01. Edit your form online
Type text, add images, blackout confidential details, add comments, highlights and more.
Treatment of HeartMate II Short-to-Shield Patients With an 2026
Here's how it works
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send it via email, link, or fax. You can also download it, export it or print it out.
How to use or fill out Treatment of HeartMate II Short-to-Shield Patients With an
Ease of Setup
DocHub User Ratings on G2
Ease of Use
DocHub User Ratings on G2
- Click ‘Get Form’ to open it in the editor.
- Begin by filling out the Patient Information section. Enter the patient's last name, first name, middle initial, and date of birth in the designated fields.
- Provide the mailing address, social security number, city, state, zip code, and sex of the patient. Ensure all information is accurate for proper processing.
- In the Reason for Consultation section, select either 'Heart Failure' or 'Heart Transplant/Ventricular Assist Device' as applicable.
- Complete the Referring Physician Information section with the physician's name, contact name, phone number, NPI number, email address, and fax number.
- Finally, review all entered information for accuracy before submitting. You can easily save or print your completed form directly from our platform.
Start using our platform today to streamline your document editing and form completion process for free!
What are the restrictions for LVAD patients?
Individuals supported by CF-LVADs typically do not have a physiological pulse.
Can you do CPR on someone with a mechanical heart valve?
Patients with mechanical devices in ventricular tachycardia or ventricular fibrillation may still have a perfusing rhythm and be conscious; these patients should not receive CPR. Patients with total artificial hearts do not respond to CPR and should not receive medications or CPR.
Do patients with LVAD need anticoagulation?
Patients with left ventricular assist devices (LVADs) are at a high risk of both bleeding and thrombotic complications. Patients must be on therapeutic anticoagulation to prevent pump thrombosis, but many develop acquired von Willebrand disease from the shear stress.
Do you do compressions on a patient with an LVAD?
Generally, even if the LVAD is functional, if the patient is unresponsive with signs of impaired perfusion with MAP 50 mmHg, end tidal 20 mmHg, decreased mentation, or abnormal cardiac contractility, external chest compressions should be initiated and ACLS protocols should be followed, including the administration
What type of LVAD can exhibit a short to shield condition?
The short-to-shield (STS) phenomenon is a specific type of LVAD driveline dysfunction observed in Heartmate II patients due to damage to driveline wiring insulation that results in pump stoppage when connected to a grounded power base.
Security and compliance
At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.
People also ask
Can you do CPR on a patient with an impella?
In general, the only activity restrictions are no swimming and no contact sports. Your physician can discuss exercise goals and guidelines with you. You will also need to increase your fluid intake because the LVAD is circulating your blood at a steady rate.
Related links
by JD Pal Cited by 5 In rare occasions, a patient is maintained on an ungrounded cable to prevent short-to-shield phenomena. The incidence of abrupt pumpRead more
by L Coyle 2020 Cited by 11 Select patients with an STS can be safely supported on an ungrounded cable for several years with close monitoring.Read more