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Published byRylie Thatcher Modified over 10 years ago
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Community Preparation for Caring for Mechanical Circulatory Device Patients University of Wisconsin Hospital And Clinics Ventricular Assist Device Program
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Mechanical Circulatory Support Device Overview MCDSs are devices to support the failing heart (one side or both) Most MCDS patients are anticoagulated with Coumadin and Aspirin All MCDSs have: – Pump (implanted inside the patients chest) – Computer to control the settings/ display VAD performance readings – Power source: batteries or console connected to AC power
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Components VAD readings Care Overview Emergency Care
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Thoratec TLC-II Can be used for RV, LV or both Can be implanted or paracorporeal Pulsatile VAD (can hear it running) Sterile dressing over cannula exit sites Each VAD has 2 mechanical valves
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Thoratec TLC-II VAD Components Inflow cannula Outflow cannula
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Thoratec TLC-II Control Panel
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Thoratec TLC-II Care Overview Can palpate a pulse Need to assess if pump if running: listen for mechanical valve clicking and the noise of console working (BOTH NEED TO BE HEARD) Blood pressure: – Keep SBP< 140 – Non-invasive blood pressure cuffs will work
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Thoratec TLC-II Care Overview (contd) EKG conduction is not affected and arrhythmias maybe tolerated including VT/ VF – Most of these patients have an ICD/ pacer. Some patients ICDs are off to avoid inappropriate shocks. – Most VAD patients tolerate the arrhythmias and may have little symptoms for period of time. Assess for patients tolerance of situation (if able). Ask for symptoms: lightheadedness, shortness of breath, palpitations, bloating, pain (anywhere), fever, chills, diaphoresis
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Emergency Care- Thoratec VAD stopped (listen for valve clicking and console running). If stopped significant risk for clot inside MCDS and thromboembolize. NO CHEST COMPRESSIONS Defibrillation- STANDARD METHOD Heparin bolus if VAD stopped (contact attending cardiac surgeon) Hand pumps can be used in case of console failure. RVAD needs to be pumped < then LVAD.
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