The medical profession is a vast field, and we often narrow it down to a few popular domains. There are usually scores of other technical and paramedical personnel we are entirely unaware about but who make up a large part of 'the team.' In short, different professionals work hand in hand to get the job done. The perfusionist is one such professional who plays a vital role during life-saving cardiac surgery.
Major cardiac surgeries require the heart to be stopped to repair them surgically. The second pair of hands is needed to keep the circulation stable and keep the heart and lungs safe until reattached and rendered functioning again. In such situations, perfusionists perform the function of stabilizing the circulation of the heart and facilitating blood oxygenation, which is otherwise performed by the lungs. Perfusionists do this with the help of a pump oxygenator (heart-lung machine). They must operate the devices in all other kinds of surgeries where the heart's function needs to be stopped. Besides the machine's operation, a perfusionist also supports the surgical staff in operating various other mechanical devices that function to conserve blood throughout the surgery. A perfusionist's job description usually varies regarding what additional support is required besides handling the heart-lung machine in a medical institute that employs them.
Similarly, their title may also vary accordingly. They might be termed a cardiovascular perfusionist, clinical perfusionist, clinical perfusion scientist, cardiac perfusionist, or just perfusionist. All of them, however, refer to the same professional. A perfusionist/s works with a Cardiac Surgeon and helps them keep the primary organs functioning while the patients undergo cardiac surgery. This artificial life support technology requires professionals to be adept in handling the equipment and understanding the extracorporeal pulmonary circulation and the in-depth knowledge on the cardiopulmonary functioning of the human body.
A surgical team usually consists of a head surgeon, an anesthesiologist, a nurse, a resident, and a perfusionist. After the patient is anesthetized, a surgeon connects the patient to the heart-lung machine by inserting a tube-like device called cannulas. The cannulas need to be inserted into the blood vessels to bypass the heart and lungs, creating an artificial operator for the heart and lungs. While the surgeon carries out the operation, the perfusionist is in charge of managing the patient's blood flow by taking over the heart's functioning and oxygenating the blood through the machine. The perfusionist is first required to administer a drug to stop the heart's natural functioning before taking over the manual control. The device draws blood from patients, adds oxygen to it, removes carbon dioxide before pumping it back into circulation. This process keeps the body alive by pumping oxygenated blood to its parts. While doing all this, a perfusionist also needs to adjust the equipment to ensure the proper blood pressure and flow during operation.
A perfusionist is required to handle the equipment and assist the functioning of the heart even before the surgery and might need to keep the devices running till after the surgery is performed, even for days or weeks until the heart becomes completely healthy.
A medical professional can become a perfusionist after completing a perfusionist certificate or a master's degree with clinical training. High school graduates looking for a career as a perfusionist can enroll in a bachelor's program, usually four years. There are different requirements for professional certification in other parts of the world. Usually, an undergraduate is required to either complete a master's level or a professional certification level. Upon completing anyone, they can undertake the national certification exam and complete a specified number of residential training before starting the practice.
Other skills besides an academic and professional degree required are communication skills as the job involves handling equipment and effective communication with the team and the patients and their families. Besides communication skills, a perfusionist is usually expected to be a team player. Without the team spirit, perfusionists or any other surgical team member cannot effectively handle the situation. One more skill required of the technicians is taking pressure. Since the functions they need to perform are usually in an agitated atmosphere, where a patient is generally hanging between life and death by a thin margin, it is of utmost importance that the perfusionists maintain their calm and handle the stress.
Perfusionists are not only limited to the insides of surgical wards. They are recognized in the field of academia as educators and researchers. Similarly, their expertise is highly regarded in the sales and marketing of perfusion equipment, and many perfusionists have been contributing to the field of medical research and development.