BASIC EMS LVAD Notes

Cardiac Review
●​ Circulation of blood in heart
○​ RATLAB
■​ Right Atrium (to right ventricle)
■​ Through Tricuspid valve
■​ Left Atrium (to left ventricle)
■​ Body (via aorta)
○​ Right atrium full of CO2 and deoxy blood
○​ Right ventricle begins to oxygenate blood and lose CO2
○​ Pulmonary artery brings deoxy blood to lungs
○​ Lungs oxygenate blood
○​ Pulmonary vein brings oxy blood towards heart
○​ Mitral valve is gate only for oxy blood to pass
○​ Left atrium brings back oxy blood into heart
○​ Left ventricle supplies oxy blood to rest of body

LVAD
●​ LVAD patients have weak left ventricle
●​ Symptoms
○​ Renal failure, poor perfusion, fluid buildup → heart failure, etc.
●​ LVAD pump from aorta via outflow graft
○​ The pump pressurizes blood → aorta → body
●​ Acceptable MAP for LVAD pt: 70-90
●​ Vitals
○​ Continuous flow
■​ No pulse, no problem
○​ Difficult to obtain BP
■​ Unreliable because continuous flow
○​ Pulse ox also unreliable due to no variability
○​ Instead, look at other examinations
■​ Check bgl, end tidal CO2, respirations
■​ Skin color, temp, mental status

Doppler
●​ Used to take BP on LVAD pt
●​ Apply conduction gel on elbow area
●​ Power on Doppler and put wand in the gel to find the “swish”
○​ Swish sound is pulse
●​ Place manual cuff above same elbow
●​ Use Doppler like stethoscope
○​ Loss of swish/pulse is systolic
○​ Return of swish/pulse is diastolic
●​ Can also use radial pulse