1 / 12

Clinical Assessment of Pulsatile and Non-Pulsaltile VADs

Clinical Assessment of Pulsatile and Non-Pulsaltile VADs. Diana Joseph RN, BSN, CCTC VAD/Heart Transplant Coordinator OSF St. Francis Medical Center Peoria, IL. Pulsatile Flow. Contraction or beating of the heart as felt through the walls of the arteries Normal patients: Pulse is accurate

Download Presentation

Clinical Assessment of Pulsatile and Non-Pulsaltile VADs

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Clinical Assessment of Pulsatile and Non-Pulsaltile VADs Diana Joseph RN, BSN, CCTC VAD/Heart Transplant Coordinator OSF St. Francis Medical Center Peoria, IL

  2. Pulsatile Flow Contraction or beating of the heart as felt through the walls of the arteries • Normal patients: Pulse is accurate • VAD patients: Not truly feeling pts heartbeat. Asynchronous to electrical rhythm

  3. Pulsatile VADs Thoratec PVAD Thoratec IVAD HeartMate XVE Non-Pulsatile VADs HeatMate II HeartWare HVAD Types of VADs

  4. Pulsatile VADs • Fixed or Auto mode • Preload sensitive/Volume dependent • Radial pulse felt is the actual VAD pumping rate • VAD rate/flows increase with activity, volume, sepsis • VAD rate/flows decrease with rest, hypovolemia, arrhythmias, RHF

  5. Blood Pressure • Ideal BP <120/ • If pt is hypotensive then • ? Volume depleted • Bleeding • Arrhythmias • ? RHF if LVAD

  6. Arrhythmias • EKG-The only true way to identify pt’s true electrical rhythm • VAD rate/pulse is asynchronous to pt’s electrical activity • Atrial Fibrillation • Ventricular Tachycardia • Ventricular Fibrillation • Majority of pts will have AICD/Defibrillators

  7. Cardioversion/Defibrillation • Most VAD pts will tolerate arrhythmias • Assess pt if hemodynamically stable • Okay to cardiovert/defibrillate • No CPR: Could possibly damage or dislodge cannulas/tubings resulting in fatal internal bleeding • Hand Pump

  8. Non-Pulsatile VADs • Axial/Continuous Flow • RPMs • Difficult to obtain a pulse or BP • Use a doppler for BP (narrow pulse pressure) • Ideal MAP >70 • Most pts will have some residual rhythmic contraction thus create a pulse

  9. Arrhythmias • EKG – Identify electrical rhythm • Okay to cardiovert/defibrillate • If RPMs too high could have “suction events” • No Hand Pump • Caution with CPR

  10. Basic Clinical Assessment • Neuro-Mental Status • Peripheral Circulation-warmth • Skin color • Respiratory status • Labs if available • ? VAD alarms

  11. Assess VAD Function • VAD alarms • VAD readings/parameters

  12. QUESTIONS ???

More Related