Lesson 1Circuit assembly and priming setup: identifying ports, connectors, venous/arterial lines, cardioplegia line integrationDetails systematic circuit assembly and priming setup, including spotting ports, connectors, venous and arterial lines, and integrating cardioplegia lines, with tips to avoid wrong connections, air bubbles, 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 hemodilutionDiscusses choosing and calculating priming solutions, covering crystalloid and colloid amounts, blood prime limits, and ways to reduce hemodilution, including practical examples and adjustments for various patient types in local 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 COPDExplains customising prime and circuit plans based on patient details like weight, body surface area, starting hematocrit, kidney risks, and COPD, balancing blood thickness, oxygen supply, and fluid levels for better results.
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 integrityOutlines key pre-bypass checks for the CPB circuit, such as leak tests, bubble detectors, pressure monitoring, emergency stops, pump blockages, and oxygenator checks, including 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 cannulationProvides a clear guide for recording and communicating before cannulation, covering checklists, role confirmations, timeout steps, expected events, and backup plans to build team understanding and ensure 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 siteEmphasises preventing infections and maintaining sterile areas at the cannulation spot, including setup, equipment placement, movement control, and teamwork among perfusionists, surgeons, and nurses to lower contamination chances.
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 partsReviews thorough checks of medicines and supplies before bypass, such as anticoagulants, blood pressure drugs, blood items, clot preventers, filters, and spare parts, with proper labelling, storage, and double-checks.
Heparin dosing, labelling, 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 deviceCovers confirming monitoring systems before bypass, including arterial and central venous lines, mixed venous samples, temperature sensors, brain oxygen checks, and ACT tools, ensuring proper setup, alarms, and records.
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 materialsExamines main CPB machine parts, comparing roller and centrifugal pumps, membrane oxygenator styles, reservoirs, and tubing types, highlighting blood flow performance, safety, and choices for clinical use in Namibia.
Roller versus centrifugal pump mechanicsMembrane oxygenator structure and functionHard-shell versus soft-shell reservoirsTubing materials and biocompatibilityComponent selection for high-risk patients
