Buttons
This is the button to change your p level.
What is flow control?
Your Impella alarms ”Impella position in aorta”, this is your action on the Impella console.
What is reduce to P2?
These are the insertion sites for Impella CP
What is femoral artery or axillary artery (rare)?
This is the CVP recommended for Impella patients.
What is 10-12?
Your patient has an increasing vasopressor requirement during the weaning process. Do you continue weaning with pressor support or are they not ready to wean?
What is not ready to wean?
This is how long an Impella lasts without being plugged in.
What is at least 60 minutes?
Your Impella alarms “purge pressure high”, this is your first action.
What is check tubing for kinks?
These are the two additives in the purge solution.
What is D5W with 25 mEq/L of sodium bicarbonate and D5W with 25 U/mL of heparin?
This is the gold standard for monitoring hemodynamics.
What is a PA catheter?
Your patient has hemolysis. You assess these two things after ruling out a traumatic foley insertion.
What is preload and Impella position?
This is how to get to the screen you should remain on to monitor waveforms.
What is display, then placement?
Your Impella has a suction alarm. After reducing the P level to break suction, you assess for these three things.
What is preload, positioning, and right heart failure?
This is the highest you can raise the head of the bed with an Impella in.
What is 30 degrees?
This is the PAPi equation, normal values and what it assesses.
What is (PaS-PaD)/CVP? Greater than 2 is normal and less than 1 suggests right heart failure. Assesses the right side of the heart.
Your patient requires defibrillation. This is the recommended action for the Impella console.
What is do nothing?
This is how to change purge tubing.
What is purge menu, change cassette and bag?
Your Impella console has a white alarm for “Impella position unknown”. This is the action you should take.
What is assess cardiac function?
This is how to manage the impella access site. (name at least 2)
What is assess for hematoma, maintain angle of entry, ensure forward tension sutures are present on blue suture hub, assess pedal pulses, avoiding blankets on Impella site, maintain sterile occlusive dressing?
This is the CPO equation, normal value, and what it assesses.
What is (CO x MAP)/451; greater than 1, and an indicator of in hospital mortality?
You are suspicious for right sided heart failure on your patient with Impella CP. You may notice these signs (name at least 3).
What is suction alarms not caused from preload or positioning, elevated CVP, narrow PA pressure, decreased PAPi score, signs of liver failure, edema, SOB?
This is how to enter your cardiac output every 8 hours.
What is menu, enter cardiac output?
You have a console failure alarm. This is how you switch consoles.
What is turning on the new console, releasing the purge tubing, unplugging white connector cable from old console and connecting to new console, removing purge cassette and tubing and placing in new console?
This is how to prevent device migration. (Name at least 3)
What is locking the T lock and tuohy borst valve, knee immobilizer, removing slack in cath lab, recording CM marking, verify placement with ECHO.
The Impella is preload _____ and after load _____.
What is preload dependent and after load sensitive?
This is the weaning process for an Impella.
What is reduce flows To P2, ACT less than 150, P1 across the aortic valve, P0 before exiting the body, hold manual pressure on site for 40 minutes?