Existing recommendations for handling acute emergencies in patients supported by left ventricular assist devices (LVADs) remain sparse and often contradictory, contributing to hesitation or errors during time-critical situations. In our high-volume tertiary LVAD centre, we designed and refined a new, streamlined resuscitation protocol tailored to in-hospital LVAD crises. The protocol was tested and optimised using realistic simulation sessions with input from the full multidisciplinary team. We then launched a dedicated “Mechanical Life Support” training programme that blended didactic teaching, practical skills stations, and scenario-based simulation to build both competence and confidence. Effectiveness was evaluated through pre- and post-training confidence ratings, a critical performance measure (time required to restore pump flow), and a formal knowledge test. Before any intervention, staff rated their confidence in managing LVAD emergencies at just 2.4 ± 1.2 out of 5. After targeted simulation training, this improved to 3.5 ± 0.8. With the new protocol in place, the average time taken to re-establish LVAD flow dropped dramatically from 49 ± 8.2 seconds to 20.4 ± 5 seconds (p < 0.0001). Participants completing the full Mechanical Life Support course reported confidence rising from 2.5 ± 1.2 to 4.0 ± 0.6 (p < 0.0001), while knowledge-test scores increased from 18.7 ± 3.4 to 22.8 ± 2.6 out of 28 (p < 0.0001). This work introduces an easy-to-follow, LVAD-specific advanced life support algorithm aimed at optimising those vital first few minutes of resuscitation when rapid, basic actions can significantly improve survival and neurological outcome.
