The EM Educator Series: Man vs Machine – Basics & Beyond of VADs

Author: Cassandra Mackey, MD (EM Resident Physician, UT Southwestern Medical Center / Parkland Memorial Hospital) and Alex Koyfman, MD (@EMHighAK) // Edited by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER)

Welcome back to the EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed.

This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. Please message us over Twitter and let us know if you have any feedback on ways to improve this for you. Enjoy!

Case #1:

A 62-year-old male is brought in by EMS with feelings of lightheadedness. He has a history of severe heart failure requiring LVAD. On examination, you detect a hum but are unable to obtain a pulse. When he is placed on monitor, you see what appears to be ventricular tachycardia.

Case #2:

A 53-year-old female with an LVAD is brought in with fever and chills. She has felt fatigued. Her MAP is 56 mm Hg, and she is febrile. The driveline site appears red.

 

Considerations:

  • Why does the patient have the LVAD?
  • What is the basic anatomy and physiology of a VAD?
  • What should you evaluate on exam, and what labs are needed?
  • What complications do you need to consider?
  • Can you defibrillate these patients? How about chest compressions?
  • Who do you need to discuss these patients with?

 

Suggested Resources: 

 

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