Medic Basics

Devices

Impella Alarms Algorithm

Suction, position, purge and stopped pump

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?

Suction → step 2Position in ventricle or in aorta → step 3Purge pressure low → step 4Purge pressure high or blocked → step 5Impella stopped → step 6

2 Suction: a filling problem

  • Lower the P-level
  • Check volume status and RV function (CVP, echo)
  • Check position by echo

End of this path.

3 Malposition

  • Placement signal ventricular, motor current flat: pump too deep
  • Placement signal aortic, motor current flat: pump in the aorta
  • Reduce to P-2; the provider repositions under imaging

End of this path.

4 Purge pressure low

  • Look for leaks and loose connections
  • Purge dextrose too dilute: use a higher concentration
  • Replace the cassette if needed

End of this path.

5 Purge pressure high

  • Look for kinks in the purge tubing
  • Dextrose too concentrated: switch to D5W
  • Watch motor current

End of this path.

6 Pump stopped

  • Try to restart
  • If it will not restart, the provider pulls the pump back into the aorta

End of this path.

Drugs in this algorithm

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