The document discusses ventricular assist devices (VADs) which are mechanical pumps that help the failing heart pump blood. The most common is the left ventricular assist device (LVAD) which takes blood from the left ventricle and pumps it to the body. An LVAD has internal and external components including a pump, driveline, controller, and batteries. LVADs are used to bridge patients to transplant, rest the heart after procedures, or as destination therapy for those not eligible for transplant. Key assessments and considerations for patients with an LVAD include listening for pump sounds, checking device alarms, treating low blood pressure/shock based on skin signs rather than readings, and transporting to the closest VAD center if possible