
LVAD patients DO NOT have a pulse! The LVAD pump circulates blood in a continuous fashion.
What are some steps to take with an unresponsive LVAD patient? They won't have a pulse (of course!), but the provider will probably notice a control device on the patient, and batteries. LVAD patients DO NOT receive traditional CPR! This may tear the intake valve away from the ventricle. The devices are complex, and the priority will be to troubleshoot the problem. Patients and devices will generally have the phone number to the LVAD coordinator for that particular device on them. The LVAD coordinator can help to trouble shoot the device, and offer advise.
To tell if an LVAD is working, several things can be done. The control device should have a green light, and batteries should have an indication of how much charge they have left. Listening to the patient's chest with a stethoscope should pick up a hum. A blood pressure can also be taken on this patient with a manual cuff, and a Doppler. The first sound heard is the Mean Arterial Pressure (MAP). There will be no traditional systolic or diastolic sounds.
LVAD patients generally are on warfarin, and often develop other clotting abnormalities, so these patients can bleed, and also have pulmonary embolism, and thrombi in the LVAD itself.