The clinical cardiovascular perfusionist (perfusionist for short) is trained and educated as a member of an open-heart, surgical team responsible for the selection, setup, and operation of a mechanical device commonly referred to as the heart-lung machine. During many types of open-heart and thoracic surgery, the patient's heart is arrested and blood is diverted away from the heart and lungs being pumped and oxygenated by the heart-lung machine. In effect, the machine does the pumping and breathing for the patient.
The perfusionist is responsible for operating the machine during surgery, monitoring the altered circulatory process closely and taking appropriate corrective action when abnormal situations arise. They're also accountable to the cardiovascular and thoracic surgeon or related physicians.
The role of the perfusionist in providing cardiovascular support has been historically outlined in broad terms, but is continually being redefined as trends in patient care and treatment are updated. The exact duties and responsibilities of a perfusionist are often dependent upon the particular institution where an individual works.
Canada has only three educational programs for the training of perfusionists. They're offered by the Michener Institute for Applied Health Sciences in Toronto; the University of Montreal; and recently the British Columbia Institute of Technology. Candidates accepted into a program have a Bachelors of Science Degree or higher or are practicing registered nurses or respiratory therapists.
The perfusionist is responsible for the operation and monitoring of those mechanical devices used in medical / surgical procedures requiring partial or complete cardiopulmonary bypass as well as other related support systems. The perfusionist requires specialized knowledge of extracorporeal physiology and mechanics (both adult and pediatric).
In addition to the application of cardiopulmonary bypass for open-heart surgery, a UHN perfusionist currently provides additional therapeutic services which include:
The perfusionist has developed the skills for all activities related to cardiopulmonary and myocardial perfusion equipment including selection, assembly, calibration, operation, sterilization and routine maintenance. They ensure quality assurance and minor repair of all related equipment, as well as its routine function and performance. They also test and evaluate new equipment for use.
The care and support of the patient in the operative and perioperative environments means regular interaction between the perfusionist and a variety of hospital staff and emergency service personnel. The continued care of the patient may involve the collaborative efforts of perfusionists with a variety of emergency service personnel outside the hospital setting.
During cardiopulmonary bypass the perfusionist has the responsibility to:
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