Cardiac surgery, by its very nature, requires that the surgeon work on an still heart. To do this, it is necessary to temporarily replace the patient’s respiratory and circulatory functions.
The perfusionist is the specialized healthcare professional that is responsible for assuming the function of the heart and/or the lungs while the surgeon is performing these medical procedures.
In short, a perfusionist operates a heart-lung machine. This is an artificial blood pump which moves oxygenated blood to the patient’s body tissues while the surgeon operates on the non-beating heart.
It is the perfusionist’s responsibility to manage the metabolic and physiological demands of the patient during the procedure. The perfusionist is also responsible for delivering the drug that stops the heart.
Perfusionists are responsible for preparation of the heart-lung machine and any other equipment critical to the specific operation.
The perfusionist must verify the functionality of the equipment. When the patient is connected to the machine, the perfusionist will continuously monitor the patient’s status to manage the rate of blood circulation, balance the hemodynamics, maintain body temperature, stabilize blood composition and oversee other monitoring devices.
The primary surgeon will work with the anesthesiology team to direct any use of pharmacological interventions or blood transfusions-- both of which are carried out by the perfusionist.
It is imperative that the perfusionist remain in close communication with the surgical team to keep them informed of the patient’s condition throughout the surgery.
All of these health care professionals working together must focus on the patient’s needs to ensure a successful outcome.
The perfusionist will be responsible for measuring various blood parameters and other indicators to identify appropriate mechanical intervention techniques, appropriate pharmacological treatments, and precise thermal manipulation techniques needed to maintain a viable physiological condition in the patient.
The perfusionist must have a thorough knowledge of the equipment available to perform extracorporeal circulation function.
A perfusionist is expected to consult with the surgeon to help in selecting the appropriate equipment and techniques to be utilized during surgery.
In order to successfully perform his or her duties, the perfusionist must have a complete understanding of both the circulatory and respiratory systems, as well as be able to operate highly sensitive and complex medical equipment.
They need a ton of skills, some of those are the following:
Must give full attention to what surgeons and other people on your team say to you since you work in a highly critical environment.
Must be able to effectively convey info to those on your team to have positive outcomes.
Must use logic and reasoning to determine the best solutions and approaches to certain problems.
Must be able to monitor your patients and determine their status and make corrective action if necessary.
Make sure all the machinery you manage is working properly.
Judgment and Decision Making
Must be able to make decisions and have autonomy in the choices you make. Use logic and skill to judge the best course of action for your patient.
Complex Problem Solving
Must be able to solve complex problems to enable positive outcomes and implement solutions.
For about 90 percent of the time, the perfusionist will be found in the OR suite where cardiac cases are performed. They may also find their duties expanded to include extending their expertise into the cardiovascular intensive care unit (CIVICU) and cardiac catheterization laboratory.
The perfusionist works as a part of the surgical team. He or she is expected to be current with the patient’s health status and medical history. Prior to the surgery beginning, the perfusionist and the surgeon will collaborate to determine which circulation equipment and which techniques will best serve the patient.
Perfusionists most often find employment in medical centers or third-party perfusion companies. Perfusionists will typically work a scheduled 40-hour week but this may include some nights, weekends and holidays of on-call duty.
On-call responsibilities can be lax or rigorous, depending on the program for which the perfusionist works. In busier facilities that perform a large number of open heart surgical procedures, a team of perfusionists may work shifts to ensure that a trained perfusionist is available at all times.
If not working in a clinical setting, a perfusionist can teach in certification programs, assist with research or work for perfusion equipment manufacturers.
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