Wednesday, September 16, 2009

Neat stuff

So last night I dragged my sorry butt to the firehouse, which I haven't seen in about a week (which I must rectify) for drill night. I've never actually been to a 'drill night' as every time I'm there on a Tuesday, I've either gotten the night wrong, and we don't have drill because we have a business meeting the next night, or I am on the ambulance and get sent out on a call that doesn't get me back to the station until drill is done.

This week was special. There is a gentleman living in our first due who has a Ventricular Assist Device (VAD). This is a little magnetic pump that is inserted into the left ventricle that, via centrifigul force, pulls blood from the ventricle and sends it through a shunt to the aorta. The atria are unsupported, but they do still beat. You will still get an EKG reading. It usually is associated with an internal pacemaker. And you will not get normal heart sounds. At all. Essentially, the heart is no longer really beating (though, if the pump fails, it can beat effectively enough to maintain life for a short period of time). The blood is being moved through the heart by this pump.

Here's the kicker...he has no pulse! Read that again. NO....PULSE. Also, no blood pressure, unless he is really super hydrated. This makes treatment slightly difficult, to say the least.

The interesting thing I found was that there are several hundred, if not thousand of people across the country who have different varieties of these things. Before last night, I wouldn't have known what to do if I had a patient present to me with no pulse or blood pressure, yet he was upright and talking.

The most important thing about the whole lesson was that he CANNOT be separated from his bag. The wire that controls the pump is connected to a computer in that bag. I shudder to think what could happen should an emergency happen (say, a car accident) and responders attempted to move the bag too far.

Anyway, these VAD's are mainly for people who have serious heart failure and are either waiting for a new heart, or aren't going to get one, and this allows them to have a much higher quality of life than they would otherwise have. I'm sure the nuisance of carrying around a mini-computer in a bag and having a wire come out of your side is much more tolerable than the nuisance of getting winded walking from your bedroom to the bathroom.

It's an interesting thing, and once more shows what technology can do. If you don't already know about these things, look them up. These people can be travelling through anyone's area at any time, and could have a problem.

Besides sounds wild!!! Like your standing near high tension lines or something. Seriously, if you don't care about anything else about this nifty bit of techology, look it up just to hear what it sounds like!


EMS Chick said...

Isn't the VAD fascinating? We haven't done formal training on it but during a drill one of my members said he had heard about it so we stopped and looked it up. It's amazing what can be done for people now.

Herbie said...

JEMS did a big article on it either last year or 2007. It was very informative; I suggest researching it.

Epijunky said...

I had a patient during a clinical who had one, it was wild. Very very cool stuff.