IABP

Question 1

The diastolic dip represents?

Answer 1

Afterload reduction.

Question 2

Which pressure is augmented by the IABP inflation?

Answer 2

left ventricular end-diastolic.

Question 3

Identify the following image

Answer 3

Early deflation

Question 4

Identify the following waveform

Answer 4

Early inflation late deflation

Question 5

During IABP transport, you notice the patient’s transition from normal sinus rhythm to atrial fibrillation at a rate of 110. You can expect the IABP to:

Answer 5

The standard IABP console has the functionality to time irregular cardiac rhythms such as A-fib. The IABP will recognize this while in an Auto Mode. It switches to “Auto R Wave Deflation” on its own. However, if it fails to recognize and change, the flight crew can activate this by moving the deflation timing to the late deflation side.

Question 6

The IABP is displaying a “Gas Loss” alarm. Your immediate actions should include:

Answer 6

Check for rust color blood ( structure balloon) and verify HOB is not elevated greater than 30 degrees to prevent balloon kinking.

Question 7

If your patient goes into cardiac arrest which triggers should you switch to?

Answer 7

Pressure trigger.

Question 8

A sharp V at the dicrotic notch for inflation and a sharp V at the end of diastole before the next contraction. T/F

Answer 8

True

Question 9

I identify the following IABP waveform.
What are the effects of early inflation?

Answer 9

Round V at the dicrotic notch point is not aligned with the unassisted dicrotic notch on both sides. The V is higher on the chart.

Increases afterload and o2 consumption.

Question 10

In IABP the balloon _________ during asystole and __________during diastole
Which activity increases blood flow to the coronary arteries?

Answer 10

deflates in asystole and inflated in diastole

Diastole.

Question 11

IABP _________ afterload during the __________phase

Answer 11

decreases afterload during the diastolic phase.

Question 12

Where is the insertion site for the IABP balloon?

Answer 12

right or left femoral artery site.

Question 13

The IABP inflates on what part of the EKG?

Answer 13

The T wave.

Question 14

The IABP deflated on what part of the EKG?

Answer 14

R wave of the QRS.

Question 15

Look at this waveform and explain what is happening.

Answer 15

C indicated unassisted systolic pressure. Diastolic augmentation
E assisted diastolic pressure and reduced systolic pressure. F and E are below the unassisted line where it reduced pressure as seen in the assisted form. This is the ultimate goal.

Question 16

Name four indications for IABP.

Answer 16

Cardiac failure after a cardiac surgical procedure.
Mitral regurgitation
complication of an MI
Failed PTCA Percutaneous transluminal coronary angioplasty

Question 17

Stroke volume has three components?

Answer 17

Preload afterload and contractility

Question 18

What are the 5 contraindications for IABP?

Answer 18

Severe aorta insufficiency
Aortic aneurysm
Aortic dissection
Limb ischemia
Thromboembolism

Question 19

A helium leak from the IABP can cause an air embolism. T/F

Answer 19

True

Question 20

Name 5 transport considerations for the IABP.

Answer 20

Balloon size
The patient history
Circulation assessment (pulses) in all extremities
Urine output 0.5-1ml/kg/hr
Is the patient balloon dependent can he be placed on standby if needed?

Question 21

The IABP balloon sits in the second intercostal space _________cm below the subclavian artery T/F

Answer 21

1-2 cm below the subclavian artery True

Question 22

The IABP balloon sits ________ the renal arteries in the _________ cavity

Answer 22

above the renal arteries in the abdominal cavities.

Question 23

The IABP deflates after aortic valve closure. T/F

Answer 23

The IABP immediately inflates after aortic valve closure to augment diastolic coronary perfusion pressure.

Question 24

IABP deflation occurs during the hearts___________? When the balloon deflates it causes a ________ effect pulling blood into the space of the balloon.

Answer 24

The balloon rapidly deflates during the heart’s contraction ( systole) to reduce the left ventricular work.

Question 25

1:1 timing is considered Full therapy. Fully augmented T/F

Answer 25

T

Question 26

The diastolic dip should be _____to______mmhg lower than the unassisted diastole.

Answer 26

5-10 mmHg lower than the unassisted diastolic.

Question 27

The augmented diastolic peek pressure should be _____to______Mmhg higher than the unassisted diastolic pressure

Answer 27

10-20 Mmhg higher the unassisted diastolic pressure

Question 28

What waveform inflated after the dicrotic notch? Dangerous or sub-optimal?

Answer 28

Late inflation you should see an exposed dicrotic notch. ( sub-optimal) dicrotic notch looks like a W

Question 29

Inflation of the IABP prior to the dicrotic notch?

Answer 29

early inflation

Question 30

What waveform has a shart drop after augmentation? Is this dangerous or sub-optimal?

Answer 30

Early deflation. (sub-optimal) bar stool is dampened

Question 31

What is the worst timing error? Dangerous for your patient?
What are the characteristics?
Is assisted pressure higher or lower than assisted?

Answer 31

Late deflation. Yes dangerous for your patient.
prolong jump slop then a V.
Assisted pressure is higher than un assisted because it is pushing against the balloon.

Question 32

If the EKG trigger is not functioning name three things we can do to troubleshoot.

Answer 32

Check patient leads.
Check the lead source, go from lead 1 to lead II.
Switch to A-line source. to pressure

Question 33

Helium Autofill failure troubleshoot?

Answer 33

Check for low helium, then balloon then check for flakes in the pressure line.

Question 34

Balloon failure troubleshoot?

Answer 34

auto-fill every 5 min with 10 mls less than the original balloon size.

Question 35

your 50ml balloon has failed how often should you inflate the balloon and with how many MLs?

Answer 35

every 5 min with 10mls less than the original balloon size. so 40 Mls. to remove blood clots. no timing is required just every 5 min.

Question 36

Which timing is the worse for your patient? WHY?

Answer 36

Late deflation because the balloon stays inflated as the heart is contracting.