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Pre-Hospital Care of the Mechanical Circulatory Support Device Patient

Pre-Hospital Care of the Mechanical Circulatory Support Device Patient. Dennis Rivard MA, CCP Mid-Atlantic Region Pre-Hospital MCS Task Force. Sept 11, 2001 . An MCS Coordinator, a Flight Nurse, and a Patient. Meeting of the Minds.

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Pre-Hospital Care of the Mechanical Circulatory Support Device Patient

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  1. Pre-Hospital Care of the Mechanical Circulatory Support Device Patient Dennis Rivard MA, CCP Mid-Atlantic Region Pre-Hospital MCS Task Force

  2. Sept 11, 2001

  3. An MCS Coordinator, a Flight Nurse, and a Patient

  4. Meeting of the Minds • Advances in medical technology is exceeding the community’s ability to safely manage patients with this technology • Decision to set up meeting to work more closely • Meetings would be multi-disciplined • Goal to create a method of identifying and provide basic management information • Bring MCSD centers together to work smarter

  5. MARPH • Covers Virginia, DC, and Maryland • Meet monthly • Core hospitals • Virginia Commonwealth University Hospital • INOVA Fairfax Hospital • Washington Hospital Center • Johns Hopkins Hospital • University of Maryland Medical Center

  6. Basic Tenets • Do not prescribe medicine • Not certifying or credentialing any clinicians • Compromise • Listen to the experts (EMS) • Collaborate whenever possible

  7. The Motley Crew

  8. Participants • MCS Coordinators • EMS providers (ground and flight) • ED medical team members • Heart Failure Cardiologist • Cardiac surgeons

  9. Field Guides • Designed to provide consistent and reliable information to first responders • Pump systems assigned a color • Colors are present on guide, labels, and luggage tags • Electronic PDF files • Updated annually

  10. Color Guides Coding • Dark Blue Heartware • Orange Heartmate II • Jarvik Lavender • VentrAssist Green • Thoratec PVAD Light Blue • Heartmate XVE Yellow

  11. Guide Design • Separate cards for each device • Allows for multiple uses • Can be separated and used separately • Color coding encircles each card • Color is printed along the edge • Allows to be photocopied • Eliminated confusion for color-blind first responders

  12. Field Guides • Each a little different in design • 10 questions • FAQ section • Emergency step by step troubleshooting section with pictures • Changing batteries • Changing controllers • Alarms • Two sided laminated and bound

  13. Heartware and Heartmate XVE

  14. VentrAssist and Heartmate II

  15. Thoratec PVAD and Jarvik 2000

  16. Guides 10 Questions 1. Can I do external CPR? • If not, is there a hand pump to use? • If device slows down (or goes into a low flow state), what alarms will go off? • How can I speed up the rate of the device? • Do I need to give heparin if the pump slows down? • Can the patient be defibrillated? • If OK to defib, is there anything that must be disconnected prior to defibrillating? • Does the patient have a pulse with this device? • What are acceptable vital sign parameters? • Can this patient be externally paced?

  17. Tags and Labels • Label controllers and tag bags • Follows same color coding system • Information on tag is for specific implant center contact information • Tags state: • Name of hospital • MCS Team contact information • Color code of device • Type of device

  18. Tags • Side one • Patient’s identification • Implanting hospital • Emergency contact info • Color code tape • Side two • Type of pump • Color code tape • Written color code

  19. Additional Uses • Non-MCSD trained units • Emergency Departments • Patients • Rehabilitation centers • Out-Patient Dialysis Centers

  20. Launch of Field Guide Program • Multi-state EMS training opportunity • Target audience was EMS educators and team leaders • 6 stations (one for each pump presented) • Patients with specific pumps at each station • MCS Coordinator at each station • Hands on exposure • Used field guides as outline for presentation

  21. Mechanical Circulatory Support Organization (McSO) • National organization • Multi-disciplined • Grant funded • Linked to other related organizations

  22. National Training Program • If we don’t do it, someone will • Expected surge in MCSD patients once DT is an FDA approved therapy • Opportunity to provide consistent messages • Safe for our patient to travel throughout the US • First national launch in San Jose this October • Air Paramedic and Nurses National Meeting • Offering pre-conference courses

  23. What Does the Future Hold??? • Need central resource center • Development of national information bank • One stop shopping • One phone number when placing a MCS patient in their residence • Coordinator hot line directory

  24. Questions

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