1. Educating the Prehospital
Provider onVADs

2. Emergency Contact Numbers
VAD coordinator/Nurse
VAD program
Physician

3. Types of Devices
• Pneumatic pulsatile- old device
• Continuous flow

4. The Controller
• A problem with the pump will be shown by text on the first line of the
controller
• The pump rarely has an issue- in testing providers are taught to change
controllers in 3 minutes
• Patients carry a backup controller and batteries at all times
• When changing a controller have the patient sit or lie down
• When removing the driveline from the original controller pull on the silver
connector, NOT the wire
• Ask patient or family members if you are in question about anything- use
coordinator too!

5. Assessment
• Skin color and temperature are great ways to assess perfusion because a pulse can’t always be felt
and BP may be hard to obtain- look, listen, and feel!!
• DON’T be afraid to do a detailed hands on assessment
• Utilize the patientsVAD coordinator, they can help troubleshoot over the phone
• Ask the patient if they have a pulse or not- knowing this will help you know if there is a critical change
in the patients condition- being hands on is very important!You can have an unresponsive and
pulseless patient who isn’t dead
• Use a stethoscope to listen to the chest, listening for humming and possible heart beat
• In the event the pump fails- use backup power sources and controller: older pneumatic pumps have
hand pumps
• If the device indicates low flow, ALS needs to give IV fluids as there’s no way to speed up flow
• Normal speed range is 2,400-3,200 RPMs
• Goal Mean Arterial Pressure is <85mmHG

6. Transport and Care
• If transporting decide if you’re able to get patient to aVAD center fastest by use of
ground or air ambulance
• Take ALL power equipment with patient-AC adapter and batteries
• Defibrillation can be done per protocol without removal of anything
• CPR can dislodge the pump, but can be done, no real information if it actually helps
• Protocols should be followed, all medications can be given like nitro and epi
• If the patient is unresponsive ALS is needed because a NIBP machine is required
• Load and go or stay and play is situation dependent

7. Common Problems with EMS Providers
• Clinical coordinators and patients can’t always get to EMS providers
• Many providers don’t want to touch the controller because it isn’t in their
protocols
• Training isn’t mandatory or consistent across the US, some states require
training and continuous training while others don’t

8. Resources
- Suzanne Wallace: Clinical coordinator and head of education for HeartWare
- Susan Wright: LVAD development specialist at HeartWare