Daily Bolus of LR: LVAD

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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?

 

These patients:

·         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

 

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