Lesson 1Circuit assembly and priming setup: identifying ports, connectors, venous/arterial lines, cardioplegia line integrationThis lesson covers step-by-step circuit assembly and priming setup, including spotting ports, connectors, venous and arterial lines, and adding the cardioplegia line, with tips to avoid wrong connections, trapped air, and flow blocks during heart operations.
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 hemodilutionThis lesson discusses choosing and calculating priming solutions, covering crystalloid and colloid amounts, when to use blood prime, and ways to reduce hemodilution, including examples and adjustments for various patient types in local settings.
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 COPDThis lesson looks 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 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 integrityThis lesson describes key pre-bypass checks for the CPB circuit, such as leak tests, bubble detectors, pressure monitors, emergency stops, pump blocks, 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 cannulationThis lesson outlines 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 theatre.
Pre-bypass checklist completionConfirming roles and responsibilitiesVerbalizing cannulation strategyDiscussing anticipated complicationsDocumenting baseline status and consentsLesson 6Infection control and sterile field coordination at cannulation siteThis lesson focuses on stopping infections and managing sterile areas at the cannulation spot, including setting up sterile fields, placing equipment, controlling movement, and working with 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 partsThis lesson covers thorough checks of medicines and supplies before bypass, including blood thinners, reversal agents, pressure drugs, heart strengtheners, blood items, clot preventers, filters, and spare parts, with 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 deviceThis lesson details confirming monitoring systems before bypass, covering arterial and central venous lines, mixed venous samples, temperature probes, brain oxygen checks, and ACT devices, ensuring proper setup, alarms, and records for accuracy.
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 materialsThis lesson reviews main CPB machine parts, comparing roller and centrifugal pumps, membrane oxygenator types, reservoirs, and tubing, highlighting blood flow performance, safety, and choices for patients in resource-limited Zambian facilities.
Roller versus centrifugal pump mechanicsMembrane oxygenator structure and functionHard-shell versus soft-shell reservoirsTubing materials and biocompatibilityComponent selection for high-risk patients
