Mr. S is a 68 year old man who presents to the emergency department with maroon stools and weakness for one day. He appears diffusely weak, diaphoretic, and pale. The tech is struggling to get vital signs while the nurse is working on placing two large bore IVs. After a minute the tech gives up - “I can’t get a heart rate or a blood pressure, doc.” With another quick glance at the (obviously still living) patient, you notice a battery pack at his side. This is followed quickly by the realization that the patient has a Left Ventricular Assist Device (LVAD)…

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