Like
@VFlutter said you really need to contact whichever local programs are placing LVADs.
Different surgeons have huge differences in which LVADs they like to place. We see a lot more membrane pumps like the Berlin heart in pediatrics, and these still produce a pulse (although it is extremely rare to see pediatric LVADs, RVAD, or BiVADs outside of the hospital).
There is also a very limited amount we can do to correct problems with LVADs in the field, so short of an easy problem like replacing battery packs if they are having a real cardiac issue transport is essentially mandatory.
It is also imperative that these patients be taken to a hospital that at a minimum has a cardiothoracic surgery program, should be a facility that can place VADs, and ideally the hospital that placed the VAD in the first place.
Also keep in mind that VADs are temporizing measures for the sickest of heart failure patients. While there are many patients who successfully bridge to transplant there are many who do not. When these patients further deteriorate there is often a very poor prognosis. They also increase the risk for carditis, stroke, and a myriad of other complications. Compressions are generally considered contraindicated as they can dislodge the device, but this certainly is approached on a case to case basis.
For centrifugal pumps you should hear a hum on ascultatuon that suggests if the pump is functioning internally, this is certainly not exclusionary for pump failure or other complication but is about the most your going to get in the field. These patients are at high risk for VF/VT, so an EKG and consideration of electricity or drugs should be made.
