Perfusionist / Perfusion.. Wondering what it is?? A trained healthcare professional who work as part of a surgical team. Perfusionist also known as a Clinical Perfusionist or a Cardiovascular Perfusionist operates the heart-lung machine during cardiac surgery and other surgeries that require cardiopulmonary bypass. In some circles, they are known as Certified Clinical Perfusionist or CCP. The name Perfusionist is derived from the word 'perfusion' which means to pump a liquid into an organ or tissue. Meaning of the word itself enlighten the nature of the job performed by Perfusionists. Some surgical procedures cannot be performed while the heart is beating, in such cases heart's functions have to be taken over by external machinery. Here comes the role of a Perfusionist to operate the heart lung machine. A heart-lung machine is used to keep the patient’s blood flowing until the heart can be restarted. During open heart surgery, patients heart is stopped and blood is diverted away from the heart and lungs into the heart-lung machine which oxygenates the blood and returns it to the patient. The heart-lung machine ensures that the breathing and circulation of the patient is adequately maintained during the process of surgery, and performs the functions of the heart by circulating oxygenated blood throughout the patient's body.In India, Cardiovascular perfusion is done by people with varying qualification and experience. Earlier the perfusionist's job was done by assistant surgeons, then later by theatre assistants but with the advancement of Oxygenators in the heart lung machine, trained hands became a necessity for the continuous monitoring and maintenance of desired Oxygen and carbon dioxide levels. It is only since the last two decades that there has been specialised training in the field as well as a demand for trained or qualified perfusionists. Perfusionists are vital members of surgical and critical care teams which consists of cardiac surgeons, anesthesiologists, physician assistants, surgical technologists and nurses. A Perfusionist continuously monitor the equipment to control the speed of blood circulation, the patient’s temperature, monitor the levels of oxygen and other gases in the blood, coagulation (blood clotting) status, the composition of the blood, adding blood products and medications when ordered by the surgeon. They keep the surgical team informed of the patient's condition throughout the surgery. Perfusionists role also extends beyond the operating room to manage extra corporeal membrane oxygenation (ECMO) machines for patients in the Intensive Care Unit (ICU) whose heart and lungs are not able to function properly. In addition to these critical responsibilities in the operating theater, Perfusionists also evaluates and selects new equipment, orders supplies, and oversees technical support staff. Eligibility Educational There are B.Sc, M.Sc and P.G diploma courses available in perfusion. Minimum requirement for a Bachelor course in Perfusion technology is Physics, Chemistry, Botany and Zoology or Mathematics and Biology as subjects in Plus-Two. If one has a background in health related fields like medical technology, respiratory therapy, or nursing, they can go for masters or post graduate courses in perfusion. For M.Sc. Perfusion Technology, eligibility is B.Sc. with Biology or B.Sc. in Perfusion Technology from a recognized university. Although not mandatory, most of the countries require perfusionists to be licensed, as well. In India, Board of Cardiovascular Perfusion India (BCP- I) certifies Perfusionists and gives accreditation to perfusion schools and courses. The board conducts exam for certification annually for degree/ diploma / certificate holders of Perfusion technology who has done at least 50 pumps a year minimum. Those who pass will be certified for a period of five years with annual review. Perfusion training programs cover topics such as heart-lung bypass for adult, pediatric and neonatal patients; heart surgery long-term use of heart-lung machines; monitoring patients who are on heart-lung machines; and autotransfusion (transfusion of a patient’s own blood or blood products back to himself). Personal skills Aspiring perfusionists should possess exceptional communication skills and be able to focus for hours at a time. Perfusionists must be able to follow complex instructions, work effectively during stressful situations, and be detail-oriented. You should have a sense of responsibility, good decision-making skills, and should be able to work well in a team as you work with several other medical professionals. Perfusionists must be healthy and fit in order to have superior stamina and mental focus, staying alert during operations. Job Prospects This career has a wide scope in ever expanding health care services and with growth of multi speciality hospitals. Increase in heart related illness and Cardiac surgeries has resulted in job openings in this field. It is a demanding but eventually very rewarding career in the field of medicine. Perfusionists mainly work in operating rooms in hospitals and surgical centers during heart and lung surgery, they also work in ICUs. The perfusionist keeps the surgical team informed of the patient’s condition throughout the surgery. One of the main roles performed by Perfusionist is to operate the heart-lung machine that keep a patient alive during serious procedures such as open-heart surgery. Perfusionists are also key personnel in placing and managing patients on ventricular assist devices as a bridge to recovery or heart transplantation and supporting patients receiving lung or liver transplants. Their work hours vary as they must answer the call of surgical and medical emergencies when needed. In this sense, a career as a perfusionist means committing to be available at all times.Perfusionists work in several different environments, but they are usually employed by hospitals. They typically work during the week and are frequently on call for emergency procedures on weekends and nights. Individual surgeons and companies that supply facilities with perfusion services employ them in various roles. With advanced education, perfusionists can go in for teaching, conduct research, and work for perfusion equipment suppliers as sales and marketing executives for perfusion products. Those with experience in the field can even enter management field- these Perfusionists who manage departments oversee budgets, equipment purchases, hiring and staff scheduling. Remuneration The salary of a Perfusionist varies depending on certain factors like education and training, expertise, geographic location, employer and experience. Salary in this field is the best compared to other areas of medical assistants or Operating Theater assistants. A Perfusionist with one year experience having B.Sc and certification in perfusion technology, will get pay ranging between Rs. 10,000-12,000 per month. Moreover, perfusionists working in East & North India earn a higher salary structure than those employed in South India. After gaining experience of 4 to 5 years one can earn upto Rs. 25,000 per month. Institutes Many medical institutes and hospitals like Christian Medical College Vellore, Apollo Hospital Institute Chennai , Ramachandra Medical College Chennai, Nizams Institute of Medical Sciences, Shree Chitra Tirunal Institute for Medical Sciences & Technology etc offer PG diploma in Perfusion technology. Frontier Lifeline Hospital offers a B.Sc. degree in Perfusion Technology for students who take Physics, Chemistry, Botany and Zoology or Mathematics and Biology as subjects in Plus-Two. You can do M.Sc. Perfusion Technology at AIIMS, for which the eligibility is B.Sc. with Biology or B.Sc. in Perfusion Technology from a recognized university with at least 60% marks. Indian Association of Cardio-Vascular and Thoracic Surgeons offer a Diploma in Perfusion Technology.