Advances in left ventricular assist device (LVAD) therapy have resulted in increasing numbers of adult LVAD recipients in the community. However, device failure, stroke, bleeding, LVAD thrombosis and systemic infection can be life-threatening emergencies. Currently, four LVAD systems are implanted in six UK transplant centres, each of which provides device-specific information to local emergency services. This has resulted in inconsistent availability and content of information with the risks of delayed or inappropriate decision-making. In order to improve patient safety, a consortium of UK healthcare professionals with expertise in LVADs developed universally applicable prehospital emergency algorithms. Guidance was framed as closely as possible on the standard ABCDE approach to the assessment of critically ill patients.
- clinical assessment
- first responders
- prehospital care
- clinical management
- left ventricular assist device
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Contributors CTB chaired the consortium and is guarantor of the manuscript’s content. RH, NW, PL, SK, LM and JD and MF provided audit data. CTB, BR, JB, CB, MM, AR, IMG, CG, NRB, SS, AS and DP contributed to algorithm development. TB, DG, PC, JP, PK made contributions during the meetings. All authors contributed to the development of the manuscript and approved the final version.
Competing interests RH and AS have had remunerated consultancy agreements with Medtronic which provided funding for this initiative.
Provenance and peer review Not commissioned; externally peer reviewed.