Medic Basics

Devices

IABP Alarms Algorithm

Trigger, gas, augmentation and position

Reviewed by Alex G, BSN, RN, CEN, CCRN, CMC, NREMT-P · From the Reference tab of the app

Each step lists what to do, then the choices that lead on. In the app the algorithm is tapped through one decision at a time.

1 Which alarm?

No trigger → step 2Gas loss or blood in the tubing → step 3Low augmentation → step 4Catheter restriction or kink → step 5Pump stopped for over 20 minutes → step 6

2 No trigger

  • Check ECG leads and skin contact; choose the lead with the tallest R wave
  • Switch to the arterial pressure trigger
  • Arrest: pressure trigger during CPR; internal mode only with no cardiac activity

End of this path.

3 Gas loss or blood

  • Blood or brown flecks in the tubing: balloon rupture
  • Stop pumping, clamp, place the leg flat; notify for removal within 30 minutes
  • No blood: check connections, kinks, helium level; refill

End of this path.

4 Low augmentation

  • Hypovolemia, tachycardia over about 110, a balloon too small or partly in the sheath
  • Check timing and the augmentation alarm limit; confirm position by x-ray

End of this path.

5 Restriction

  • Straighten the leg and the catheter; HOB 30° or less
  • Check that the balloon has left the sheath
  • Persistent: notify for repositioning

End of this path.

6 Balloon idle

  • A still balloon can form clot within 30 minutes
  • Restart, or inflate and deflate by hand per the manufacturer every 5 minutes if the console has failed and there is no rupture

End of this path.

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