PERFUSION COURSE DETAILS
Enrolments are no longer being taken into this course, all students who would like to study perfusion should visit Swinburne University's Website
The information below describes the OLD perfusion course this is NO LONGER being offered.
This Diploma of Perfusion Course has been specially designed for the basic training of Cardiac Perfusionists in Australasia.
It is not intended to provide full training in the sub-specialties, such as paediatric perfusion, ECMO, etc. The Course will provide theory and practical experience suitable to fulfil the requirements of the Australasian Board of Cardiovascular Perfusion, for candidates to sit the examination for Australasian Diploma of Perfusion.
The Course modules should be completed in two years and be conducted by the cardiac unit employing the candidate. It is essential that the candidate receive full support from the cardiac team, in terms of theoretical and practical teaching. Only teaching hospitals or ABCP accredited hospitals will be recognised by the ABCP as suitable training centres.
PREREQUISITES
Candidates will be accepted into the Course providing they fulfil the ABCP's minimum academic requirements, (existing at time of writing but reviewed each year) as follows:
- A Bachelors Degree in Science or Applied Science conferred by an Australian or New Zealand University or Technical Institute.
- For candidates with overseas qualifications . Their qualifications should be assessed by the Australian Education International National Organization of Overseas Skills Recognition (AEI)-NOOSR or NZ equivalent .
- Employment as a full-time Trainee Clinical Perfusionist in a cardiothoracic surgery department in a recognised teaching or other hospital duly recognised by the Australasian Board of Cardiovascular Perfusion for the purpose of the Course.
- Agreement from the Practitioner in Charge of Perfusion at the candidate's employing institution to undertake supervision and arrange lectures and tutorials specified in the course for the candidate.
- Payment of application and Course fees.
All practical and theoretical training will take place in the candidate's own hospital but should be supplemented by visits to other units.
CONTENT
The perfusion modules and their general objectives are set out in the following pages. Each module has its overall numbered objectives and a decimal number indicates the breakdown of these into specific objectives.
The topics are in a particular sequence but they do not limit the trainee's objectives, and may be done in any order. There may be overlap and the candidates should read the entire module before starting.
The general objectives give the teaching goals, and the specific objective gives the means by which trainees demonstrate their attainment of them. (Note that tuition will not be provided and it is up to the institution (Medical/Technical Staff) to provide theoretical and practical training while the ABCP provides only objectives and references.)
OBJECTIVES
Many of the objectives will require a minimum period of service or a minimum number of procedures. They will be indicated by a time period or number of procedures in brackets.
Assessment will be carried out by the Practitioner in Charge of Perfusion and other nominated staff, during the training period.
On completion of all the individual objectives of a topic, an examination will be given.
The examinations will be set by the ABCP and marked by both the ABCP and the Supervisor once administered by the candidate's Supervisor. On successful completion of all Module exams within the manual, a trainee will have covered the theoretical and practical skills of a Perfusionist and be prepared to sit the final certification exams for the Diploma of Perfusion.
The manual and completed log must be received by the ABCP by 1st May of the final year. Once the completion of the manual has been confirmed by the ABCP, approval will be given to the candidate to sit the Diploma of Perfusion examination.
The manual will be returned to the candidate.
PERFUSION MODULES
- Anatomy. *
- Pathology.*
- Physiology.*
- Pharmacology.*
- Physics and chemistry.
- Biomedical electronics.
- Instrumentation and measurement .
- Introduction to perfusion technology.*
- Details of perfusion techniques.*
- Perfusion equipment.*
- Clinical application of bypass techniques.
- Support of cardiac operating theatre procedures.
- Occupational aspects of perfusion / Management / Quality control.
- Log of perfusion cases.
The modules marked with a * indicate the modules which require the most study time.
ANATOMY
- Heart
- Blood vessels
- Lungs
- Kidneys
- Nervous system
- Congenital lesions
PATHOLOGY
- Blood vessels (atheroscierosis, medial necrosis)
- Heart (aneurysmal changes, valvular lesions)
- Blood (results of exposure to foreign surfaces)
- Lungs (ARDS)
- Kidney (ischaemia, acute tubular necrosis)
- Nervous system (results of embolism, ischaemia)
PHYSIOLOGY
- Basic review of cardiovascular, respiratory, renal, fluid and electrolyte, blood and immunological systems
- Detailed coverage of:
* Blood * Blood Flow *Blood gases and acid base balance *Oxygen and Carbon Dioxide Transport * Electrolytes * Hypothermia * Cardiac haemodynamics, including congenital abnormalities * Basic ECG patterns * Microcirculation * Physiology and pathophysiology of coagulation * Physiology of hemodilution * Plasma proteins
PHARMACOLOGY
- Basic facts and pharmacological
actions of drugs used in the cardiac operating room during
perfusion:
* Inotropes * Vasoactive agents * Anti-arrhythmic agents * Diuretics * Steroids * Antibiotics * Anaesthetic agents * Cardioplegia * Muscle relaxants * Beta blockers * Calcium antagonists * Anticoagulants * Antiplatelet drugs * Anti-hypertensives
- Detailed review of drugs and
fluids commonly added to the pump/oxygenator by the perfusionist
and/or anaesthetist
* Mannitol * Sodium bicarbonate * Cardioplegic solutions * Potassium, magnesium, and calcium ions * Heparin * Blood and blood products * Crystalloid and colloid solutions * Vasoactive drugs * Anaesthetic vapour agents
BASIC PHYSICS AND CHEMISTRY
- Gas laws, solubility of gases
- Volume, pressure, flow.
- Mass, density, viscosity.
- Heat units, temperature scales, heat transfer
- Diffusion/osmosis
- Molarity, concentrations
- S.I. units
BIOMEDICAL ELECTRONICS
- Principles of electrical safety
- Principles of recording biological signals
- Principles of cardiac pacing and defibrillation
INSTRUMENTATION AND MEASUREMENT
- Know the various methods and
instruments for measuring the following parameters:
* Temperature * Cardiac output * Gas flow/concentrations * Physiological pressures * ECG * EEG * End-expired CO2 * Blood gases * Oxygen saturation * Electrolytes *Haemaoglobin/Haematocrit * Activated coagulation - Know methods to test equipment for accuracy.
- General information on artifact and distortion of physiological parameters, and how they can be avoided.
- Quality controls
INTRODUCTION TO PERFUSION TECHNOLOGY
- History and principles of operation of oxygenators
- Design and efficiency of heat exchangers, oxygenators, roller pumps
- Biocompatibility of equipment and techniques, comparing damage to the blood and implications for organ function
- Sterilisation techniques of equipment
- Technical aspects of ultraflitration
DETAILS OF PERFUSION TECHNIQUES
- Adult perfusion
- Paediatric perfusion
- Assessment of patient (via history) before bypass
- Assessment of patient post bypass
- Calculation of prime components
- Selection of cannulae
- Assembly of equipment
- Priming of oxygenator
- Going on and coming off bypass
- Monitoring and control of:
* Flow/pressure * Hemodilution * Acid/base balance * Oxygen and carbon dioxide exchange * Patient core temperature * Anticoagulation * Hypothermia * Pressure, flow, resistance * Adequacy of perfusion * Myocardial preservation
- Calculation of:
| * Oxygen Content |
| * Oxygen Consumption |
| * Systemic vascular resistance |
| * Pulmonary vascular resistance |
- Management of complications and disasters
- Autotransfusion
- Recording of bypass data
- Check lists
- Safety of perfusion
- Power and equipment failures
- Preventative maintenance
PERFUSION EQUIPMENT
- Hardware:
* Heart-lung machines/centrifugal pumps * Pressure and low level alarm devices * Heart-lung heater/coolers * Mechanical/electronic flowmeters, blenders * Computerised perfusion data systems * In-line oxygen saturation devices * In-line blood gas devices * Oxygen analysers * Cell savers * lntra-aortic balloon pumps - Disposable:
* Membrane and bubble oxygenators * Reservoirs * Arterial filters * Prebypass filters * Arterial, venous cannulae * Hemoconcentrator devices * Cardioplegia sets, filters, cannulae
CLINICAL APPLICATION OF BYPASS TECHNIQUES
- General bypass
- Coronary
- Valvular
- Re-Operations
- Congenital
- Ventricular assist
- Transplant
- Isolated limb perfusion
- ECMO
- Total body washout
SUPPORT OF CARDIAC OPERATING THEATRE PROCEDURES
- Monitoring
* Setup for ECG and intravascular pressure monitoring * Coronary artery and graft flow measurement
- Resuscitation and support
* Catheterisation * Angiography * Angioplasty * EPS Studies * Valvuloplasty * lntra-aortic balloon - Sterilization within the hospital
- Administrative aspects of perfusion
OCCUPATIONAL ASPECTS OF PERFUSION
- Infectious diseases
- Precautions
- Stress/fatigue
- Philosophy of ending life by termination of bypass
- Perfusionist and the law
- Professional standards and modes of conduct
- Bioethics
MANAGEMENT/QUALITY CONTROL
- Quality control
- Quality assurance
- Management
LOG OF PERFUSION CASES
- Adult
- Paediatric