10
Treatment
Figure 7. Algorithm showing response to a patient with a
left ventricular assist device (LVAD) with unresponsiveness
or other altered mental status
Adequate
perfusion?
Assist ventilation if necessary and assess perfusion
• Normal skin color and temperature?
• Normal capillary refill?
Assess and treat
non-LVAD causes for altered
mental status, such as:
• Hypoxia
• Blood glucose
• Overdose
• Stroke
Assess LVAD function
• Look/listen for alarms
• Listen for LVAD hum
LVAD
functioning?
Attempt to restart
LVAD
• Driveline connected?
• Power source
connected?
• Need to replace
system controller?
Do not perform
external chest
compressions
Perform
external chest
compressions
LVAD
restarted?
Follow local
EMS and ACLS
protocols
Notify VAD
center and/or
medical control
and transport
* e PETCO
2
cutoff of >20 mm Hg should be used only when
an ET tube or tracheostomy is used to ventilate the patient. Use
of a supraglottic (eg, King ) airway results in a falsely elevated
PETCO
2
value.
NO
NO
YES
NO
YES
MAP >50 mm
Hg and/or PETC0
2
>20 mm Hg*?
YES