Troubleshooting
Patient Care
Values
Support
Impella is FUN
100
Upon entering the room you notice the placement signal has a "LV" waveform with a flat motor current. What should you recommend?
What is turn the Impella to P2 and call for an echo to reposition.
100
The correct number of op sites to use when dressing the impella site.
What is one?
100
The components of preload
What is volume (CVP) and right heart function?
100
Delivers approx 0.5L of flow through counter pulsation
What is IABP?
100
The appropriate P level during CPR
What is P2?
200
The LV is unable to squeeze hard enough to open the aortic valve, the patient has no pulse, is in sinus rhythm, and has a pulsatilte motor current.
What is it low pulsatility?
200
The assessments that should be done before turning a patient.
What is check tuohy borst and centimeter marking?
200
MAP x CO x 0.0022 Hint this is the greatest predictor of mortality
Cardiac Power Output
200
Delivers up to 3.5L of flow and directly unloads the left ventricle.
What is Impella CP?
200
Contraindications for Impella placement.
What is LV thrombus, VSD, mechanical aortic valve?
300
The Impella CP is on P8 flow is 2.7, the blood pressure is 120/80 (94) on Epi and Dopamine.
What is high afterload?
300
The optimal medications for supporting right heart function.
What is Milrinone and Dobutamine?
300
The best way to assess right heart function.
What is a swan?
300
Measures approximately 3.5-4cm from aortic valve annulus to tear drop
What is correct positioning of Impella in left ventricle?
300
Appropriate action for responding to a suction alarm.
What is reducing P level to break suction then evaluating P.A.P. for cause?
400
The patient has low flows 2.0 on P8 and frequent suction alarms. The patient has a CVP of 6 and the Impella is in good position.
What is decreased preload? Give volume.
400
The best way to prevent tenting of the artery.
What is maintaining the angle of the sheath insertion site?
400
The appropriate ACT for maintaining Impella?
What is 160-180?
400
D5W with 50 units/mL of Heparin
What is purge fluid?
400
The patient has pink/red urine and hemolyzed labs.
What is hemolysis?
500
Patient has flows of 1.9 on P8, ABP 100/80 (87), CVP 22, Impella 3.5cm from aortic valve annulus.
What is right heart dysfunction and high afterload?
500
The function of the purge fluid.
What is to protect the Impella motor?
500
The most common coronary artery lesions that cause RV dysfunction.
What is RCA and LAD (septal perforators)?
500
The best screen for monitoring Impella placement and function?
What is placement screen?
500
The P level appropriate to reposition Impella or to pull back across the aortic valve
What is P2?
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