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 in Zimbabwean 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 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 for better results in local settings.
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 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 cannulationOutlines organised record-keeping and communication before inserting cannulas, covering checklists, role confirmations, timeout steps, expected events, and backup plans to ensure everyone is on the same page for 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 managing sterile areas at the cannulation spot, including setup, equipment placement, movement control, and teamwork between 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 partsCovers thorough checks of medicines and supplies before bypass, including blood thinners, reversal agents, pressure drugs, heart supporters, blood items, clot preventers, filters, and spare parts, with proper labelling 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 deviceDetails checking monitoring systems before bypass, such as arterial and central venous lines, mixed venous samples, temperature sensors, brain oxygen monitors, and ACT machines, ensuring correct 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 materialsReviews main parts of the CPB machine, comparing roller and centrifugal pumps, membrane oxygenator designs, reservoirs, and tubing types, highlighting blood flow performance, safety, and choices for patients in high-risk situations.
Roller versus centrifugal pump mechanicsMembrane oxygenator structure and functionHard-shell versus soft-shell reservoirsTubing materials and biocompatibilityComponent selection for high-risk patients
