LVADS in the community - page 3
by traumaRUs 6,623 Views | 26 Comments Admin
I'm an outpt APN who works in mulitple dialysis units. We have been asked recently to accept LVAD pts who would live at home and dialyze at the outpt unit while awaiting a heart tx. Has anyone heard of this? Just curious what... Read More
- 0May 6, '11 by highlandlass1592Quote from GreyGullOur VAD center offers training to first responders in the area where a VAD patient lives. They go and teach classes discussing VAD's, how to troubleshoot problems, quite a bit of information. I know this first hand as a friend of mine who is a VAD coordinator actually went to inservice the EMT's of a small town where one of our patients lived. The town was 5 hours away. She coordinated the class, drove up, spent 2 days inservicing everyone then drove home the following day.In fairness to the EMT, LVADs are not covered nor is there enough Anatomy or Physiology taught in the EMT class to barely cover what an MI is. Even Paramedics usually do not get LVADs mentioned in their class. Hopefully once they hear the term they will seek out more education about them. Usually the patient or caregiver will provide whatever information is needed for transport. In my area if it is an interfacility transport, RNs work on the CCT with the EMTs to do the driving and help move the patient. At least the EMTs working these trucks should have some info about them depending on how involved they want to be with the patient.
I do agree that LVAD's aren't taught to EMT's as a part of regular coursework. But to say ALL EMT's aren't taught LVAD's, just isn't true. I am not sure if ALL LVAD centers do this but I know mine does. And, just as an aside, they teaching first responders get about VAD's is way better than I got when I first started dealing with them. The VAD coordinators where I work have put together a great education package.
- 0May 6, '11 by BiffbradfordQuote from highlandlass1592careful. it was inferred earlier that all emts are trained on vads. i mentioned one, a friend of mine that was not. clearly some emts are, some aren't, just like rns or mds for that matter.[color=silver]our vad center offers training to first responders in the area where a vad patient lives. they go and teach classes discussing vad's, how to troubleshoot problems, quite a bit of information. i know this first hand as a friend of mine who is a vad coordinator actually went to inservice the emt's of a small town where one of our patients lived. the town was 5 hours away. she coordinated the class, drove up, spent 2 days inservicing everyone then drove home the following day.
i do agree that lvad's aren't taught to emt's as a part of regular coursework. but to say all emt's aren't taught lvad's, just isn't true. [color=silver]i am not sure if all lvad centers do this but i know mine does. and, just as an aside, they teaching first responders get about vad's is way better than i got when i first started dealing with them. the vad coordinators where i work have put together a great education package.
- 0May 6, '11 by GreyGullQuote from highlandlass1592I don't think any one stated "ALL". But it is unfair to expect an EMT especially at the Basic or Intermediate level to have knowledge of these devices or even the pathology behind the disease process. The 110 - 120 hour EMT course is barely enough time for them to master CPR, first aid and emergency driving. They need to get the basics down and hopefully will have an employer who will see they get more training as it becomes available or necessary. Right now in one county we have over 2000 firefighters who are Paramedics. It is very difficult to get everyone the necessary training for everything. They just started doing 12 - lead ECGs a couple of years ago and it has been a slow process even with machine interpretation and transmitting to the hospital. There are still many counties which do not do 12 - leads. So, it is unfair to assume everyone in EMS is as advanced as your area also. I think just like any other health care professional, there is just not enough time in the day to learn all about everything new even though we'd like to nor can we expect someone to be procificient in every detail if it is something they don't see daily.I do agree that LVAD's aren't taught to EMT's as a part of regular coursework. But to say ALL EMT's aren't taught LVAD's, just isn't true.Last edit by GreyGull on May 6, '11
- 0May 7, '11 by CardioTransI was the one who mentioned EMS being trained for the VAD patients.... but what I said was the EMS that would respond to the pt with a VAD would be trained. As Highlandlass stated, our VAD coordinators do go into the community where the pts live and teach the EMS how to take care of the VAD.... I agree that not all EMTs are taught how to take care of them.
- 0May 7, '11 by highlandlass1592Quote from BiffbradfordActually, I didn't see that there was an inference that all EMT's are trained on VAD's. My point, as you cared to highlight it is that there are inroads being made into training more and more first responders about VAD's. As more patients are implanted this type of training will become more and more necessary.Careful. It was inferred earlier that all EMTs are trained on VADs. I mentioned one, a friend of mine that was not. Clearly some EMTs are, some aren't, just like RNs or MDs for that matter.
I have many friends who are EMT's and Paramedics. I find it disheartening that their training doesn't adequately prepare them to care for many patients...their learning takes place on the job, similar to nursing. But I also have to admit until we had an influx of VAD coordinators who actually cared about teaching, I became a self-directed learner about VAD's and now find them to be my favorite patient population. There is so much misconception out there about VAD patients which, in getting back to the origin of this thread-is clearly demonstrated. By thinking that VAD patients are too high risk to be handled at an outpatient dialysis clinic shows a lack of education regarding VAD's and their uses. It was that ultimate point I was trying to address.
As a side note, at no time in my post did I make a unilateral statement-which is what you seem to be implying. I wanted to share the experiences of our VAD center and maybe spur discussion amongst others.
- 0May 8, '11 by ghillbert GuideQuote from traumaRUsI don't really understand the question - what do you mean, where are these caregivers? The caregiver is with the patient if they require one. People that are independent with their care may not have caregiver but most do as they are often elderly.Ghilbert. Where are these caregivers? Dialysis units are not a place where we have room for extra people.
Re EMS: there's not much point training EMS overall on something that is high tech and low incidence. Most RNs and many physicians haven't heard of LVADs either; transplant and VAD is highly specialized. We definitely go out and train the first due EMS in a patient's area prior to/at hospital discharge. If possible we get the patient to go visit the station when they get back to their community. We also do re-education whenever requested or when they have regional competency days for ACLS etc.
There is a group working on EMS field guides (well they are already available in some areas) which permits easy recognition of different VADs for first responders as well as troubleshooting chart.