ANESTHESIA AND PERFUSION ASSISTANT

The Primary Purpose of this job is to provide assistance to the Anesthesia and Perfusion Services departments by performing various tasks involving the setting up of the cardiac OR suites with necessary supplies, setting up pressure monitoring lines and pressure monitoring line trays, providing assistance to Anesthesia personnel as needed, providing assistance to Perfusionists as needed and by stocking the mini-core with Perfusion supplies, assisting with preparing cell savers for QC, pacemaker battery changes, and assisting with preventive maintenance of heater-cooler machines. Responsibilities

GENERAL DUTIES: A) Direct Patient Care Perfusion Duties Intra-Operative Autotransfusion Blood Therapy Devices: Determine the appropriate centrifuge bowl size for the procedure Correctly set-up the disposables onto the machine Determine and prepare the appropriate anti-coagulant Review the patient chart for necessary and relevant patient information Determine if there are contra-indications to autotransfusion from the patient chart information Using the devices, correctly process the collected blood Correctly label the processed blood Correctly complete the patient Auto-Transfusion Record Perform periodic quality control testing on the cell washer machines Enter the appropriate patient charges for Auto-Transfusion procedure Ensure that the order for “Auto-Transfusion” is entered in the chart Anesthesia Duties Cardiac rooms : Don PPE and perform sterile set up for all line insertions Assist anesthesia provider with insertion of introducers and catheters ensuring appropriate supplies, fluids, solutions and local medications are available and ready for use. Ensure all monitoring equipment is assembled, prepared and in good working order for hemodynamic monitoring Assist with securing and dressing invasive catheters as needed Establish and maintain par levels for all anesthesia supplies utilized in the CVOR’s; work with purchasing and sales representatives for supply procurement. Coordinate regular maintenance for all anesthesia equipment with clinical engineering. Participate / facilitate room turnover procedures ensuring efficient, effective and safe patient care. Assist the CVOR team with delivery and procurement of labs and blood products as directed. Ultrasound equipment : Assemble probe cover, gel and printing capability for line placement. Assemble and assist with their usage as directed by the ACT. Video laryngoscopy equipment . Assemble and assist with usage as directed by the ACT. Fiber optic equipment . Assemble and assist with usage as directed by the ACT. Difficult airway patients : Procure, maintain, assemble, and assist with equipment and supplies, including fiber optic, jet ventilation, video, specialty tubes, laser tubes, micro endotracheal tube (ETT), endotracheal tube exchangers/intubating stylets and laryngeal mask airway (LMA’s) as directed by the anesthesia care team. Massive transfusion : Assemble and assist with usage as directed by the anesthesia care team all equipment for massive transfusion. Includes assembly of the appropriate disposable cassette, filter system and proper infusion tubing for a rapid transfuser. Assemble general blood administration tubing. Emergency situations arising in any location the OR or in the hospital at large (e.g. ER, patient rooms):

All anesthesia technicians are BLS certified and are expected to assist with chest compressions if requested as well as assist with their other duties. Other duties include securing TEE capability, ultrasound, emergency line placement, emergency intubations and/or difficult airway, MH resuscitation, lab draws, blood administration and any other duties as directed by the ACT. Computer system , network issues both with hard wire connections and cabling are first addressed by anesthesia technicians and then directed to clinical engineering. Bedside assistance:

Assist a member of the ACT and CVOR teams in providing patient care including but not limited to the moving of the patient, IV and pressure lines, ventilation tubing, infusion pumps and oxygen circuits. They may assist an ACT member by opening sterile supplies or trays. Patient transport:

Assist the ACT and CVOR teams in transportation of patients that requires the transportation of emergency equipment or ongoing resuscitation. This is often an extension of care involving emergency situations. Assist with assembly of anesthesia equipment in the new location while the patient remains under anesthesia. B) TEAM SUPPORT Perfusion Care Team Ensure adequate stocking levels are maintained in the pump room, cardiac mini-core, and the perfusion carts. On a scheduled basis, check sterility outdates of all Perfusion-related disposables Maintain the Perfusion Supply shelves in the storeroom in a neat andorderly fashion Put away new stock unto the shelves Maintain adequate supply levels in all Perfusion areas Inform Director of low inventory levels Assist in running POCT as requested in the OR Perform “medium- and high-complexity” test analysis on POC devices Perform periodic quality competencies on all POCT devices Maintain POCT supplies Perform monthly QC testing on POCT devices Assist in performing preventive maintenance, QC testing, data gathering/entry on all manner of perfusion-related equipment PM of Heater/Cooler Devices on a bi-weekly basis Setting up Cell Savers with supplies needed for QC Change Batteries in Perfusion Pacemakers on a monthly scheduledbasis Go to CVICU daily to retrieve Perfusion-related equipment such as IABPs, pacemakers, Impella pumps. Take extra IABPs to the Cath Lab Assist in preparing Perfusion supplies for upcoming cases Building pump packs in order to set up a pump Setting up case the room by plugging in the pump and getting drug carts in the room for bypass. Connecting heater cooler to the pump and booting the system Prepares the Cell saver for use prior to surgical case. Prime Heart-lung machines so they are ready for cardiac surgery. Is able to build and operate IABPs within the cardiac OR. Perioperative Blood Management Technician Knows how to run all POC devices including: Hemochron, Hemochron, TEG, and IStat in the cardiac and other ORs. Is able to QC and run validation level support for all the above devices. Can troubleshoot should the need arise for any of the above devices. Works in concert with the lab to obtain and QC all disposable items, i.e. cuvettes and QC materials Is able to chart and decipher critical lab data from the results of the above tests. Runs Cell Salvage cases independently Sets up a case from start to finish Can adequately spin and return autologous blood to patients Knows indications and contraindications to autologous blood usage Knows how to troubleshoot cell salvage devices Knows how to chart and record all autologous returned blood Runs platelet gel cases independently Sets up a case from start to finish Knows how to run all platelet gel equipment to give platelet gel back to patients. Can troubleshoot a platelet gel device Can chart and record for the platelet gel procedure. Anesthesia Care Team All mechanical, pneumatic and electronic equipment used in the anesthesia department also undergoes general inspection, maintenance, operating, servicing, scheduled cleaning, assembling, calibrating, testing and trouble shooting in the event of performance issues. This includes (but is not limited to) the anesthesia gas machine, anesthesia cart, MH cart, fiber optic equipment, specialty anesthesia storage areas in OR’s A, B, 3, 4, and 24. specialty cardiovascular line placement carts in OR’s A, B, 3 and 4, 3D echocardiography (TEE) machines, ultrasound machines, all infusion pumps (fluid, blood, or medication) that are maintained by the Anesthesia Department and video laryngoscopy equipment maintained by the Anesthesia Department. Readily available to set-up anesthesia in a remote location( including but not limited to High dose radiation, CT, Cancer Center, Pain Practice Center and the Heart Station). Power down the equipment in the initial location, move and restore the system in the remote location. Includes relocation of anesthesia cart, supplies and additional monitoring as needed. Also includes computer system (Epic) network set-ups. Prepare equipment and supplies used daily in the Anesthesia Department. 2. COMMUNICATION Discuss any contra-indications to Autotransfusion with the surgeon and discuss possible alternatives Inform Director of requests for new items In collaboration with the CV Clinical coordinator, serves as the primary resource for collaborating with purchasing, clinical engineering, sales representatives regarding cardiac anesthesia equipment and supplies Shares pertinent patient information. Open communication regarding anesthesia needs between all team members and ancillary departments and/or other areas. Reports observations/data to appropriate team members (R.N., AAC, and/or surgeon). Daily documentation of activities assigned 3.

LEADERSHIP Demonstrate leadership skills such as the ability to motivate, educate, and mentor peers. Acts rapidly and calmly during emergencies, and provides the necessary items called for by appropriate O.R. team. Cooperation is demonstrated in the performance of other duties within scope of job description; unit meetings are attended when on duty; attends required in-services and education programs as assigned. Adheres to established standards in personal appearance and conduct. Dress code is followed. Conduct is consistent with the ExCEL core values. Attendance is prompt and regular. Follows chain of command. Special projects as requested by Perfusion Director and Anesthesia Director or a member of the ACT 4.

PRODUCTIVITY Requisition supplies as needed. Continuing education on the care, maintenance and proper usage of equipment. Organization of all materials and supplies used within the department. Hospital wide sweeps, quarterly and as needed, for wayward anesthesia equipment. Maintains orderliness and efficiency of the work environment Display flexibility, accepting change in assignments Understand fiscal responsibility by utilizing time, equipment, and supplies appropriately. 5.

SAFETY Document and report any equipment maintenance or failure issues to the appropriate personnel and ensure failures are corrected. Adhere to principles and techniques of biohazards, infection control and standard precautions. This includes cleanliness, sanitation, high level disinfection and sterility measures of supplies and equipment as indicated. Storage use and safe handling of bulk, cylinder and pipeline gases. Adhere to the principles of fire, radiation and electrical safety. Stocks supplies in storage areas according to standards. Infection Control: Safety hazardous are corrected and/or reported to the appropriate person; location of all fire alarms, extinguishers and hoses are known. Spills and hazardous spills are handled according to hospital policy. Returns to unit promptly in case of patient emergency, fire, or disaster and reports to person in charge. Understands sterile technique. Qualifications

KNOWLEDGE AND SKILLS: Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not personalize the job description, credentials, or knowledge and skills based on the current associate. List any special education required for this position. EDUCATION: High School diploma or GED required. Certified blood Management course completion required after starting the position. REQUIRED SKILLS AND KNOWLEDGE: Basic understanding of human anatomy and physiology, sterile technique, computer use, inventory management, mechanical aptitude. Ability to function independently in stressful situations. Completion of formal training program in Autologous Blood Transfusion therapy. Knowledge of regulatory, legislative and Joint Commission standards related to Anesthesia, surgery, and infection control. Knowledge of care and maintenance of technical equipment. Excellent communication skills and organizational ability. Ability to mechanically trouble shoot equipment problems. YEARS OF EXPERIENCE: 3 years of experience in the Operating Room environment. 1 year of CVOR experience. REQUIRED:

PREFERRED:

BLS certification

Anesthesia Technician Certification (ASATT)

CPBMT Certification required within 3 years of taking position.

National Registry of Autologous Blood Therapists (NRABT)