EMT : NYS : TOTAL ARTIFICIAL HEART

Pulse rate is set and regular

between 120-135 bpm

[TOTAL ARTIFICIAL HEART] Assess blood pressure:

goal blood pressure is >90 mmHg and <150 mmHg

[TOTAL ARTIFICIAL HEART] Assure that patient has both drivers (compressors)

hand pump, all batteries, and power cords for transport

[TOTAL ARTIFICIAL HEART] Perform a secondary assessment and treat per protocol

If unresponsive with a pulse, evaluate for noncardiac etiologies

Target blood pressure is

<150 mmHg and > 90 mmHg

[TOTAL ARTIFICIAL HEART] Do not use an

AED or cardiac monitor.

CRITERIA

Any request for service that requires evaluation and transport of a patient with a Total Artificial Heart.

Check battery position and power status (replace if possible)

Assess pulse and artificial heart function:

Check for severed or kinked TAH driveline (address if possible)

Assess pulse and artificial heart function:

Consider early consult with TAH coordinator or medical control

Assess pulse and artificial heart function:

Do not perform chest compressions or place an AED

Assess pulse and artificial heart function:

Use the backup driver, or hand pump, if available

Assess pulse and artificial heart function:

[TOTAL ARTIFICIAL HEART] Assess airway and breathing

Hypertension or volume overload can quickly cause pulmonary edema to develop

TAH patients have had their heart removed

and replaced with a rigid device which pneumatically pumps blood throughout the body

TAH patients are on

anticoagulation and may have significant bleeding with minor injuries

[TOTAL ARTIFICIAL HEART] Any trained support member

should remain with patient

[TOTAL ARTIFICIAL HEART] Notify receiving hospital

that your patient has a TAH while on scene or promptly after initiation of transport regardless of patient's complaint

As these patients do not have a heart

there is no indication for an ECG or cardiac monitoring.

A functioning TAH

will not result in any measurable electrical activity

KEY POINTS/CONSIDERATIONS

• TAH patients have had their heart removed and replaced with a rigid device which pneumatically pumps blood throughout the body • As these patients do not have a heart, there is no indication for an ECG or cardiac monitoring. A functioning TAH will not result in any measurable electrical activity • TAH patients are on anticoagulation and may have significant bleeding with minor injuries • The TAH patient has normal pulse and blood pressure detectable by conventional methods and are highly preload and afterload sensitive: • Target blood pressure is <150 mmHg and > 90 mmHg • Pulse rate is set and regular, between 120-135 bpm

MEDICAL CONTROL CONSIDERATIONS

• Termination of resuscitation • Consultation with a TAH program provider

[TOTAL ARTIFICIAL HEART] Assess pulse and artificial heart function: If no pulse present:

▪ Consider early consult with TAH coordinator or medical control ▪ Check for severed or kinked TAH driveline (address if possible) ▪ Check battery position and power status (replace if possible) ▪ Use the backup driver, or hand pump, if available ▪ Do not perform chest compressions or place an AED