Impella

• Motor line flat, echo stat! No pulsatility means that the tip of the pump is either too far in or not far enough. Drop down to P2 then do medical support because pump is not working.
• Red and green are measured. Grey is calculated.
• Subcostal view (off-axis) is best for locating pump.
• If too deep, the machine can walk you through repositioning.
• If you need to torque the impella to rotate it, give one turn of the catheter, then while holding torque, pull it out and push it in 1 cm to release friction and allow the torque to translate to the device. You might need to disconnect it from the three point fixation to make the blue thing straight in order to make position adjustments.