AHA GUIDELINES Bundle (free trial)

CPR for Mechanical Circulatory Support

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11 Figure 8. Algorithm showing response to a patient with a total artificial heart (TAH) with altered mental status, unresponsiveness, or respiratory distress Do not use ECG or telemetry Pulse present No pulse present Monitor respiratory status (assist ventilations if required) • If unresponsive, check for noncardiac etiologies for possible causes • Consider hypoglycemia, stroke, hypoxia, or overdose ≥150 mm Hg <90 mm Hg Maintain SBP ≥90 mm Hg Consider: • Sublingual nitroglycerin • Furosemide 40 mg IV • Assist patient with self-administration of hydralazine Administer NS bolus (maximum 1 L infusion) Initiate transport to receiving hospital Do not use: • Manual or mechanical chest compressions • ECG/defibrillation/pacing or AED • Vasopressors (epinephrine or vasopressin) • Antiarrythmic medications (lidocaine, amiodarone, etc) Check TAH driveline Consider page to TAH center coordinator or physician if family has information available Has pulse returned? Check battery position and power status (replace if necessary) Has pulse returned? Use backup driver (if available) Has pulse returned? • Administer NS bolus (maximum 1 L infusion) • Monitor respiratory status (assist ventilations if required) YES YES YES Use "pulse present" approach NO NO NO Check systolic BP <150 mm Hg ≥90 mm Hg

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