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 setup.
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 volumes, when to use blood prime, and ways to reduce hemodilution, including practical examples and adjustments for various patient types like adults and children.
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 COPDLooks at 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 to improve surgery 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 integrityDescribes vital pre-bypass checks for the CPB circuit, such as leak tests, bubble detector checks, pressure monitoring, emergency stops, pump block tests, and oxygenator condition, including steps to fix any issues found.
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 record-keeping and team talks before cannulation, covering checklists, role confirmations, timeout steps, expected events, and backup plans to build common understanding and ensure patient safety in the team.
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 procedures at the cannulation area, including setting up the sterile field, positioning equipment, controlling movement, and teamwork between perfusionist, surgeon, 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 partsCovers thorough checks of medicines and supplies before bypass, including anticoagulants like heparin, reversal agents, blood pressure drugs, heart support meds, blood products, clot preventers, filters, and spare parts, with proper labelling and double-checks.
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 confirming monitoring systems before bypass, such as arterial and central venous lines, mixed venous samples, temperature probes, brain oxygen monitors, and ACT testers, ensuring correct setup, 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 parts of the CPB machine, comparing roller and centrifugal pumps, types of membrane oxygenators, reservoirs, and tubing options, highlighting blood flow performance, safety aspects, and choices for different clinical needs.
Roller versus centrifugal pump mechanicsMembrane oxygenator structure and functionHard-shell versus soft-shell reservoirsTubing materials and biocompatibilityComponent selection for high-risk patients
