![]() ![]() As part of the supervised visit, the patient and patient’s family are required to make a test call. Patients with a newly implanted VAD will save the VAD Emergency Line telephone number as part of their supervised visit before discharge. Implementation of this new process included patient education, which involved notifying current and new patients with VAD of the process change. If the VAD Coordinator does not receive a page because of technical reasons, the protocol is to page the VAD Coordinator twice and then page the attending physician. HVA agreed to follow an algorithm to determine next steps of patient care. VAD coordinators are paged with any call the VAD Emergency Line receives however, now the patient speaks immediately with trained personnel, who can activate 911, if the situation is appropriate, which shortens the time from minutes to seconds for patients to receive care. The profiles of our 162 patients, including their attending physician, home address, pertinent medical conditions, and local ambulance company, were loaded to the HVA database. Evaluation/OutcomeĪccording to our new protocol, patients will call the VAD Emergency Line, which is a dedicated telephone number staffed by Huron Valley Ambulance (HVA) for any emergencies and for all after-hours calls. Upon decannulation, while still receiving ventilatory support, the patient ambulated the hallways and steps and played catch with nursing staff to improve coordination and balance. While receiving V-V ECMO, the patient progressed from sitting upright to use of a recumbent bike to ambulation from bed to chair. Despite multisystem organ failure and septic shock secondary to streptococcal pneumonia, a bifurcated endotracheal tube for high-frequency percussive ventilation to one lung and conventional ventilation to the other, and a physician recommendation to withdraw treatment, the nurses persevered with rehabilitation. The clinical nurses in this medical-surgical critical care unit initiated collaboration among perfusion, respiratory therapy, and physical therapy services to devise a mobility regimen. ![]() Driving forces to consider mobilizing this patient were that he would require long-term V-V–ECMO support, ineligibility for transplant or posthospital rehabilitation, and the growing evidence that mobility could be safely achieved while receiving ECMO. Before this case study, patients receiving V-V ECMO were not mobilized. The V-V–ECMO program was initiated in this academic, Magnet hospital in 2012 and outcomes have exceeded the Extracorporeal Life Support Organization benchmarks. ![]()
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