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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


Sept 11 2001
Sept 11, 2001 Device Patient


An mcs coordinator a flight nurse and a patient
An MCS Coordinator, a Flight Nurse, Device Patientand a Patient


Meeting of the minds
Meeting of the Minds Device Patient

  • 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 Device Patient

  • 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 Device Patient

  • 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 Device Patient


Participants
Participants Device Patient

  • MCS Coordinators

  • EMS providers (ground and flight)

  • ED medical team members

  • Heart Failure Cardiologist

  • Cardiac surgeons


Field guides
Field Guides Device Patient

  • 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 Device Patient

  • Dark Blue Heartware

  • Orange Heartmate II

  • Jarvik Lavender

  • VentrAssist Green

  • Thoratec PVAD Light Blue

  • Heartmate XVE Yellow


Guide design
Guide Design Device Patient

  • 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 Device Patient

  • 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 Device Patient

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 Device Patient

  • 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 Device Patient

  • 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 Device Patient

  • Non-MCSD trained units

  • Emergency Departments

  • Patients

  • Rehabilitation centers

  • Out-Patient Dialysis Centers


Launch of field guide program
Launch of Field Guide Program Device Patient

  • 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 ( Device PatientMcSO)

  • National organization

  • Multi-disciplined

  • Grant funded

  • Linked to other related organizations


National training program
National Training Program Device Patient

  • 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??? Device Patient

  • 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 Device Patient