Clinical Perfusionist

Take, where appropriate, delegated responsibility for the delivery of a highly specialist perfusion service, ensuring the service is effective and wellcoordinated. Offer and undertake a range of highly specialised perfusion techniques during routine and emergency cardiopulmonary bypass. Assess the patients relevant medical history, pathology and diagnosis and make appropriate decisions concerning conduct of the procedure. Advise clinicians on the suitability of equipment and persuade clinicians on appropriate course of action.

Set up, prime and run the cardiopulmonary bypass machine to maintain life support for the period of cardiopulmonary bypass according to broad occupational and clinical policies as well as recent scientific evidence seeking advice when necessary. Undertake, analyse, interpret and correct arterial/venous blood gases and patient coagulation status. Administer drugs including colloid/crystalloid fluids, vasoactive drugs, cardioplegia solution, potassium, anticoagulants, haemostatic drugs, sodium bicarbonate and osmotic diuretics as clinically indicated. Monitor a wide range of highly complex and routinely conflicting clinical information on a minute-to-minute basis such as the blood oximetry, cardiac output, systemic vascular resistance, ventilation and anticoagulation whilst monitoring renal status and blood glucose and take appropriate autonomous action.

Manipulate on a second-to-second basis the patients cardiovascular system whilst on cardiopulmonary bypass. Determine requirement for, and perform where clinically indicated, haemofiltration and blood transfusion during cardiopulmonary bypass. Set up and manage, where appropriate; antegrade/retrograde cerebral perfusion; deep hypothermic circulatory arrest; mechanical support devices; extracorporeal membrane oxygenation; and extracorporeal carbon dioxide removal. Ensure quality control, calibration and maintenance of expensive complex medical equipment in Clinical Perfusion and their safe use in compliance with Near-Patient Testing Policies.

Participate in the running of an intra-aortic balloon counter-pulsation service across the Trust, ensuring availability of skilled clinical perfusion staff to support less-experienced staff in surgery, cardiology, and intensive care. Understand and interpret imaging for example chest x-ray and transoesophageal echo especially in conjunction with the use of intra-aortic counterpulsation*. Participate fully in Clinical Perfusions 24hr on-call cover. Fully employ VISION data acquisition and ensure patient record is complete.

Review VISION data to audit own practice in terms of blood usage; patient physiological indicators and pharmacology. Contribute to collective practice audit and lead on specific required topics*. For further details please see attached JD&PS.