LVADs anyone?

I've only just begun dialysis, but have quite a bit of experience with LVADS.

Lemme ask this, do you treat your patients' wounds or do wound dressing changes? No? Then why should you have to worry about a patient's VAD? They should know enough to carry spare batteries, plug into the wall when possible, and know what the alarms mean. If you get trouble, you call the transplant clinic - the patient certainly knows THAT number! :) Guess you could call 911, but what do they know about VADs?

FWIW , depending on which LVAD you're dealing with ... DO NOT do CPR!

As far as dealing with blood volume issues, you would probably use your more experienced RNs to run those patients. Probably someone with acute setting experience that have probably run those patients in the hospital many times. Depending on what controller the patient is on, you could watch the blood flows to make sure you don't dry them out too much. If you do, then give them a N/S bolus like you do everyone else.

It ain't rocket science ... well, okay, maybe it is. But you get used to it.

I know that most of our medical directors are used to having LVAD patients. I'll have to ask the folks in the clinic if they've ever had one there.

Don't worry, the alarms are quite loud. If the patient is stable enough to be on their own at home, then you really shouldn't have much to fret about. Those folks are out at the mall, working in the yard, although I don't think they drive. Syncardia used to have a photo on their web page of a guy with a total artificial heart, at home, cutting logs with a chain saw! I don't see it now though. I think the transplant clinic could give your unit an inservice on the devices and you'd be good to go. :) Usually, when they do dialysis in the ICU they watch BPs and VAD flows as indicators of volume status. If they start alarming, then you'd probably give volume while calling the on-call VAD engineer, or NP at the nearest transplant clinic. I imagine the local EMTs have had a heads up that there is a VAD patient in the area, I'm not sure. I know an EMT, I'll send him an email to see if he's ever gotten info on are VAD patients or what they do.

Okay, just received a reply from my EMT friend. He did not know what a VAD was, had to Google it, so by all means call 911 for the quick trip to the hospital, but don't expect them to know what to do. Talk to the transplant clinic for that. *wine