Vanderbilt Transplant Center Executive Summary

6. What happens to Caleb’s systemic cardiac output as a result of his ventricular septal defect (VSD)? Explain your answer. Caleb’s systemic cardiac output will be decreased. His blood will enter the right ventricle be pumped to the lungs, return to the left ventricle and then be shunted back to the right ventricle. This causes more blood to enter the right ventricle. The extra blood then leaving the right ventricle causes a volume overload to the lungs. Because blood is being shunted back to the right ventricle, there is a lesser volume of oxygenated blood that leaves the heart to supply the rest of the body.

A ventricular septal defect (VSD) is one of the most common congenital heart defects. During fetus development, a gap occurs in the heart’s lower wall between two ventricular chambers and allows blood to pass through from the left to the right side of the heart. The blood rich with oxygen, pumped back to the lungs instead of out to the body and cause the heart to work harder than usual.

The LifeVest is a defibrillator that is placed in a vest that patient is able to wear under his cloth. The vest helps save and individual in cardiac arrest. My patient was going to use this device because of his cardiac condition and due to his recent MI; these factors put him at a higher risk of cardiac arrest. It was amazing to watch how all the technology in the vest can save someone’s life. Watching my patient through his vest fitting and teaching was the highlight of the day. It was the first time that I

secure access to a major artery or vein. "The object in embalming is to pump

Clipboard and stethoscope in hand, I walked toward the double doors that flashed emergency in bright red letters above. It was my first clinical shift as an EMT student, and first day jitters flittered around in my stomach, I had no idea what to expect. However, I was not expecting to witness the fragility of life. About a half an hour into my shift the rapid response alarm blared through the emergency room. I turned to my preceptor and quizzically asked what this meant. “A rapid response is a patient who is in need of immediate medical care and intervention. As an EMT who is part of the rapid response team you will be expected to assist with vitals and chest compressions. Let’s head toward the recess room, and I’ll explain more there.” Eventually, we reached the recess room, and the rapid response team was already there preparing for the arrival of the patient. A nurse was on the phone with the firefighters that were bringing the patient in. Seconds later she announced “It’s a STEMI”. Then fright ran through my veins. A STEMI is medical jargon for a segment elevation on an EKG. In other words the patient’s coronary artery is completely occluded. The patient is suffering from a heart attack. Prior to this, I had never seen someone who was having a heart attack. However, the thing that terrified me the most was that I knew I would be expected to perform chest compressions. I had only ever performed chest compressions on a dummy.

In this process a particular patient is selected and then the information is gathered about the treatment, care or services the patient has received at the hospital. This is done through interviewing, questionnaires and scrutiny of documents related to the patient (Uselton, Kienle, Murdaugh & Coe, 2010).

I was able to check the patient in a systemic order and to make her feel comfortable around me allowing openness and honesty about medical conditions. I responded to the patient in a professional way as to not make her feel uncomfortable and to represent myself as a professional. The patient felt very comfortable with me during the interview, I had asked her upon completion if I was professional and if she felt comfortable. She said that I was very gentle in examining her and that she was very comfortable speaking to me. During the examination there were moment when the patient and I had light conversation, as I did not want the experience to feel cold and calculated. She showed me picture of her family and the books that she loves to

Invasive Cardiovascular Technicians are an integral part of the healthcare setting. The discipline takes many years of learning and dedication to do well. It also requires individuals who are competent, skillful, knowledgeable, and open to saving the lives of others. Invasive Cardiovascular Technicians are knowledgeable in anatomy, physiology, pathology, cardiovascular pharmacology, basic and advanced electrocardiography and electrophysiology, physics, hemodynamics, and radiology (). They are also skilled in IV administration, diagnostic cardiac catheterizations, Advanced Cardiac Life Support, angioplasty, stents, and vital sign monitoring (). The purpose of a Cardiovascular Technicians is to assist the cardiologist with data formation and collection and to aid in interventional and diagnostic procedures. Cardiovascular Technicians are trained and responsible to treat patients who go into cardiac arrest or who experience other complications. And under a physician, an invasive cardiovascular technician is also responsible for administering cardiovascular medications to patients.

A large ventricular septal defect (VSD) is a hole in the wall between your heart’s main pumping chambers.

The patient requests a more intensive service or test that is deemed to be medically necessary by the provider.

Among the indications for Ventricular Assist Device the presence of decompensated or life-threatening end-stage cardiac disease, for patients with severe circulatory compromise, and when hypo-perfusion, cardiogenic shock, failure to wean off cardiopulmonary bypass after surgery. Also, as destination therapy for patients that are not good candidates for a heart transplant; or inability to wean off from cardiopulmonary bypass after surgery.

It is important to follow instructions from your health care provider about caring for your ventricular assist device (VAD) at home (destination therapy). You will continue to work with a health care provider who specializes in VADs (VAD coordinator) and a heart specialist (cardiologist).

I was introduced to N.J. when I started in Transplant Administration. There was something about her. I believed it was knowledge. And knowledge is powerful. She knew so much about the rules and regulations about United Network for Organ Sharing and The Centers for Medicare and Medicaid (CMS). And, when she spoke, everyone listened. I wanted to be that person. Even the physicians stopped what they were doing and listened. The physicians and surgeons can do all the mouthing they want, but as soon as she speaks rules and regulations, they quiet down. I have observed a physician asking for one of the CMS policies so that he can interpret it himself. And when she sent it out, it was over 200 pages. No amount of surgeon or physicians can argue or

An Automated External Defibrillator (AED) is a tool that saves lives on a constant basis. This device is used to send an electrical charge to stabilize the heart into pumping normally. This device is normally found in EMT kits, hospitals, many public buildings. The AED is an easy tool to use that provides instructions on how effectively use one without damaging the patient.

The Valsalva maneuver, it is the attempt to exhale with the nostril (nose) and mouth, or the glottis (vocal cords), closed (Ant23; Ant23). It may seem simple, but it is in no way trivial. The Valsalva maneuver consists, and is made up of way more complicated ideas and claims. The Valsalva maneuver can be a cheap easy way to cure SVT and high heart rate. When you close your nostrils mouth and vocal cords and just press down exerting energy and a breath it basically tells the heart not take any more blood since it can’t hold anymore. In more fancy terms it decreases the preload. As the blood goes to the heart it stretches by itself as the preload get higher it increases the efficiency of the heart and the individuals breathing increases, just