127Patient Management and Education
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Appendix
Reference
Guides
Alarms and
Emergencies
Patient
Management
Surgical
Implant and
Explant
Monitor
Peripherals
and
Accessories
HVAD
®
PumpOverviewIntroduction
7.2 Driveline Care*
To minimize the risk of infection, driveline exit site dressings should routinely be changed. Routine
driveline/exit site care is the responsibility of the patient and the primary caregiver. For proper
HVAD
®
Pump driveline and exit site care, please ensure the following:
1. Use good hand-washing technique before and after dressing changes.
2. Always use aseptic technique.
3. Change dressings per institutional protocol/guidelines.
4. Once the exit site dressing is removed, the driveline should be visually inspected for kinks,
tears or other damage. If blood is seen within the lumen of the driveline, the implanting
* Infection Control Guidelines and Driveline Care based on recommendations from “Multicenter
Experience: Prevention and Management of Left Ventricular Assist Device Infections”. Chinn et al.
5. In general, exit site care is performed every 24-48 hours using an antiseptic cleansing agent,
such as a diluted chlorhexidine scrub solution. Following aseptic cleansing, dry the site to
avoid tissue injury. Aseptic technique should be followed anytime the dressing is removed
and the exit site is exposed, inspected, dressed or handled. When performing exit site care,
be sure to wear a cap, mask and sterile gloves.
CAUTION:
povidone iodine (betadine), or polymyxin-neomycin-bacitracin ointment on the exit site.
These ointments can injure the tissue next to the driveline.
6. Immobilize the driveline with a dressing and stabilize it with a binder or device, such as a
foley anchor, Montgomery strap, or a custom-made percutaneous lead immobilization belt.
Keep the extra external length of the driveline under a binder or clothing.
7. Complicated, non-routine driveline dressing changes that involve exit site infections may
require assistance/supervision from a health care professional.
8. For wounds/incisions other than the driveline exit site that require dressing changes and/or
other care, the ability of the patient and caregiver to provide that care will be evaluated by
the implanting center. Treatment plans will be dependent upon this evaluation.
CAUTION: ALWAYS examine the driveline for evidence of tears, punctures or breakdown of any of the
material during exit site dressing changes. Driveline damage may affect HeartWare
™
HVAD
™
System
performance.
CAUTION:
completely covered when in the sun. Instruct patients not to use tanning lights or black lights. The light from
these sources contains ultraviolet radiation which may damage the outer sheath of the driveline.
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