The prevalence of patients living with a left ventricular assist device (LVAD) is rapidly increasing due to improvements in pump technology, limiting the adverse event profile, and to expanding device indications. To date, over 22,000 patients have been implanted with LVADs either as destination therapy or as a bridge to transplant. It is critical for emergency physicians to be knowledgeable of current ventricular assist devices (VAD), and to be able to troubleshoot associated complications and optimally treat patients with emergent pathology. Special consideration must be taken when managing patients with VADs including device inspection, alarm interpretation, and blood pressure measurement. The emergency physician should be prepared to evaluate these patients for cerebral vascular accidents, gastrointestinal bleeds, pump failure or thrombosis, right ventricular failure, and VAD driveline infections. Early communication with the VAD team and appropriate consultants is essential for emergent care for patients with VADs.
Purpose of Review
Emergency airway management is populated by many new concepts, evolving equipment, and contemporary strategies for optimal procedural success. This review aims to discuss various topics within these realms and to continue the ongoing conversation regarding improvement of emergency airway management.
Recent Findings
Various literature, opinion pieces, podcasts, and trials have prompted renewed interest in the field of emergency airway management. Though common threads can be found, there is significant debate on optimal practice. Accompanying these conversations is continuous production of new equipment which can be beneficial to providers. However, this ongoing accumulation of material, data, and pathways can create challenges in remaining up to date. Rather than a comprehensive review of current literature and discussion of research findings, this article aims to discuss selected and impactful concepts in real time context and provide potentially immediate additions to emergency airway manager practice.
Summary
As emergency airway management evolves, it remains a significant task to maintain up to date on current trends, data, and new equipment. This article aims to discuss several of these items in a digestible fashion and provide immediate impact for emergency airway providers.
Resuscitation of cardiac arrest in coronavirus disease 2019 (COVID-19) patients places the healthcare staff at higher risk of exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Unfortunately, COVID-19 status is unknown in most patients presenting to the emergency department (ED), and therefore special attention must be given to protect the healthcare staff along with the other patients. This is particularly true for out-of-hospital cardiac arrest patients who are transported to the ED. Based on the current data available on transmissibility of SARS-CoV-2, we have proposed a protocolized approach to out-of-hospital cardiac arrests to limit risk of transmission.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.