Perfusionist II

Perfusionist

At Stanford Health Care, our Perfusionists play a crucial role in some of the most advanced surgical procedures globally. They operate the heart-lung machine, support vital functions, and ensure stability during life-saving operations. Their responsibilities extend beyond technical skills; they are trusted clinical partners to surgeons and anesthesiologists, managing oxygenation, administering medications, and making critical decisions in high-pressure situations. Whether running ECMO for critically ill patients or supporting advanced VAD technology, our Perfusionists exemplify Stanford's standard of excellence.

What distinguishes Stanford is our commitment to professional growth and support. We offer a four-tiered career ladder that recognizes clinical skills, leadership, and certification, providing a clear path from trainee to team lead. Initially, you will work 10-hour shifts, transitioning to 12-hour shifts with a rotating on-call schedule, all supported by a collaborative and expert team. With access to cutting-edge equipment and a strong culture of mentorship, this is a place where your skills are valued, your development is prioritized, and your work truly saves lives.

The Perfusionist is responsible for operating extracorporeal circulation equipment during any medical situation where it is necessary to support or temporarily replace the patient's circulatory or respiratory function. All actions of the Perfusionist are performed as prescribed by an attending physician and in accordance with SHC policy. Perfusionists perform all routine and advanced clinical and non-clinical functions as described in Perfusion Service Protocols, Policies and Guidelines and in conformance with the Scope of Practice outlined in the California Perfusion Titling Act (Business & Professions Code 2590) as well as the Ethical Standards of the American Board of Cardiovascular Perfusion (ABCP) Under the direction of and in consultation with a physician(s), Perfusionists set up and operate the heart-lung machine and other sophisticated equipment used in the operating room, such as physiological monitoring instrumentation, and related ancillary equipment, which keeps the patient alive while a surgeon is operating on them by supporting their circulatory and respiratory functions. The Perfusionist manages the patient's altered physiological functions throughout the procedure.

In addition, Perfusionists, directed by the surgeon and anesthesiologist, are responsible for regulating the patient's levels of oxygen and carbon dioxide; for measuring selected laboratory values such as blood cell count; and for monitoring circulation. At times, Perfusionists administer blood products, anesthetic or other pharmaceutical agents through the cardiopulmonary bypass circuit on prescription and/or appropriate protocol. The Perfusionist is responsible for the monitoring of blood gases and the adequate anticoagulation of the patient, induction of hypothermia, hemodilution, and other duties, when prescribed. The Perfusionist is knowledgeable concerning the variety of equipment available to perform extracorporeal circulation functions and provides consultation to the physician in the selection of the appropriate equipment and techniques to be used.

The Perfusionist career ladder consists of four levels plus a lead based on management assessment of staffing needs. The distinction between levels is based on certification by the American Board of Cardiovascular Perfusion (ABCP), the degree of supervision exercised over the position, and the assignment of advanced/lead responsibilities.

LEVEL I: This is the entry, trainee, and contributing level. Under close supervision, incumbents assist a higher-level Perfusionist in the performance of clinical duties. Incumbents are expected to obtain active ABCP certification as a CCP within two (2) years of appointment or be terminated from employment.

LEVEL II: This is the career level where incumbents function at the full performance level. Under general supervision, incumbents perform the full range of clinical perfusion duties.

LEVEL III: This is the advanced, specialist and lead level. Incumbents at this level perform as a consultant to and may be designated lead-worker for other Perfusionists. Under general supervision, incumbents perform the full range of clinical perfusion duties and, in addition: assign and lead the work of other Perfusionists, including trainees; may assist in the recruitment and selection of Perfusionists; develop and implement training in-service programs; participate in equipment evaluation and procurement; maintain records pertaining to equipment use and maintenance; and may participate in research programs. Able to perform duties as shift contact Perfusionist

LEVEL IV: Team Lead or team supervisor for each shift. Able to Perform and mentor most complex cases. Grows and mentors' staff on all aspects of Perfusion Services, ECMO and VAD management and perfusion therapy.

Demonstrates competency in operating the various types of perfusion equipment available at Stanford that includes but not limited to: Heart/Lung Machines: Roller blood pumps: Sorin, Jostra Centrifugal blood pumps: BioMedicus Bard CPS System Variety of Oxygenators Temperature Regulation Devices - Heater/Coolers: Intra-Aortic Balloon Pumps: Datascope, Bard, Arrow Ventricular Assist Devices: BioMedicus Autotransfusion Machines: Heamonetics, Medtronic Blood Saturation Monitors: Blood Gas analyzers: I-stat Coagulation Monitors: Hemochron, Hemotec Hemodynamic Pressure Transducers Hemoconcentrators: Cardioplegia delivery systems: Sorin, Medtronic Accessory Equipment: Blenders, Vaporizers, Sat/Hct monitors, Bubble and level detectors. Knowledge requirements to the above equipment; to also include trouble-shooting skills. Demonstrates a comprehensive knowledge of all policies and procedures concerning clinical perfusion. Provide special perfusion services as described under the guidelines found in the established manual of clinical protocols and procedures of SHC and/or through direct order of the physician. Identify the needs of the patient regarding types of equipment, priming solution, and methodology in consultation with the surgeon and anesthesiologist. Communicate accurate information to the surgeon and the anesthesiologist pertaining to the patient response to the extracorporeal procedure. Provide adequate "Conduct of Perfusion" for each patient undergoing cardiac surgery utilizing the heart-lung machine in accordance with established surgeon and SHC protocols. Provides safe performance, monitoring and/or management of perfusion that includes but are not limited to: Extracorporeal circulation/ cardiopulmonary support Counterpulsation equipment set-up and operation Circulatory Support with Ventricular Assist Devices Extracorporeal membrane oxygenation Autotransfusion and Blood conservation techniques Myocardial preservation Anticoagulation and Hematologic monitoring/analysis Physiologic monitoring/analysis Blood gas and blood chemistry monitoring /analysis Techniques of Hyperthermia and Hypothermia Techniques of Hemodilution Techniques of Profound Hypothermia and Circulatory Arrest Techniques of Retrograde and Antegrade Cerebral Perfusion Administration of medication, blood components and anesthetic agents via the extracorporeal circuit Techniques of Veno/Venous bypass Techniques of Vacuum Assisted Venous Drainage (VAVD) and Kinetic Assisted Venous Drainage (KAVD) Maintains aseptic technique in assembling and operating perfusion equipment. Follows manufacture operating instructions for equipment and disposables. Utilize safety devices when available on equipment. Assists in the transport of VAD or high-risk patients to Stanford Hospital. Works in a variety of clinical settings where patients require perfusion services e.g. ICU's, Cath lab and operating rooms. Records and maintains all data pertinent to extracorporeal procedures to ensure that an adequate record of the procedure is developed. Correctly documents patient care and charges utilizing Stanford Hospital and Clinics approved documents. Performs other related and incidental duties as needed or assigned. Additional Responsibilities Level III Perfusionists May perform such functions as are consistent with the Level Descriptor narrative, including at least one approved annual project related to supplies and cost savings, education of staff, metrics to improve patient care, protocol development, or department process improvement. Level IV Perfusionists May assume responsibility for the clinical management of the department during an assigned shift. DEPARTMENTAL QUALITY ASSURANCE AND IMPROVEMENT RESPONSIBILITIES Completes in a timely manner, hospital required regulatory modules and training requirements. Provides necessary documents to maintain current "personnel file". (i.e. ABCP certificate, TB test, CPR certificate, continuing education) Provides all documentation as required by Hospital. Assist in data collection, data base maintenance and analysis of all Perfusion data related to research, cost analysis, and clinical outcome studies. Manages and monitors the provision of quality, cost-effective patient care in accordance with standards of practice and SHC policies and procedures. Record and maintain all data pertinent to Perfusion Services management Participate in team effort at cost containment of disposable supplies and drugs. Perform required inspection of equipment and supplies stored in other areas of hospital. Implements and evaluates systems and practices which facilitate smooth workflow and desired outcomes. Solicits input from Department of Anesthesia, Department of Cardiovascular Surgery, managers, and staff. Recommends changes and enhancements to the Perfusion Department Manager. Works with Perfusion Director to develop, maintain, and evaluate a comprehensive continuous quality improvement program that complies with Operation Room Region Services and the hospital at large. Proactively uses problem solving process to identify, prevent, or resolve clinical or departmental related problems, utilizing the chain of command, as necessary. Assist in administration and department operation, including all follow-up documentation and reporting, and reports events to Perfusion Director. Responsible for self-assessment of skill level and seeking resources to learn new skills or clinical knowledge to maintain currency in position. Apprises self and complies with the policies and procedures of Stanford Hospital and Clinics. Continuously assesses and improves personal performance based on "customer" needs; participates in improving performance and services which benefit staff, patients, and other customers Participate in the education of Hospital staff, Nursing staff, and associate Perfusionist as