoided.

AS FAR AS the entry point, where the driveline enters my lower adomen, this is dressed with guaze and film/tape to keep it clean. a binder is worn around the lower body to cover the dressing and to prevent the driveline from pulling on the entry point. ALSO this area must be kept dry at all times so that the chance of infections are kept low.

thanks

 

[8jimi8]

Does this mean that you are on a transplant list?

What was your ejection fraction before the treatment?

Hope you don't mind the personal questions.

Thank you for your efforts at spreading awareness

 

[LVADone]

You brought up a great topic that makes me wonder:

Edgar Allan Poe, one of our finest American writers, had epilepsy. It drove so much of his writing, and a consistent fear for him was that he would be in a neighboring town where no one knew him, suffer a seizure, be taken for dead and buried. (He actually had a system installed in his coffin so he could let the medics know they goofed!)

It's be great if more people like yourself would post here, letting us know of those anomalies of treatment or disease medics might encounter and where. Maybe there should be a thread specifically dedicated to this so everyone on this site could have easy access.

More than anything, Thank You for your appreciation, and blessings to you and yours.

Thanks... Good Ol Edgar Allan Poe's house is just 3 miles from mine, in the Bronx (NY)... off the Grand Concourse and open to the public...yeah he had it rough and on top of it all his wife suffered from depression and was suicidal.

Opening up a THREAD is new to me... but if ADMIN wants, i dont mind

Thanks again and YES blessings to you and yours as well!

 

[LVADone]

We have a patient with an LVAD in my fire district. A nurse from Baylor is going to come and do a class for us. I won't be able to attend unfortunately do to me having school that day. But I do plan on going to the house and when the family is able to, teach me about it.

Its nice that Baylor has an outreach program like this. Is it given in general or just because of the Patient living in your jurisdiction?

thanks

 

[LucidResq]

I wish all my patients took this much initiative to be informed and proactive about their conditions and interventions.

 

[LVADone]

Does this mean that you are on a transplant list?

What was your ejection fraction before the treatment?

Hope you don't mind the personal questions.

Thank you for your efforts at spreading awareness

Nice question! my EF was around 0.10... i think... i have a doctors appt on monday and will find out exactly. i do remember that my heart was only functioning at 13% capacity.

Yes i am on the transplant list... i am O neg so they think here in NYC, i will have a 3 year wait... SOMETIMES THE LVAD GIVES THE HEART TIME TO rest and can repair itself... kinda like hibernation... we'll see

Thanks

 

[LVADone]

I wish all my patients took this much initiative to be informed and proactive about their conditions and interventions.

LOL thank you, i feel blessed enough to be living, so this is my way of thanking the "LVAD"... If my heart attack occured 5 or 3 years ago I wouldnt be around.

Most times i feel so normal that i have the LVAD implant... until one of my wires gets caught up on a door knob!

This is my 1st EMT forum to discuss, i will join others...

thanks

 

[8jimi8]

Nice question! my EF was around 0.10... i think... i have a doctors appt on monday and will find out exactly. i do remember that my heart was only functioning at 13% capacity.

Yes i am on the transplant list... i am O neg so they think here in NYC, i will have a 3 year wait... SOMETIMES THE LVAD GIVES THE HEART TIME TO rest and can repair itself... kinda like hibernation... we'll see

Thanks

Do you remember all of the factors that lead your doctor to consider the use of the LVAD. From what I read you said that your EF was 10% and that your total heart function was 13%? I am glad that this intervention has somewhat given you a normal life again!

 

[LVADone]

Do you remember all of the factors that lead your doctor to consider the use of the LVAD. From what I read you said that your EF was 10% and that your total heart function was 13%? I am glad that this intervention has somewhat given you a normal life again!

www.FromTheBottomOfMyLVAD.blogspot.com i discuss it in length, the factors and indicators of my heart attack... Originally I thought i had Food poisoning! I HAD NO chest pains nor left arm pain or numbness. I stayed home for a week and noticed i couldnt walk more than 10 feet before falling out of breath. I couldnt even hold my 6 month old grandson!!! so we called a close friend of mine who is a physician. he layed me on the floor and examined me... he found that my heart rate was 140! he then sent me to emergency.

At emergency, they hooked me up to an EKG and thought i was having a heart attack then! i wasnt, i had it already... a week prior.

This hospital then sent me to Columbia Presbyterian Hospital in NYC because it was technologically advanced (its where president Clinton has his heart taken care of).

So after having a stent placed and being in the hospital for a week, i was discharged. But then was re-admitted 3 days later as i still couldnt walk more than 10 feet and developed a bad "Cardiac Cough".

It was then, i took on a new Doctor, and she told me i can be re-admitted again and again as my heart wasnt getting any better and my other organs could fail, she said my only prayer was a transplant... but 1st the LVAD!

And yes, i do have a pretty normal life... considering what is makin me tick

thanks

 

[amberdt03]

Its nice that Baylor has an outreach program like this. Is it given in general or just because of the Patient living in your jurisdiction?

thanks

Its just because he lives in our district. I definitely look forward to learning about it. We have already had it set up in dispatch so that when his address is typed in, they can alert us that its him. The paperwork that was sent to our fire station says he must be transported to Baylor Dallas, which would be an hour drive via ambulance. And I already know what's going to happen. We will get called out to him when its crappy weather and we can't get a helicopter. I have asked one of the medics that works the ambulance to ask the nurse in the case of bad weather, if we can transport him to the closest Baylor, or does he need to go all the way to Dallas.