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What Is Your job Title?
Clinical Perfusionist.
What Does a Perfusionist Do?
A clinical Perfusionist is a trained health professional that operates the heart-lung machine during cardiac surgery and other surgeries that require cardiopulmonary bypass.
A clinical Perfusionist is a highly trained member of the cardiothoracic surgical team which consists of cardiovascular surgeons, anesthesiologists, and nurses. The Perfusionist’s main responsibility is to support the physiological and metabolic needs of the cardiac surgical patient so that the cardiac surgeon may operate on a still, un-beating heart. This is accomplished through the utilization of the heart-lung machine; as well it’s associated components of an oxygenator, filters, reservoirs and tubing. The Perfusionist is solely responsible for the circulatory and respiratory functions of the heart-lung machine. In addition, there is a spectrum of physiologic parameters that are constantly monitored by the Perfusionist that ensures that the circulatory and respiratory needs of the patient are being met and allows the cardiac surgeon to focus on the actual surgical procedure and less on the immediate needs of the patient.
In addition to this, the clinical Perfusionist works with invasive cardiologists to insert, operate and trouble shoot intra aortic balloon pumps (IABP). For this therapy, a catheter is inserted into a patient’s aorta and, with the attached console, assistance to a failing heart is given.
Other responsibilities include autologous blood collection and processing, adult and infant extracorporeal membrane oxygenation (ECMO), ventricular assist devices as a bridge to recovery or heart transplantation, as well as monitoring of anticoagulation, electrolyte, acid-base balance and blood-gas composition.
What Training Is Necessary to Do Your Work?
- Bachelor’s degree and
- Either training as a Respiratory therapist (RRT) or Registered Nurse (RN) and
- Critical care experience within the last 5 years
- Bachelor’s degree and
- Successful completion of certain math and science university courses.
Followed by a two year Advanced Diploma Program at the Michener Institute in Toronto or BCIT in Vancouver. The candidate may then write National Certification Exams.
Where Do You Work?
Perfusionists employed by Saskatchewan Health Regions work in Hospitals in Regina and Saskatoon.
Who Needs Your Services and Why?
The following patients require our services:
- Open heart/cardiovascular surgical patients having heart surgery,
- Unstable cardiology patients,
- Vascular, Orthopedic, Obstetrical, Neuro-surgical, General surgical and trauma patients that are bleeding and would benefit from autotransfusion (receiving their own blood back),
- In general whenever a patients heart and lungs need to be temporarily supported or they are bleeding heavily, a Perfusionists would be involved.
What Is Your Favourite Part of Your Job?
The application of the best evidence based care to our most challenging patients.
What Challenges Do You Have in Your Job?
Recruiting a new Perfusionist normally takes about a year. At the current staffing level, a full time Perfusionist will be on stand by for over 3000 hours/year and work over 300 hours of overtime and call back in one year. In such an environment, a Perfusionist may work well into the night and be faced with going home to sleep the next day, which risks an open heart surgery cancellation or they may work the next day tired.
What Are the Consequences When There Are Not Enough People with Your Training to Provide Service?
Cancellation of operations such as repair of an abdominal aortic aneurysm or open- heart surgery. Perfusionists working heavy hours over several days (more than 7 consecutive days) with overtime callback and standby results in a very tired staff. Errors arising from exhaustion are a threat to patient care. Perfusion is a demanding and stressful profession. Sick leave is not common among Perfusionist but when it happens it normally takes a Perfusionist away from work for weeks. Acuity is high for patients that Perfusionists work on and due to the specific services Perfusionists provide, not having a Perfusionist can impact the care of a bleeding and/or unstable patient.