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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