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Mechanical life support algorithm developed by simulation for inpatient emergency management of recipients of implantable left ventricular assist devices

BACKGROUND: Published guidance concerning emergency management of left ventricular assist device (LVAD) recipients is both limited and lacking in consensus which increases the risk of delayed and/or inappropriate actions. METHODS: In our specialist tertiary referral centre we developed, by iteration...

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Autores principales: Akhtar, Waqas, Gamble, Brigitte, Kiff, Kristine, Wypych-Zych, Agnieszka, Raj, Binu, Takata, Junko, Gil, Fernando Riesgo, Hurtado, Ana, Rosenberg, Alex, Bowles, Christopher T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9162943/
https://www.ncbi.nlm.nih.gov/pubmed/35669526
http://dx.doi.org/10.1016/j.resplu.2022.100254
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author Akhtar, Waqas
Gamble, Brigitte
Kiff, Kristine
Wypych-Zych, Agnieszka
Raj, Binu
Takata, Junko
Gil, Fernando Riesgo
Hurtado, Ana
Rosenberg, Alex
Bowles, Christopher T.
author_facet Akhtar, Waqas
Gamble, Brigitte
Kiff, Kristine
Wypych-Zych, Agnieszka
Raj, Binu
Takata, Junko
Gil, Fernando Riesgo
Hurtado, Ana
Rosenberg, Alex
Bowles, Christopher T.
author_sort Akhtar, Waqas
collection PubMed
description BACKGROUND: Published guidance concerning emergency management of left ventricular assist device (LVAD) recipients is both limited and lacking in consensus which increases the risk of delayed and/or inappropriate actions. METHODS: In our specialist tertiary referral centre we developed, by iteration, a novel in-hospital resuscitation algorithm for LVAD emergencies which we validated through simulation and assessment of our multi-disciplinary team. A Mechanical Life Support course was established to provide theoretical and practical education combined with simulation to consolidate knowledge and confidence in algorithm use. We assessed these measures using confidence scoring, a key performance indicator (the time taken to restart LVAD function) and a multiple-choice question (MCQ) examination. RESULTS: The mean baseline staff confidence score in management of LVAD emergencies was 2.4 ± 1.2 out of a maximum of 5 (n = 29). After training with simulation, mean confidence score increased to 3.5 ± 0.8 (n = 13). Clinical personnel who were provided with the novel resuscitation algorithm were able to reduce time taken to restart LVAD function from a mean value of 49 ± 8.2 seconds (pre-training) to 20.4 ± 5 seconds (post-training) (n = 42, p < 0.0001). The Mechanical Life Support course increased mean confidence from 2.5 ± 1.2 to 4 ± 0.6 (n = 44, p < 0.0001) and mean MCQ score from 18.7 ± 3.4 to 22.8 ± 2.6, out of a maximum of 28 (n = 44, p < 0.0001). CONCLUSION: We present a simplified LVAD Advanced Life Support algorithm to aid the crucial first minutes of resuscitation where basic interventions are likely to be critical in assuring good patient outcomes.
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spelling pubmed-91629432022-06-05 Mechanical life support algorithm developed by simulation for inpatient emergency management of recipients of implantable left ventricular assist devices Akhtar, Waqas Gamble, Brigitte Kiff, Kristine Wypych-Zych, Agnieszka Raj, Binu Takata, Junko Gil, Fernando Riesgo Hurtado, Ana Rosenberg, Alex Bowles, Christopher T. Resusc Plus Simulation and Education BACKGROUND: Published guidance concerning emergency management of left ventricular assist device (LVAD) recipients is both limited and lacking in consensus which increases the risk of delayed and/or inappropriate actions. METHODS: In our specialist tertiary referral centre we developed, by iteration, a novel in-hospital resuscitation algorithm for LVAD emergencies which we validated through simulation and assessment of our multi-disciplinary team. A Mechanical Life Support course was established to provide theoretical and practical education combined with simulation to consolidate knowledge and confidence in algorithm use. We assessed these measures using confidence scoring, a key performance indicator (the time taken to restart LVAD function) and a multiple-choice question (MCQ) examination. RESULTS: The mean baseline staff confidence score in management of LVAD emergencies was 2.4 ± 1.2 out of a maximum of 5 (n = 29). After training with simulation, mean confidence score increased to 3.5 ± 0.8 (n = 13). Clinical personnel who were provided with the novel resuscitation algorithm were able to reduce time taken to restart LVAD function from a mean value of 49 ± 8.2 seconds (pre-training) to 20.4 ± 5 seconds (post-training) (n = 42, p < 0.0001). The Mechanical Life Support course increased mean confidence from 2.5 ± 1.2 to 4 ± 0.6 (n = 44, p < 0.0001) and mean MCQ score from 18.7 ± 3.4 to 22.8 ± 2.6, out of a maximum of 28 (n = 44, p < 0.0001). CONCLUSION: We present a simplified LVAD Advanced Life Support algorithm to aid the crucial first minutes of resuscitation where basic interventions are likely to be critical in assuring good patient outcomes. Elsevier 2022-05-31 /pmc/articles/PMC9162943/ /pubmed/35669526 http://dx.doi.org/10.1016/j.resplu.2022.100254 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Simulation and Education
Akhtar, Waqas
Gamble, Brigitte
Kiff, Kristine
Wypych-Zych, Agnieszka
Raj, Binu
Takata, Junko
Gil, Fernando Riesgo
Hurtado, Ana
Rosenberg, Alex
Bowles, Christopher T.
Mechanical life support algorithm developed by simulation for inpatient emergency management of recipients of implantable left ventricular assist devices
title Mechanical life support algorithm developed by simulation for inpatient emergency management of recipients of implantable left ventricular assist devices
title_full Mechanical life support algorithm developed by simulation for inpatient emergency management of recipients of implantable left ventricular assist devices
title_fullStr Mechanical life support algorithm developed by simulation for inpatient emergency management of recipients of implantable left ventricular assist devices
title_full_unstemmed Mechanical life support algorithm developed by simulation for inpatient emergency management of recipients of implantable left ventricular assist devices
title_short Mechanical life support algorithm developed by simulation for inpatient emergency management of recipients of implantable left ventricular assist devices
title_sort mechanical life support algorithm developed by simulation for inpatient emergency management of recipients of implantable left ventricular assist devices
topic Simulation and Education
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9162943/
https://www.ncbi.nlm.nih.gov/pubmed/35669526
http://dx.doi.org/10.1016/j.resplu.2022.100254
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