Certain critically ill patients will have additional life-sustaining equipment attached. This equipment poses unique considerations when offloading. In addition to extra tubes/wires to watch, these devices have a short “leash” and must remain close to the patient.

Extreme caution should be taken to ensure that these devices do not become dislodged from the patient as that could lead to rapid complications and death.

Additional loading/offloading help is required when moving a patient on one of these devices.

Intra-Aortic Balloon Pump (IABP):

An intra-aortic balloon pump (IABP) is a mechanical device used to support the heart in patients with severe cardiac conditions. It consists of a balloon attached to a catheter that is inserted into the aorta. The balloon inflates and deflates in sync with the heartbeat to help increase blood flow to the coronary arteries and reduce the heart's workload. It's commonly used in cases of cardiogenic shock, after a heart attack, or during high-risk cardiac procedures.

Impella:

An Impella is a small, catheter-based mechanical heart pump used to support patients with severe heart failure or during high-risk cardiac procedures. Inserted through a large artery and positioned inside the left ventricle, it helps the heart pump blood to the rest of the body by actively drawing blood out of the ventricle and into the aorta. This reduces the heart's workload and improves circulation, providing short-term support for the heart to recover or during interventions.

ECMO (Extracorporeal Membrane Oxygenation):

ECMO is an advanced life support system used for patients with severe heart or lung failure. It works by temporarily taking over the function of the heart and/or lungs: blood is pumped outside the body to a machine that removes carbon dioxide, adds oxygen, and then returns the blood to the patient. ECMO provides critical support when conventional treatments are not enough, giving the heart and lungs time to heal.