AHA GUIDELINES Bundle (free trial)

CPR for Mechanical Circulatory Support

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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

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