What should EMS providers rely on when assessing a VAD patient?

In the context of assessing a patient with a Ventricular Assist Device (VAD), relying on clinical signs such as level of consciousness and capillary refill is crucial due to the unique challenges presented by these devices. VADs assist the heart in pumping blood, but they can sometimes lead to situations where traditional vital signs, like blood pressure and heart rate, are not reliable indicators of a patient's condition.

For example, many VAD patients may not have palpable pulses or may present with diminished blood pressure readings due to the nature of how the device works. Therefore, evaluating the patient's level of consciousness provides essential insight into their neurological status and overall perfusion. Capillary refill offers additional information about peripheral circulation and tissue perfusion. These clinical signs are vital for determining the patient's stability and identifying any necessary interventions.

In contrast, while heart rate variability, pulse oximetry readings, and blood pressure readings can provide some information, they might not reflect the patient's true hemodynamic status effectively in VAD patients. Monitoring clinical signs helps EMS providers prioritize assessment and intervention based on the most accurate indicators of the patient’s immediate health.