Perfusionists operate heart-lung machines, which maintain life during periods when these organs are not functioning, such as during organ transplantation or coronary bypass surgery. This machine removes carbon dioxide and infuses oxygen into the blood of anesthetized patients during these surgeries.

Duties, Activities, and Scope of Practice

The perfusionist operates the heart-lung machine during complicated surgeries or emergencies. This machine is used for extracorporeal (outside the body) circulation to sustain life while the heart and/or lungs are not functioning.

The perfusionist also helps with the procedure by salvaging the patient's blood prior to the procedure. In response to the fear of AIDS and the shortages of blood supplies, many patients choose to donate their own blood over a period of time, ideally several weeks prior to the procedure, to minimize the need for replacement with donor blood.

Perfusionists are also trained to use other technology such as cell-savers, which use centrifugal force to remove the plasma, damaged platelets, and saline left in the heart-lung machine so that it is not returned to the body after the surgery.

They are also trained in ECMO (extracorporeal membrane oxygenation), which is a procedure used for premature infants in respiratory distress or for certain post-op heart patients, especially those awaiting organ transplants. By attaching the patient to a heart-lung machine, the physician buys time for transplant candidates awaiting an organ, for premature lungs to develop, or other healing to take place. The perfusionist must be present during this procedure to monitor the patient and operate the machine.

In other circumstances, such as other organ transplants or other surgeries where rapid infusion of lost blood is needed, or to replace low blood volume with warmed blood, a perfusionist and the heart-lung machine are utilized to help maximize healing and minimize the traumatic effects on the body.

Education and Training

In the early days of perfusion, nurses and respiratory therapists usually received on-the-job training in the procedures. Today it is a freestanding field. The Commission on Accreditation of Allied Health Education Programs (CAAHEP) accredits the formal education programs for perfusionists.

The curriculum is usually one to two years, depending on the program and/or the applicant's background. The curriculum includes anatomy and physiology, pathology, chemistry, pharmacology, and courses in the heart-lung bypass for adults as well as infants and children. It also includes study of heart surgeries and respiratory emergencies. Use and special applications of the perfusion equipment and technology and necessary aspects of long-term support of extracorporeal circulation are also covered extensively. Supervised clinical applications of perfusion are also a vital part of the education for perfusionists.

Licensure/Certification

Certification is available from the American Board of Cardiovascular Perfusion (ABCP). The candidate must meet educational and clinical experience requirements, and pass an oral and written exam. Certified perfusionists may use the title CCP (certified cardiovascular perfusionist).

Work Settings and Salaries

Perfusionists work long hours and have on-call responsibilities for emergencies. The job is highly stressful, as it involves situations of life or death and requires attention to detail, constant alertness, and making quick decisions. Perfusionists work in hospitals and medical centers, usually in large cities.

The American Society of Extra-Corporeal Technology (AmSECT) reports the starting salary for perfusionists in 2004 was $58,000 to $61,000, and for those with ten or more years of experience, salaries can range from $85,000 to $100,000 annually.

Career Potential and Additional Information

There were about 3,700 perfusionist working in 2004 according to AmSECT, and there is a shortage of perfusionists. This presents tremendous growth opportunities over the next decade.

For further information about a career as a perfusionist, contact the American Society of Extra-Corporeal Technology (AmSECT). Their Web site is www.amsect.org. Their address is 2209 Dickens Road, Richmond, VA 23230.