Going Home with the HeartMate II VAD
This is a review of things you need to know to care for yourself at home. It will also help you to know what to expect. It is vital that you follow these instructions.
Change the drive line exit site dressing at least once a day. Be sure to use the sterile technique listed below to prevent infection. You are taught how to do this at the hospital before you go home.
1. Put on a mask.
2. Wash your hands
3. Put on non-sterile gloves.
4. Remove the old dressing.
5. Take off the gloves and wash your hands.
6. Set up the supplies using the sterile technique you learned in the hospital.
7. Put on the sterile gloves.
8. Clean the site with Hibiclens® and saline soaked sponges.
9. Gently dry the site with dry sterile gauze.
10. Remove gloves and put on a 2nd pair of sterile gloves.
11. Apply drain sponges to the site then cover with 4x4 gauze.
12. Cover with abdominal pads if there is a lot of drainage.
13. Tape the dressing to keep it closed.
14. Put on your abdominal binder to keep the drive line from moving around.
You can also use tape or an anchoring device discussed with you in the
hospital. This prevents infection.
Look at the driveline exit site at least once a day, during the dressing change. Look for the following signs of infection:
• New drainage when there was not any before
• Foul odor
• New or increased warmth at the site
• Temperature above 101.5°F
Call your Heart Failure doctor or your LVAD coordinator for any of these symptoms.
Each day, record these on your flow sheet:
• LVAD speed (rpm)
• Pulsatility index (PI)
• Power (in watts)
• Flow (L/min)
Do a system check on the controller and power module.
Look at the latch guard. Make sure it is in the locked position at all times.
• Check the system controller connections to the driveline. Do not disconnect
either of these.
• Check both the white and black connections to the power cords for damage
• Check the latch guard is locked.
• Check the batteries to see if there is any 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, please
notify your LVAD coordinator.
• Clean the outside surfaces of your HeartMate system as needed with a damp
• Make sure you rotate your batteries through the charger.
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
• Do not block or kink your driveline.
• Keep water/moisture or debris from your controller.
• Call your heart failure doctor or LVAD Coordinator right away if you notice
any changes in how the LVAD feels, works, sounds, or if you feel different.
• Do not use a tool to tighten any connections.
• Be careful around computers and TVs due to static electricity.
• Do not clean or try to fix any connections. If something is wrong, call LVAD
coordinator or heart failure doctor on-call.
• Do not plug power module 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 power
cables at the same time will cause the pump to stop!
• Do not take baths or go swimming while you have the pump.
• You may shower when your doctor says it is okay. Do not take showers
without using the shower kit.
• Avoid any activity with the potential for being covered in water. This can
cause pump the pump to fail.
• Do not play contact sports while implanted with the LVAD.
• Avoid jumping up and down.
• Do not lift more than10 pounds for at least 8 weeks.
• No vacuuming.
• 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 module.
• Do not sleep on your stomach.
• When you go home, you may feel sore, but you should not have a lot of pain.
• Your doctor may order medicine to relieve any pain that you may have. Take
these as told.
• Call your doctor or LVAD coordinator right away for any new or worsening
You are on a medicine called Coumadin® (warfarin). It is a blood thinner. You need to have blood tests done at your local lab. The blood test is checked by the Heart Failure team. The blood test drawn is called INR (international ration). This keeps track of how thin your blood is.
Your target INR level is __________.
• Follow your heart healthy diet given to you by your dietician.
• If you have diabetes, be sure to talk about nutritional supplements, carbohydrate counting and meal planning with your doctor.
Smoking and Tobacco Products
Do not smoke. Avoid places where you are exposed to second hand smoke. Smoking and second hand smoke cause your arteries to tighten and will decrease your blood flow. This makes your pump work harder. Smoking and second hand smoke also lowers your ability to fight off infection.
Do not drink alcohol. It can get in the way or interact with certain drugs. Alcohol makes you loose fluid from your body. It can make you dehydrated. Your LVAD needs enough blood supply to work best. It is important that your non-alcoholic routine be maintained. Drinking alcohol may impair your judgment and ability to react to system alarms.
Avoid being active in very hot or cold temperatures. If you go outdoors, during very hot or humid weather drink lots of water and non-alcoholic drinks. Before going outside in the cold, avoid kinking or bending your LVAD cables when you put on heavy coats or jackets.
When you are at home, you and your caregiver need to be sure that your surroundings are safe. If you have any questions or concerns about your home environment, 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.
Do not drive or operate heavy machines for as long as you have a VAD. Do not sit in the front seat in a car, truck, or SUV with airbags. 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
There are no restrictions for airplane (fixed-wing aircraft), train or bus travel. Please notify your LVAD coordinator prior to any travel. You need permission from your doctor before you travel via air or train. Airline or train security needs to be called. You may need a copy of your chest x-ray for them to see. Arrangements need to be made to have the drive console 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 LVAD coordinator or heart failure doctor on call will give you information about the LVAD center nearest to your destination. That hospital’s LVAD team may be notified of the dates you will be in the area. You 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
• Battery charger
• Backup controller
Returning To Work
You cannot go back to work until your doctor says you can.
Call the LVAD coordinator during weekday hours of 8-4:30 at 608-262-0773 or 608-261-0962.
Call the Heart Failure Doctor (after hours, weekends, and holidays) at
608-262-0486 with all LVAD concerns and signs of infection.
If you live out of the area, call 1-800-323-8942.
Call your heart failure doctor or LVAD coordinator if:
this may be a sign of water retention.
appearance of driveline site. Temperature > 101.5°F
|An Emergency happens any time the heart pump cannot pump enough blood. Call 911 for all emergencies. Make sure 911 is available and 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 affecting your heart
• Red Heart Alarm
In an emergency: Stay calm….
If the Pump is Running:
If the Pump is Not Running, Call 911 right away.
you to nearest hospital.
coming to the 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: 08/19/2013
Copyright © 08/19/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6440
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