The “heart pump” population grows every year. And usually, it’s the left ventricular that requires assistance from the pump, so we see more patients with an LVAD (left ventricular assist device) every year. Taking care of patients with any ventricular assist device (VAD) is such a big concern that even the NREMT now requires at least half an hour of education specifically towards this life-saving technology. What we do in the prehospital setting can help or harm these patients.
However, LVADs are nothing to fear *if* you know how to assess these patients, use appropriate treatments, and avoid ones that could cause harm. Why not just defer these decisions to the “doc” instead? Truth is, not many physicians are familiar with VADs either! You have a golden opportunity to become the patient’s true advocate through this video case review education.
This CE includes one of UMC EMS’ case reviews from 2016. University Medical Center of Lubbock is now a heart center for the HeartMate II LVAD devices, surgically implanting and managing the care of their patients whose lives have improved significantly with this device. Although this education focuses on the HeartMate devices, the general concepts apply to any LVAD device in the United States.
As with any of our case reviews, we start off heavy on the education and then cover a couple of patient care reports. Your own treatment protocols will probably be different. But, rather than focus on the algorithm itself, consider why certain treatments were used and others avoided during patient care. The quiz avoids protocol-specific questions, and is tailored for all certification levels.
Please remember to always follow your own service’s treatment protocol.
Step 1: Media: This education is a case review housed on our Lubbock Prehospital/UMC EMS YouTube channel. View it at https://youtu.be/FMZRpXAKss4
We also offer some helpful supplemental material for you or your EMS service that isn’t part of the CE, but can help with your VAD patient care down the road:
Supplementary UMC EMS Protocol Appendix. This 2.1 MB PDF file was created specifically for the prehospital care of patients with an LVAD. It covers some of the basic treatment needs (such as avoiding medications that decrease preload), the external components, and basic alarms.
Controller Alarms Simulator. If you want to see and hear the alarms from a pocket controller virtually before you encounter them in person, you can download our PowerPoint presentation (27.1 MB ZIP file) that includes a short simulator video for the more common alarms.
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Step 2: Take the Quiz at QuestBase. Log into your QuestBase account at www.questbase.com/a/umcems. If you don’t have a free account yet, please visit our Contact Us page for information on how to obtain one. Once you’ve logged in, look for the CE entitled:”Case Review: Prehospital Care of Patients with an LVAD“.
Step 3: Education you’ll earn upon successful completion:
- Texas state:
- 1 hour for the Medical component
- NREMT for NCCP requirements: 1 hour towards:
- Paramedic: Cardiovascular: Ventricular Assist Devices
- Advanced EMT: Cardiovascular: Cardiac Arrest & Ventricular Assist Devices
- EMT: Cardiovascular: Cardiac Arrest & Ventricular Assist Devices
The NCCP National component only requires 0.5 hour of VAD education, yet the case review is an hour. You can allocate the remaining half hour towards your Individual or Local (Local if your EMS service dictates) continuing education component for the NCCP.