Perfusionists

Perfusionists operate circulation equipment during medical situations when it is necessary to temporarily and artificially replace the patient’s circulatory or respiratory functions. This occurs during heart surgery and other operations. At least 10 states license perfusionists.

The American Board of Cardiovascular Perfusion is a national certification body.

A “perfusionist” is trained to operate special equipment that temporarily takes over a patient’s respiratory and/or circulatory functions. This equipment ensures that oxygen reaches the patient’s body through the blood even when the patient’s lungs and heart are temporarily not functioning. A perfusionist is part of the surgical team for operations such as open-heart surgery.

Perfusion (extracorporeal circulation) procedures involve specialized instrumentation and advanced life-support techniques and may include a variety of related functions. During cardiopulmonary bypass, the perfusionist may administer blood products, anesthetic agents, or drugs through the extracorporeal circuit on prescription or appropriate protocol. The perfusionist is responsible for monitoring the patient’s blood gases and adequate anticoagulation, induction of hypothermia, hemodilution, and other duties, when prescribed. Final medical responsibility for extracorporeal perfusion rests with the surgeon in charge.

Accredited programs leading to a perfusionist certificate are generally one to four years in length, depending on the program design, objectives, prerequisites, and student qualifications. Programs require applicants to have a bachelor’s degree. Prerequisites vary depending on the program’s length and design; most programs require college-level science and mathematics. A background in medical technology, respiratory therapy, or nursing is suggested for some programs.

Curricula include courses covering heart-lung bypass for adult, pediatric, and infant patients undergoing heart surgery; long-term supportive extracorporeal circulation; patient monitoring; autotransfusion; and special applications of the technology. The curriculum includes clinical experience that incorporates and requires performance of an adequate number and variety of circulatory procedures.

In 1977, the American Medical Association began to recognize perfusion as an allied health profession. Texas and Oklahoma were the first states to license perfusionists, each passing legislation in 1996. Since that time, at least six other states have taken action to require the licensure of perfusionists (Arkansas, Georgia, Illinois, Massachusetts, Missouri, New Jersey, Tennessee, and Wisconsin). We will highlight two of the states below.

Massachusetts passed legislation on perfusionist licensing in 2000 (Chapter 44 of the Acts of 2000; attached). “Perfusion” is defined as “the functions necessary for the support, treatment, measurement, or supplementation of the cardiovascular, circulatory, or respiratory system or other organs or a combination of those activities and to ensure the safe management of physiologic functions by monitoring and analyzing the parameters of the systems under an order and under the supervision of a licensed physician…” (Mass. Gen. Laws, Title 112, § 211).

The act established a Board of Registration in Perfusion, with the power to adopt rules necessary to regulate the field and practice of perfusion and perfusionists. The board receives, reviews, approves or disapproves applications for licensing, and issues the licenses (§ 212).

1. successful completion of a perfusion education program approved by the board, provided that the program has educational standards no less stringent that those established by the Accreditation Committee for Perfusion Education and approved by the Commission on Accreditation of Allied Health Education Programs; and

2. passage of a written competency examination approved by the board that tests the applicant’s knowledge of basic and clinical sciences as they relate to perfusion theory and practice and other subjects the board may deem useful to determine the applicant’s fitness to act as a perfusionist. The board can use a national examination (§ 213).

The Illinois Perfusion Practice Act (attached) uses basically the same definition of perfusion as found in the Massachusetts law (§ 10 of act). The Illinois act gives the state’s director of the Department of Professional Regulation administrative responsibility for the licensure act. The director must appoint a five-member Board of Perfusion to advise him (§ 25).

1. successfully completed the examination provided by the American Board of Cardiovascular Perfusion (ABCP) or its successor agency or a substantially equivalent examination approved by the department;

2. met the requirements for certification set forth by ABCP or its successor; and

3. graduated from a school accredited by the Commission on the Accreditation of Allied Health Education Programs or a similar accrediting body approved by the department (§ 30).


January 18, 2005		2005-R-0085
PERFUSIONISTS

By: John Kasprak, Senior Attorney