1. Pre-Hospital Care of the Mechanical Circulatory Support Device Patient
Dennis Rivard MA, CCP
Mid-Atlantic Region Pre-Hospital MCS Task Force

2. Sept 11, 2001

3. An MCS Coordinator, a Flight Nurse, and a Patient

4. Meeting of the Minds
Advances in medical technology is exceeding the community’s ability to safely manage patients with this technology
Decision to set up meeting to work more closely
Meetings would be multi-disciplined
Goal to create a method of identifying and provide basic management information
Bring MCSD centers together to work smarter

5. MARPH Covers Virginia, DC, and Maryland Meet monthly Core hospitals
Virginia Commonwealth University Hospital
INOVA Fairfax Hospital
Washington Hospital Center
Johns Hopkins Hospital
University of Maryland Medical Center

6. Basic Tenets Do not prescribe medicine
Not certifying or credentialing any clinicians
Compromise
Listen to the experts (EMS)
Collaborate whenever possible

7. The Motley Crew

8. Participants MCS Coordinators EMS providers (ground and flight)
ED medical team members
Heart Failure Cardiologist
Cardiac surgeons

9. Field Guides
Designed to provide consistent and reliable information to first responders
Pump systems assigned a color
Colors are present on guide, labels, and luggage tags
Electronic PDF files
Updated annually

10. Color Guides Coding Dark Blue Heartware Orange Heartmate II
Jarvik Lavender
VentrAssist Green
Thoratec PVAD Light Blue
Heartmate XVE Yellow

11. Guide Design Separate cards for each device
Allows for multiple uses
Can be separated and used separately
Color coding encircles each card
Color is printed along the edge
Allows to be photocopied
Eliminated confusion for color-blind first responders

12. Field Guides Each a little different in design 10 questions
FAQ section
Emergency step by step troubleshooting section with pictures
Changing batteries
Changing controllers
Alarms
Two sided laminated and bound

13. Heartware and Heartmate XVE

14. VentrAssist and Heartmate II

15. Thoratec PVAD and Jarvik 2000

16. Guides 10 Questions 1. Can I do external CPR?
If not, is there a hand pump to use?
If device slows down (or goes into a low flow state), what alarms will go off?
How can I speed up the rate of the device?
Do I need to give heparin if the pump slows down?
Can the patient be defibrillated?
If OK to defib, is there anything that must be disconnected prior to defibrillating?
Does the patient have a pulse with this device?
What are acceptable vital sign parameters?
Can this patient be externally paced?

17. Tags and Labels Label controllers and tag bags
Follows same color coding system
Information on tag is for specific implant center contact information
Tags state:
Name of hospital
MCS Team contact information
Color code of device
Type of device

18. Tags Side one Side two Patient’s identification Implanting hospital
Emergency contact info
Color code tape
Side two
Type of pump
Written color code

19. Additional Uses Non-MCSD trained units Emergency Departments Patients
Rehabilitation centers
Out-Patient Dialysis Centers

20. Launch of Field Guide Program
Multi-state EMS training opportunity
Target audience was EMS educators and team leaders
6 stations (one for each pump presented)
Patients with specific pumps at each station
MCS Coordinator at each station
Hands on exposure
Used field guides as outline for presentation

22. Mechanical Circulatory Support Organization (McSO)
National organization
Multi-disciplined
Grant funded
Linked to other related organizations

23. National Training Program
If we don’t do it, someone will
Expected surge in MCSD patients once DT is an FDA approved therapy
Opportunity to provide consistent messages
Safe for our patient to travel throughout the US
First national launch in San Jose this October
Air Paramedic and Nurses National Meeting
Offering pre-conference courses

24. What Does the Future Hold???
Need central resource center
Development of national information bank
One stop shopping
One phone number when placing a MCS patient in their residence
Coordinator hot line directory

25. Questions