CVICU - Impella 5.0:LD - Knowledge Check
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Impella 5.0/LD
Knowledge Check
1.
The heart pictogram on the Home screen provides real-time operating data for the system and displays the current placement signal waveform
a.
True
b.
False
*** The home screen provides a visual representation of the Impella catheter position and positioning message
2.
Which statement are true about the purge system function? (select all that apply)
a.
Protects the impella motor by preventing blood from entering the motor
b.
Regulates the purge flow and purge pressure
c.
Regulates only the purge pressure
d.
Regulates only the purge flow
3.
Abiomed recommends using D5W with 25U/mL of heparin as the purge fluid
a.
True
b.
False
4.
5.
6.
7.
The impella purge system delivers purge fluid to prevent blood from entering the impella device motor
a.
True
b.
False
***purge fluid flows through the monitor in the opposite direction of blood flow, keeping blood from entering the motor. This pressure barrier only works however, if
the purge pressure is always greater than systolic blood pressure. Purge pressure must always be > 300 mmHg
8.
9.
10.
When correctly positioned, the Impella 5.0 or Impella LD… (select all that apply)
a.
Pumps blood from the femoral artery to the aorta
b.
Pumps blood from the left ventricle to the aorta
c.
Reduces end diastolic volume and pressure
d.
Reduces the mean aortic pressure
11.
What is the first step you should take to address a red “Impella Position Wrong” alarm (select one)
a.
Call the abiomed clinical support center
b.
Using imaging, position the inlet area 3.5 cm below the aortic valve annulus
c.
Reduce the P-level to P-2
d.
Increase catheter flow to 5.0L/min
12.
13.
A suction alarm is active on the automated impella controller. Which of the following might be the cause of a suction alarm? (select all that apply)
a.
The catheter is lodged in the papillary muscle and blood flow to the inlet area is restricted
b.
Patient’s blood pressure is too high
c.
There is inadequate filling of the left ventricle due to right heart function
d.
There is inadequate volume status
14.
In addition to managing the impella catheter for position, caregivers must also monitor the purge system. What would you look for if the purge pressure
was low? (select all that apply)
a.
Leak in the purge cassette
b.
Loose connection at the luer
c.
Kinked purge tubing
d.
Dextrose concentration is too low
***if the purse pressure is low, the impella device purge system will not be able to deliver adequate rinsing fluid to the impella device motor. Be sure
to look for open connections or leaks in the purge system pathway, tighten any loose connections, and check the dextrose concentration of the purge
fluid. You may need to increase from 5% dextrose to 20% to increase the viscosity of the purge fluid
15.
Which of the following might be a sign of right heart failure in a patient being supported by the Impella 5.0 or Impella LD heart pump (select all that apply)
a.
Suction alarms
b.
Elevated filling pressures
c.
Reduced flow
d.
Elevated pulmonary pressure
16.
When caring for a patient with the impella 5.0 catheter placed in the femoral artery (select all that apply)
a.
Raise the head of the bed higher than a 30 degree angle
b.
Assess the vascular access site for bleeding
c.
Perform dressing changes per hospital protocol
d.
Avoid echo’s during repositioning
17.
What action is recommended when initiating CPR in a patient supported with the Impella heart pump?
a.
Fully explant the impella catheter
b.
Reduce the impella device performance to level P-2
c.
Increase the impella catheter flow rate
d.
Pull the impella catheter into the aorta
18.
Set the automated impella controller to surgical mode when (select all that apply)
a.
The impella device flow is turned off during open heart surgery
b.
The impella catheter is fully explanted
c.
The impella catheter is less across the aortic valve while cross clamped and the flow is turned off (P-0)
d.
The impella device is pulled back into the descending aorta
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