AIC states "Impella Position Unknown". Family member asks you what it means. - Answer Talk to the nurse. RN explains that it's normal because the pump has taken over for the heart.
Continue to watch and evaluate MAP.
Turn off alarm.
Transferring AIC to AIC - Answer Turn on Console B.
...
AIC states "Impella Position Unknown". Family member asks you what it means. - Answer Talk to the
nurse. RN explains that it's normal because the pump has taken over for the heart.
Continue to watch and evaluate MAP.
Turn off alarm.
Transferring AIC to AIC - Answer Turn on Console B.
Disconnect white cable from console A, plug it into console B.
Press the selector knob to accept the previous settings.
Disconnect the yellow leur locks and reconnect it.
Transfer purge cassette and purse solution to console B.
Purge Menu to change purge fluid bag and estimate remaining volume.
"Air in Line" - Answer Purge Menu
Deair purge.
Pink urine and doc asks if it could be the Impella. - Answer It's possible, however studies show when
the pump is correctly positioned and patient has appropriate volume, the incidence of hemolysis are
clinically insignificant.
Suggest sending plasma-free Hgb and UA.
Order an echo to evaluate position
"Placement Signal Lumen Blocked" - Answer *Only seen in 2.5 and CP w/o SA.
Threshold for this alarm: PP <10mmHg.
Likely clot.
Make sure pressure bag is properly inflated to 300mmHg.
, Take 20cc syringe and aspirate the red connection port.
-If it clears, flush and reattach pressure bag.
-If you can't aspirate, cap off pressure port. Disable placement signal (under Menu). **Will lose suction
alarms and PS. Monitor MC.
Fellow believes the patient has HIT. - Answer HIT is 50% drop in platelets after Heparin administration.
Can we run an ELISA or SRA to confirm?
If confirmed, contact medical officer to get appropriate alternative of Angiomax or Argatroban.
"Impella Position Wrong" - Answer PS: AO. MC: flat. Home Screen will show "Impella Position Wrong"
with a question mark.
Drop to P-2. Get an echo to determine where the catheter is (3 options):
*If you can't get the pump restarted, pull the catheter back across AoV. Treat medically PRN.
Sudden drop in flows... - Answer -probably a clot.
What was the ACT? Did you flush the sheath? Reduce to P-1, pull back across AoV. Replace pump.
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