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