My Broken Heart.

Audience: The target audience for the key learning objectives of this Left-Ventricular Assist Device (LVAD) simulation are emergency medicine residents. Other team members such as attendings, nurses, pharmacists, and technicians could potentially be integrated. Introduction: Left ventricular assist devices (LVADs) are common bridge therapy for patients suffering from severe heart failure to cardiac transplant or destination therapy for non-transplant candidates.1 Emergency medicine physicians must be prepared for a variety of device complications that may result in an acute care presentation, such as drive-line infections, suction events, arrhythmias, and cardiac arrest with device failure. In a review investigating ED presentations for patients with LVADs, device-specific complaints were among the fewest, with the most common presentations involving bleeding, infection, and arrythmias.2 The present case involves a suction event that is precipitated by a gastrointestinal (GI) bleed, which has an incidence of 30% for LVAD patients.3 This case was developed for a technology failure-themed resident simulation competition during the Western Society for Academic Emergency Medicine (SEAM) conference held on April 1, 2022. Educational Objectives: By the end of this simulation session, learners will be able to: 1) assess the hemodynamics of an LVAD patient by using a Doppler to determine mean arterial pressure, 2) Manage an arrhythmia in an LVAD patient with a suction event by addressing preload, 3) Identify and treat the source of hypovolemia (a massive lower gastrointestinal hemorrhage), 4) Perform clear closed-loop communication with other team members. Educational Methods: This high-fidelity simulation case aims to train emergency medicine residents on recognition and management of an LVAD suction event, a rare but serious presentation encountered in the emergency department. This simulation can be successfully implemented either Research Methods: A working group of two simulation-trained faculty, a simulation fellow, and three senior emergency medicine residents chose and developed the simulation case. Two simulation-trained faculty implemented the pilot case series to gather feedback on performance against the critical action checklist. One simulation-trained faculty then facilitated two additional Results: During March 2022, in a three-case pilot Discussion: Overall, this simulation was well received, effective, and easy to implement and translate to immersive, Topics: