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Ventricular Assist Devices Zoll LifeVest External Defibrillator

Ventricular Assist Devices Zoll LifeVest External Defibrillator. Edward Hospital EMSS. Topics . Zoll LifeVest What it is Who it treats How does EMS handle these patients?. Topics . Ventricular Assist Devices What they are What they do How to treat these patients. Video.

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Ventricular Assist Devices Zoll LifeVest External Defibrillator

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  1. Ventricular Assist Devices Zoll LifeVest External Defibrillator Edward Hospital EMSS

  2. Topics • Zoll LifeVest • What it is • Who it treats • How does EMS handle these patients?

  3. Topics • Ventricular Assist Devices • What they are • What they do • How to treat these patients

  4. Video

  5. Zoll LifeVest • Wearable AED • Harness • Control Module • Battery • Three Pads • Electrodes

  6. Who Uses Them? • ICD Removal • Potential for SCA • Current or old MI • Cardiomyopathy Patients

  7. Statistics • Over 25,000 Patients • 358 Saves • Dupage County • 1 Save • 200+% increase

  8. How Do We Treat These Patients? • Normal AED Patient • Alarm will sound • 45 seconds • Disable Vest

  9. How Do We Treat These Patients? • Remove Battery

  10. How Do We Treat These Patients? • Remove the vest Itself

  11. Ventricular Assist Devices

  12. Video

  13. Pulsatile Vs. Non-Pulsatile • Pulsatile • Older first generation models • Non-Pulsatile • Second / Third Generation Models

  14. VAD’s • Ventricular Assist Devices • LVAD • RVAD • Bi-Vad

  15. VAD

  16. Who uses VAD’s? • 7318 people were waiting for a heart • 2210 received one • 623 died waiting • ~1200-1500 VAD implanted in 2008

  17. Who uses VAD’s? • Bridge to Transplant • Bridge to Recovery • Destination Therapy

  18. Field Considerations • Treat patient as an adult with special health care needs. • Find family member or aide who is familiar with equipment • Always treat the patient!

  19. Field Considerations • If patient has an LVAD and it is working properly, it is providing patient's cardiac output and is not in time with patient's real heart. • Patient’s EKG rate will not equal pulse rate. Instead pulse should be at rate of the LVAD pump

  20. Field Considerations • All VADs are dependant on adequate preload in order to maintain proper functioning • Pump can “cavitate” if there is a decreased preload • Volume resuscitation in an unstable VAD patient is the first line of therapy before vasopressors but be cautious with fluid as to not over load the right ventricle in LVADs only

  21. Field Considerations • Nitrates can be detrimental to a VAD patient because of the reduction in preload • Results in decreased pump efficiency • Consult with medical control before administering nitrates per protocol • Initiate IV therapy with all VAD patients if possible

  22. Field Considerations • A patient can be in a lethal arrhythmia and be asymptomatic. Treat the patient not the monitor. • Do not cardiovert/defib unless the patient is unstable with the arrhythmia. • Electrical shock from cardiovert/defib will not damage any of the VAD equipment

  23. Field Considerations • Chest Compressions are NOT recommended. Chest compressions can disrupt the implanted equipment causing massive hemorrhaging.

  24. Transport Consideration • If able, transport the patient with any other pertinent equipment needed for the VAD pump. • Batteries • Charging unit • Hand pump (if available)

  25. Questions???

  26. Sources • http://www.mayoclinic.org/heart-transplant/vad.html • http://www.medicinenet.com/left_ventricular_assist_device_lvad/page2.htm • www.mfri.org/dom/Drill_pdf/DM_0911.ppt • http://www.uchospitals.edu/specialties/heart/services/heart-failure/assist-devices.html

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