Pediatric and Congenital Perfusion Practice
Published by American Society of ExtraCorporeal Technology (AmSECT)
Summary
AI-generatedThe document provides an updated framework for safe and effective extracorporeal support care for pediatric and congenital patients, updated in 2024 to include new crisis management standards and modifications for better interpretation.
Key Takeaways
- 1Institutions must develop and implement an annual operating procedure (protocol) for each standard.
- 2A read-verify checklist is mandated for each cardiopulmonary bypass procedure and must be kept in the permanent medical record.
- 3Continuous monitoring of parameters like arterial blood pressure, blood flow, venous and arterial oxygen saturation, and cerebral oximetry is required.
- 4The 'n+1' staffing model shall be utilized at all times to ensure adequate staffing and patient safety.
- 5A crisis management plan must be implemented for unforeseen circumstances, and duty hours must allow for adequate rest (minimum 8 hours rest per 16-hour shift).
What's New in This Version
The 2024 update includes modifications to existing standards (and their respective guidelines) to enhance their interpretation and use, as well as updating references. In addition, the update includes a new standard that focuses on crisis management.
Key Recommendations
Development of Institutionally-based Protocols
- Standard 1.1
As a mechanism for applying each standard to clinical practice, an institution or service provider shall develop and implement an operating procedure (protocol) for each of the standards.
StandardProtocol Development
Qualification, Competency and Support Staff
- Standard 2.1
A perfusionist, who is board certified by the American Board of Cardiovascular Perfusion or who demonstrates equivalent qualifications and competency, shall conduct cardiopulmonary bypass procedures.
StandardStaffing
Checklist
- Standard 5.1
The perfusionist shall use a checklist for each cardiopulmonary bypass procedure.
StandardClinical Practice
Monitoring
- Standard 7.1
Patient arterial blood pressure shall be monitored continuously during cardiopulmonary bypass procedures.
StandardMonitoring
Staffing and On-call
- Standard 18.1
At minimum, the “n+1” staffing model shall be utilized at all times, where “n” equals the number of operating/procedure rooms in use at any given time at a single site.
StandardAdministrative/Staffing
Crisis Management
- Standard 22.1
The perfusionist shall participate in a collaborative effort to implement an actionable crisis management plan for unforeseen circumstances that may prohibit the ability to perform standard duties.
StandardAdministrative
Scope & Objectives
Clinical Topic
Pediatric and Congenital Perfusion
Objectives
To provide perfusionists with a framework to guide safe and effective extracorporeal support care to pediatric and congenital patients.
Target Patient Population
Pediatric and congenital patients receiving extracorporeal support
Target Providers
Patient Criteria & Setting
Therapeutic Area
CardiovascularGuideline Scope
Care Settings
Special Populations
Safety & Contraindications
Contraindications
- Assisted venous return
Monitoring Guidance
Requires continuous monitoring of arterial blood pressure, line pressure, arterial blood flow, gas exchange, and temperature (patient and device).
Guideline Features
Learning Context
Difficulty
advanced
Exam Relevance
Learning Paths