Pre hospital care of the mechanical circulatory support device patient
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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

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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

Sept 11, 2001


An mcs coordinator a flight nurse and a patient

An MCS Coordinator, a Flight Nurse, and a Patient


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


Marph

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


Basic tenets

Basic Tenets

  • Do not prescribe medicine

  • Not certifying or credentialing any clinicians

  • Compromise

  • Listen to the experts (EMS)

  • Collaborate whenever possible


The motley crew

The Motley Crew


Participants

Participants

  • 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 BlueHeartware

  • OrangeHeartmate II

  • JarvikLavender

  • VentrAssistGreen

  • Thoratec PVADLight Blue

  • Heartmate XVEYellow


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


Heartware and heartmate xve

Heartware and Heartmate XVE


Ventrassist and heartmate ii

VentrAssist and Heartmate II


Thoratec pvad and jarvik 2000

Thoratec PVAD and Jarvik 2000


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


Pre hospital care of the mechanical circulatory support device patient

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


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


Questions

Questions


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