March 8, 2011 by dailybolusoflr
Patients on Left Ventricular Assist Devices.
The LVAD is a device which attaches to the left ventricle and pumps blood from there to the aorta. The LVAD has typically been used a “bridge” device for patients who are awaiting transplant. However many patients are not being treated with LVADs (who are non-transplant patients with end stage heart failure) and are seeking improved quality of life.
We will, without a doubt, be seeing more of these patients in the ED.
Most of these devices are continuous flow LVADS. What this means for you?
· Have no palpable pulses as the continuous flow is NOT pulsatile flow
· Will not have an obtainable BP via normal measurement. If you attempt to do an automatic BP, you may receive no measurement or simply a MAP.
· To obtain a “BP” on these patients, you should use a Doppler and a BP cuff to measure what would be considered the “systolic” number.
Linda Regan, MD FACEP
Program Director, Emergency Medicine Residency
Johns Hopkins Medical Institutions