Naomi Ghahrai Contributing Writer
The Henrico County Division of Fire, in partnership with the Weil Institute of Emergency and Critical Care Research at VCU, will host an emergency medical services event on managing left ventricular assist devices (LVADs) and total artificial heart (TAH) patients Sept. 29.
LVADs and TAHs are mechanical circulatory support devices used as treatment options for heart failure patients. LVADs are pumps implanted in a patient’s abdomen and attached to the heart in order to help pump blood from the left ventricle to the aorta — the main mechanism for carrying oxygen-rich blood to the rest of the body. TAHs fully replace the heart in cases of biventricular failure.
VCU is one of the national leaders in TAH implants, said Dr. Joseph Ornato, department chairman of emergency medicine at VCU Medical Center and medical director of the Richmond and Henrico fire departments.
“This event is a giant step in the new national standard of training, and I am excited to provide for the Richmond community,” Ornato said.
The Joint Commission, a non-profit organization accrediting and certifying healthcare programs, awarded VCU Medical Center’s VAD program its gold seal of approval in 2008.
These devices “are more common than [they] used to be,” said paramedic and EMS instructor Johnna Chandler. “You would be surprised how many people actually have them and you do not even realize it.”
The percentage of U.S. heart failure patients 75 and older with LVADs rose from three percent in 2003 to 11 percent in 2014, as reported by Mitchel Doler in The Hospitalist, a newsmagazine of the Society of Hospital Medicine.
At the event, participants will rotate through a series of stations including lectures and hands-on experience with volunteer LVAD or TAH patients.
Ornato, along with VCU Health cardiologist Dr. Mary Ann Peberdy, organized the event with the support of several VCU and Richmond health organizations.
“I would probably attend this event because it seems really interesting and I’ve never seen this type of patient in the field,” said Liz Lott, a student and Virginia Beach emergency medical technician.
According to Dr. Stephanie Louka — a clinical instructor in the VCU Department of Emergency Medicine — as of 2015, American Heart Association guidelines for cardiovascular life support did not include information on the assessment and treatment of an unconscious mechanical assist device patient. The guidelines for administering chest compressions — an essential part of CPR — were ambiguous and different hospitals and EMS systems diverged in their treatment of unresponsive mechanical assist device patients.
In 2017, the American Heart Association published a detailed, evidence-based approach for unconscious or cardiac-arresting patients with mechanical assist devices. These findings helped shape better guidelines for supporting patients with LVADs and TAHs.
“VCU remains actively engaged in being at the forefront of advanced therapies for end-stage heart failure,” said Dr. Daniel Tang, VCU Health Pauley Heart Center cardiothoracic surgeon.
The EMS education training will be held at the Henrico Training Center on East Parham Road. Only 100 certified EMS providers — with priority given to paramedics — can attend Sept. 29 from 7 a.m. to 4 p.m. Certified EMS students can register for this event at ctcce.vcu.edu.