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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

Pre-Hospital Care of the Mechanical Circulatory Support Device Patient

Dennis Rivard MA, CCP

Mid-Atlantic Region Pre-Hospital MCS Task Force

meeting of the minds
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
  • 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
basic tenets
Basic Tenets
  • Do not prescribe medicine
  • Not certifying or credentialing any clinicians
  • Compromise
  • Listen to the experts (EMS)
  • Collaborate whenever possible
  • MCS Coordinators
  • EMS providers (ground and flight)
  • ED medical team members
  • Heart Failure Cardiologist
  • Cardiac surgeons
field guides
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
color guides coding
Color Guides Coding
  • Dark Blue Heartware
  • Orange Heartmate II
  • Jarvik Lavender
  • VentrAssist Green
  • Thoratec PVAD Light Blue
  • Heartmate XVE Yellow
guide design
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
field guides1
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
guides 10 questions
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?
tags and labels
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
  • Side one
    • Patient’s identification
    • Implanting hospital
    • Emergency contact info
    • Color code tape
  • Side two
    • Type of pump
    • Color code tape
    • Written color code
additional uses
Additional Uses
  • Non-MCSD trained units
  • Emergency Departments
  • Patients
  • Rehabilitation centers
  • Out-Patient Dialysis Centers
launch of field guide program
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
mechanical circulatory support organization mcso
Mechanical Circulatory Support Organization (McSO)
  • National organization
  • Multi-disciplined
  • Grant funded
  • Linked to other related organizations
national training program
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
what does the future hold
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