Hemodynamics
Impella is ________ dependent and ______ sensitive.
What is preload dependent afterload sensitive
This button silences and clears alarm messages if they have been resolved
What is mute Alarm
This is the formula for Mean Arterial pressure.
What is systolic+2 diastolic/3
Patient scenario 3
What is wean Epi and Vaso
This wave form will be pulsatile when the impella is in the correct position ….. Hint its green.
What is motor current?
Normal CVP for impella patient
What is 10-12.
These three things can cause you to have a Suction Alarm
What is volume, position, RHF
This is the formula for CO.
CO=HR X SV
Patient Scenario 4
What is impella moved to close to the valve
What is call echo and md
This compromises 2/3 of the patients cardiac cycle. In this phase, the patients AO valve is normally closed and they have no cardiac output.
What is diastole?
What is normal pa pressures
what is 25/10
Impella Alarms placement signal low ….. You may want tohave the MD do this!!
What is get an echo and move the outflow away from the ao valve
This is the formula for PaPi…… Pulmonary artery pulsatility index.
PaPi=PaS-PaD/CVP
Patient scenario 7
What is Possibly the impella, but would get a UA and examine the labs. HH plts
if your patient needs cpr this is the p-level you should be running at.
What is p2
This number is approximately the same as left as left ventricular end diastolic pressure, can be measured with a PA catheter, and is a marker of Left ventricular compliance and filling.
What is PCWP? Pulmonary Capillary Wedge Pressure
Your arterial line is flat and corresponds to the placement signal on the Impella this is concerning if this is low
What is Map? Less than 65
This is the formula for Cardiac Power Output….CPO
CPO= MAP X CO/451
Patient scenario 9
P2 medically manage, reposition with echo and restore flow
You’ve all seen my favorite slide a million times…… lets see if you were listening. There are 13 clinical benefits to Impella ….14 if you count the DTU study. Name any 4……. 200 dollar bonus is you give me 4 and add the one under investigation.
What is 1.decrease in LVedp, 2 decrease in LVEDP, 3 decrease in wall tension, 4 decrease in LAP, 5 Decrease in mechanical work,6 decrease in micro vascular resistance, 7. Increase in myocardial perfusion, 8 decrease in pulmonary congestion, 9 increase 02 supply, 10 decrease o2 demand, 11. Increase CO, 12 increase MAP, 13 increase CPO……Bonus Reperfusion injury
This is considered normal range for SVR…….. Depending on which text you ask.
800-1200
The console alarms purge pressure High. This is usually the Problem (SIMPLE FIX)200 dollar bonus is you can tell me the other cause and the solution
What is kinked pressure tubing?
what is protein build up in impella gap…. TPA
this is the formula for CPP…..Coronary Perfusion Pressure ….. We want it to be greater than 40 mmHG
What is CPP=DBP-LVEDP
Patient scenario 8
What is RHF, Swan, possible rat side support
Patient Scenario 10
What is Echo and reposition