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Duties and Responsibilities of a Perfusionist Brian Schwartz, CCP September 2, 2003 Perfusion I Primary Duty of a Perfusionist Assuring the safety of the patient undergoing surgery  #1 hazard is the introduction of air  “The ultimate and primary responsibility of the cardiovascular perfusionist not to allow the oxygenating device be emptied thereby introducing air into the cardiovascular system of the patient”  Primary Duty (cont) Safety must be the overriding consideration…regardless of any other responsibilities  The perfusionist is responsible for maintaining sterility of the disposables, monitoring, and protecting the heart and lung machine from damage  Maintaining Adequate Blood Flow Must be able to calculate adequate blood flows  Must maintain blood flow throughout procedure  Must be able to adjust flow according to metabolic needs and hemodynamic changes  Maintaining Adequate Blood Pressure Must maintain and regulate blood pressure of patient according to your hospitals policy and procedures  Maintain open communication with all members of the open-heart team  Maintaining Adequate Oxygenation of Blood Must consider each case individually and choice the proper device to be used for cardiopulmonary bypass (CPB)  Must be able to adjust the device to maintain   Normal Blood Gases  Normal Base Excess  Adequate Oxygenation  Adequate Removal of Carbon Dioxide Operation of Suction Pumps and Vent System With this responsibility one needs complete communication with surgeons  Suction Pumps   Allow surgeon to have better visualization of surgical field  Vent System  Help with the evacuation of air in certain chambers of the heart  Helps to maintain the decompression of the heart Maintaining Proper Blood Temperatures Maintaining proper temperature gradients of blood  Maintaining proper temperatures of the following according to policy and procedures   Blood  Organs  Patient’s Temperature Maintaining All Relevant Information  Information should include but not limited to:  Past medical history  Drug allergies  Diagnosis  Vital signs  Results of blood gases  Important times  Must be written neatly and precisely for legal reason Proper Maintenance of all Equipment Preventative Maintenance (PM’s) helps reduce accidents  Must keep records of all PM’s  PM’s should be done every six months  Proper Standards of Practice  Standards may be:  Hospital Protocols  Surgeons  Regional Protocol or National Protocol Perfusion Services  Perfusionist must be available to provide their services to a patient  Perfusionist in-house  Perfusionist on-call  Perfusionist only 30 minutes away from hospital