Lesson 1Circuit assembly and priming setup: identifying ports, connectors, venous/arterial lines, cardioplegia line integrationExplains step-by-step circuit assembly and priming setup, including spotting ports, connectors, venous and arterial lines, and integrating the cardioplegia line, with tips to avoid wrong connections, trapped air, and flow blockages during preparation.
Mapping venous and arterial line pathsIdentifying ports, connectors, and shuntsCardioplegia line routing and safetyStrategies to prevent misconnectionsAir management during initial primingLesson 2Priming solutions selection and calculation: formulas to calculate crystalloid/colloid volumes, blood prime thresholds, strategies to limit hemodilutionCovers choosing and calculating priming solutions, including volumes of crystalloid and colloid, thresholds for blood prime, and ways to limit hemodilution, with practical examples and adjustments for various patient types in Botswana hospitals.
Estimating circuit volume and target hematocritCrystalloid versus colloid prime choicesBlood prime indications and thresholdsFormulas to limit hemodilutionWorked calculation examples by weightLesson 3Patient-specific priming considerations: adjusting prime for weight, BSA, hematocrit, renal risk, and COPDAddresses customising prime and circuit strategy based on patient factors like weight, body surface area, baseline hematocrit, kidney risks, and COPD, balancing blood thickness, oxygen supply, and fluid load to improve patient outcomes.
Adjusting prime for weight and BSATarget hematocrit by comorbidity profileRenal risk and fluid balance planningStrategies for COPD and lung protectionUltrafiltration and hemoconcentration useLesson 4Pre-bypass functional checks: leak tests, bubble detectors, pressure monitors, emergency stop, pump occlusion, oxygenator integrityDescribes key pre-bypass functional checks of the CPB circuit, including leak tests, bubble detector operation, pressure monitoring, emergency stop, pump occlusion, and oxygenator checks, with steps to fix any issues before starting.
Static and dynamic leak testingBubble detector placement and testingPressure transducer zeroing and alarmsPump occlusion and emergency stop testsOxygenator integrity and gas path checksLesson 5Documentation and team communication checklist before cannulationOutlines organised documentation and communication steps before cannulation, including checklists, role confirmation, timeout procedures, expected events, and backup plans to ensure everyone shares the same understanding and patient safety.
Pre-bypass checklist completionConfirming roles and responsibilitiesVerbalizing cannulation strategyDiscussing anticipated complicationsDocumenting baseline status and consentsLesson 6Infection control and sterile field coordination at cannulation siteFocuses on preventing infections and maintaining sterile workflow at the cannulation site, including setting up the sterile field, positioning equipment, controlling movement, and coordinating between perfusionist, surgeon, and nurses to lower contamination risks.
Sterile field layout and boundariesPerfusionist interaction with sterile teamHandling of cannulas and tubing endsManaging line contamination eventsDocumentation of infection control stepsLesson 7Medication and consumable checks: heparin, protamine, vasopressors, inotropes, blood products, antifibrinolytics, filters and oxygenator spare partsCovers thorough verification of medications and consumables before bypass, including anticoagulants, vasoactive drugs, blood products, antifibrinolytics, filters, and spare parts, with proper labelling, storage, and double-checks for safety.
Heparin dosing, labeling, and availabilityProtamine preparation and backup plansVasopressors and inotropes readinessBlood products and antifibrinolytics setupFilters, oxygenator, and key spare partsLesson 8Monitoring setup verification: arterial lines, central venous/Mixed venous monitoring, temperature probes, cerebral oximetry, ACT point-of-care deviceDetails checking monitoring systems before bypass, including arterial and central venous lines, mixed venous sampling, temperature probes, cerebral oximetry, and ACT devices, ensuring proper calibration, alarms, and records for accurate tracking.
Arterial pressure line calibrationCentral and mixed venous monitoring setupTemperature probe placement and checksCerebral oximetry positioning and baselinesACT device quality control and loggingLesson 9CPB machine components: roller pump vs centrifugal, membrane oxygenator types, reservoirs, tubing materialsReviews main CPB machine parts, comparing roller and centrifugal pumps, membrane oxygenator designs, reservoirs, and tubing materials, highlighting blood flow performance, safety features, and choices for clinical use in diverse settings.
Roller versus centrifugal pump mechanicsMembrane oxygenator structure and functionHard-shell versus soft-shell reservoirsTubing materials and biocompatibilityComponent selection for high-risk patients
