How Alarming
This color alarm needs immediate action.
What is a red alarm?
Your Impella 5.5 is running at P8: 5.3LPM. ”Impella Position Unknown” alarm. Pt is awake, warm, wanting lunch. BP 101/99.
Impella 5.5 is fully unloading and supporting LV function.
This number will help you determine if the Impella catheter has moved.
What is the centimeter marking?
This monitoring is important to make sure clot does not form on the Impella.
What is PTT, ACT, or Anti XA?
Name 3 of your Impella reps.
Who are:
Emily. Ingrid. Skyler. Adam.
Morgan. Mike. Laura.
An alarm that is triggered when there is not enough volume in the LV.
What is suction?
Dr. Saleem asks if you had any Impella alarms overnight, but you haven’t gotten report yet.
What is Menu—> Alarm History?
The preferred additive to the purge solution.
What is Sodium Bicarbonate?
This lab value helps us determine tissue hypoperfusion
What is Lactate?
What is three point fixation?
Continued suction despite CVP >10 and good Impella position may indicate this.
Right Ventricular Failure
CPO 0.7. Q2 Lactate 12, 8.1, 7, 8.5.
What is escalate to Impella 5.5 or ECMO?
These two locks keep the Impella CP from moving.
What is T-Lock and tuohy-borst valve?
If this lab value is low, we might also have a suction alarm.
What is Hemoglobin/Hematocrit?
Always your art line or NIBP. If nonpulsatile—Doppler MAPs.
This alarm occurs when the Impella outlet is sitting at the level of the aortic valve. Or your patient is crashing.
What is “Placement Signal Low” alarm?
Patient arrives with Impella CP. The dressing is bloody and covered with tegaderm from groin to knee.
Redress. Angle of Entry Match. Occlusive dressing w/ ”shirt and pants”. Hold pressure if necessary.
This is the best way to verify Impella position in the heart.
What is Echo?
This value can tell us how well our patient is supported with current therapies and can help us differentiate shock types. Hint: “xx%”
What is a PA sat or SvO2?
(sPAP-dPAP)/RA.
And is automatically calculated on the Impella RP Flex.
What is PAPi?
RV dysfunction <1.0
This red alarm occurs when Purge Flow drops <2ml/hr and Purge Pressure >1100mmHg.
What is “Purge Pressure High” alarm.
DAILY DOUBLE
BP: 90/48 (62), CO: 4.1, CI: 1.6
Dr. Loghmani asks, what‘s your CPO.
What is neurovascular assessment? Pain, Pallor, Paresthesia, Pulselessness, Paralysis
This lab value is the gold standard for verifying hemolysis.
What is plasma free hemoglobin?
Lifeline brought your Impella patient on another hospital’s console. What should we do.
If your patient is relatively hemodynamically stable, proceed with AIC to AIC transfer. Call Impella team to assist.