The following scans are from an 80 year old male who is exhibiting some stroke like symptoms per the family. He has had an LVAD for approximately 2 years and EMS attempts to get in touch with the LVAD coordinator were unsuccessful.
Troubleshooting the LVAD can be difficult without an accurate assessment of blood pressure, specifically the mean arterial pressure (MAP). We utilized our ultrasound to get a MAP reading so that we could appropriately treat the patient. The ultrasound was set up on Vascular Access and the brachial artery was found. The color flow doppler option was selected. Utilizing a second provider, a manual BP cuff is placed on the patient and inflated to a pressure of around 200 to 220. As the pressure is released off the cuff, the second provider calls out what the descending pressures are…180, 170, 150, etc. When the color flow shows up on the ultrasound screen it is assigned the correlating pressure and that number is equal to the MAP.
This is another benefit of having prehospital ultrasound available to 911 crews!
Jay Barrera
Battalion Chief of EMS Training
Licensed Paramedic | NRP
HCESD-48 Fire & EMS