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Going Home with the Heart Mate XVE LVAD HF#5959

 While living at home with your ventricular assist device (VAD), it is vital that you follow these instructions.  You must know and understand the warnings and cautions that go along with having a VAD.  Be sure that you are aware of the guidelines for safe VAD function.

 

Daily Care

 

  1. Change the driveline exit site dressing at least once a day.  Use the sterile technique you learned in the hospital. 
  • Wear a mask.
  • Put on non-sterile gloves
  • Remove the old dressing.
  • Take off the gloves and wash your hands.
  • Set up the supplies using the sterile technique you learned in the hospital.
  • Put on sterile gloves.
  • Clean the site with Hibiclens® and saline soaked sponges.
  • Gently dry the site with dry sterile gauze.
  • Remove gloves and put on a 2nd pair of sterile gloves.
  • Apply drain sponges to the site then cover with 4 x 4 gauze.
  • Cover with abdominal pads if there is a lot of drainage.
  • Close dressing with Montgomerystraps or tape.Keep the drive line from moving around with an abdominal binder, tape or anchoring device discussed with you in the hospital.  This prevents infection.

 

Dressing supplies vendor: ______________________

Contact number: __________________________

 

Take a good look at the driveline exit site at least once a day.  Do this during the dressing change.  Look for signs of infection.

  • Redness
  • Swelling           
  • Drainage (blood or pus)
  • New drainage where there was not any before
  • Foul odor
  • Increased warmth at the site
  • Temperature > 100° F

 

  1. Each day, record these on your flowsheet.
  • Blood pressure
  • Temperature
  • Weight
  • LVAD rate (bpm)
  • Stroke volume (ml)
  • Mode (auto/fixed)
  • Flow (L/min)

 

Caring for your LVAD

 

Do NOT block or kink the driveline or vent filter.

Daily:

  • Inspect vent filter at least once a day.  If it contains excessive amounts of black dust and needs changing more than once a week, call your heart failure Doctor on call (after hours, holidays, or weekends) or VAD coordinator (during work hours) right away.
  • System check
  • Dressing change
  • Vital signs, weight, temperature, and VAD numbers

 

Every Night:

  • Inspect the system controller connections to the driveline.  Do not disconnect either of these.
  • Check both the white and black connections to the power cords.

 

Weekly:

  • Change the vent filter once a week so that it does not become dirty or clogged.
  • If you need more vent filters call before using the last filter.
  • Inspect batteries for physical damage.  Clean battery terminals and inside contacts of   battery clips with a dry clean cloth.  Do not use liquids.  This prevents build-up.  If there is physical damage, notify your VAD coordinator.  Remember to rotate and fully charge all batteries.
  • Clean the outside surfaces of your HeartMate system as needed with a damp cloth.

 

System Upkeep

  • Do NOT block or kink your driveline.
  • Keep water/moisture or debris from your controller.
  • Do NOT use a tool to tighten any connections.
  • Be careful around computers and TV’s due to static electricity.
  • Do NOT clean or try to fix any connections.  If there is something wrong, call LVAD coordinator or heart failure attending on-call.
  • Do NOT plug power base unit into an outlet controlled by a wall switch.
  • Remember:  At least one system controller cable must be connected to a power source (battery, power module) at all times.  Disconnecting both controller cables at the same time will cause the pump to stop!

 

 

 

Other

You must know and understand the warnings and cautions that go along with having an LVAD. Be sure that you are familiar with the guidelines for safe LVAD operation.

  • No MRI.No chest compressions.

Activities

 

  • Do NOT take tub baths or go swimming while implanted with the pump.You may shower once your Doctor says that it is okay to do so.  Do NOT take showers without using the shower kit.
  • Do NOT play contact sports while implanted with the LVAD.
  • Avoid jumping up and down.
  • Do NOT lift more than 10 pounds for at least 8 weeks.
  • Do NOT vacuum.
  • No driving.  Sit in the back seat to prevent possible trauma to your chest bone from airbags or the dashboard.
  • Keep the system controller next to you while you sleep.  When you go to sleep, you need to be on the power base unit.
  • Do NOT sleep on your stomach.
  • Do NOT let water or fluids get into your vent filter.  Water entering the pump or vent filter can cause your pump to stop.  Avoid activities that would cause your pump to get into water.

 

Pain 

 

  • When you go home, you should not have much pain.  You may feel sore.
  • You may get pain medicine and should be taken as ordered. 
  • If you have a change or increase in pain, call your VAD coordinator right away.

 

Diet

 

  • When you first start, you must eat foods high in protein and calories.  Try to limit in your diet salt and oral fluid intake.
  • If you have diabetes, discuss nutrition supplements, carbohydrate counting and meal planning with your Doctor.
  • Since the LVAD is implanted near your stomach, you may feel full faster.  You may need to eat small meals more often during the day rather than a few large meals.

 

Smoking and Tobacco products

 

DO NOT smoke.  Avoid places where you will be exposed to second hand smoke.  Smoking and second hand smoke cause your arteries to tighten and decrease blood flow.  This will make your pump work harder. Smoking and second hand smoke also lowers your ability to fight off infection.

 

Alcohol

 

DO NOT drink alcohol.  It can hinder or interact with certain drugs.  Alcohol is a diuretic.  It can cause you to dehydrate.  Your LVAD depends on enough blood supply to work best.  It is important that your non-alcoholic routine be maintained.  Drinking alcohol may impair judgement and ability to react to system alarms.

 

Weather

 

Avoid being active in very hot or cold weather.  If you go outdoors, during very hot or humid weather, be sure to drink lots of water and non-alcoholic drinks.  When putting on heavy coats or jackets, before going outside in the cold, take care to avoid kinking or bending your LVAD cables.

 

Home Safety

 

Once you are at home, you and your caregiver need to be sure that the area around you is safe.  If you have any questions or concerns about your home call your LVAD coordinator.  If you are not comfortable testing your home’s electrical system, you can hire an electrician to do it for you.  Avoid the strong static discharge that comes from a TV or computer screen and from scuffing your feet on carpets.  A strong static discharge can cause the LVAD to stop.  Consider spraying carpets with Static Guard® or other similar products.  If you keep humidity level in your home between 30 – 40 % in the winter, you can decrease the amount of static electricity in your home.  It is vital you have grounded outlets in your home.  Have an electrician check your outlets.

 

Leaving Home

 

Do NOT drive or operate heavy machines for as long as you have the VAD.  Your doctor will tell you when you can go more than a few hours away from the hospital.  When leaving home for a few hours, be sure to take these items with you:

  • Backup system controller
  • Extra batteries
  • Hand pump
  • Emergency power pack
  • Vent filters

 

Traveling:

 

No driving until approved by your physician/surgeon.  Until then, sit in the back seat to prevent possible trauma to your chest bone from airbags or the dashboard.

 

There are no restrictions for airplane (fixed-wing aircraft), train or bus travel. Notify your VAD coordinator prior to any travel.  You need permission from your Doctor before you travel via air or train.  Airline or train security will need to be called.   You may need a copy of your chest   x-ray for them to see.  You will need to have the power module inspected by hand instead of going through the x-ray machine.  Do NOT go through the security arch but rather have them use the wand.  Your LAVD coordinator or heart failure attending on call will tell you where the nearest LVAD center will be.  That hospital’s LVAD team may be told of the dates you will be in the area.  You will need to put the equipment in a suitcase that will fit under the seat in front of you or in the overhead bin.  Your LVAD will not interfere with the radar system.  To prevent loss, you must carry:

  • Power module/monitor/cable
  • BatterychargerBackup controller Batteries Hand pump Emergency power pack Vent filters

 

Returning to Work

 

You cannot return to work until cleared by your doctor.

 

When to Call the Heart Failure Attending on call (after hours, holidays, or weekends) or VAD coordinator (during work hours)
  • If the LVAD flow is less than___or greater than 8
  • If the LVAD rate is greater than 100bpm.
  • If your systolic blood pressure (top number) is greater than 150
  • Do not take your medicines if systolic blood pressure (top number) is less than ____
  • Notices changes in how the LVAD feels, operates or sounds
  • Black dust from the filter area when changing or needs changing more than 1 time a week
  • Call with concerns, questions or problems
  • Call your heart failure Doctor or LVAD Coordinator right away if you notice any changes inhow the LVAD feels, works, sound or if you feel different.
  • Signs of infection at the driveline site, redness, swelling, drainage such as blood or pus, foul odor, increased warmth at the site, or a temperature of 100º by mouth
  • Alarms
  • Pain at LVAD site
  • Emergency Department visit
  • Hospital admission
  • LVAD failure

VAD Coordinator:  608-262-0773 or 608-261-0962

 

After hours, weekends and holidays call Heart Failure Attending on call

(608) 262-0486.

  • Give your name and phone number with the area code.
  • The Doctor will call you back.

 

Emergency

 

An emergency occurs any time the heart pump cannot pump enough blood.  Call 911.  Make sure 911 works in your area before relying on it.  When to call 911

  • Loss of power to the pump
  • Broken wires
  • Damage to the pump motor or system controller
  • Health changes which affect your heart
  • Hand pumping
  • Red Heart alarm


Call 911 with any signs of stroke

  • Changes in speech
  • Numbness or tingling in one extremity only
  • Weakness or unable to move one side of body
  • Uneven smile

 

Ambulance name:___________________________

 

Phone number:______________________________


In an emergency:  Stay calm

 

If the Pump is running

  • Check all cable connections
  • Reconnect any loose or disconnected cables
  • Prepare to hand pump
  • Call LAVD coordinator, Heart Failure Attending or 911
  • Refer to trouble shooting guide

 

If the Pump is NOT Running, call 911 right away

  • Refer to trouble shooting guide
  • Check connections, change power source, switch to back-up system controller
  • Hand pump if less than 5 minutes since failure
  • One family member/friend may need to ride in the ambulance with you to the nearest hospital
  • Make sure that emergency backup supplies are with you
  • Someone needs to call Heart Failure Attending to alert us you are going to nearest hospital


The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 02/26/2013

Copyright © 03/14/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5959

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