The Complacency Trap and Perfusionists Part 2 by Gary Grist RN CCP Emeritus
“Complacency is the lethal enemy of excellence.” Clark Gaither, MD, FAAP, Medical Director of the North Carolina Physicians Health Program. CPB CHANGES Shaken from my complacency, I realized that I could not prevent all of the complications associated with the… Read More
The Complacency Trap and Perfusionists Part 1 by Gary Grist RN CCP Emeritus
“Complacency is the lethal enemy of excellence.” Clark Gaither, MD, FAAP, Medical Director of the North Carolina Physicians Health Program. COMPLACENCY Complacency is a human failing that is very hard to quantify, but that has not stopped some from trying… Read More
PREVENTING PERFUSION INCIDENTS: A RISK REGISTER by Gary Grist RN CCP Emeritus
Playing It Safe A recent Perfusion Improvement Reporting System (PIRS) report (8/12/2021) describes the changeout of an oxygenator because it appeared to have a manufacturing defect that was only noticed once blood entered the fiber bundle of the oxygenator (1)…. Read More
A Face Full of Blood by Gary Grist RN CCP Emeritus
Pet Peeve I will use this article to address a pet peeve that I have had for over 50 years; the lack of eyewash stations at scrub sinks in ORs. How many of you have seen eyewash stations in the… Read More
THE THREE “P’s” OF PERFUSION: POLICIES, PROCESSES AND PROCEDURES AND THEIR ORGANIZATION by Gary Grist RN CCP Emeritus
I am sorry about this but the job is never done until the paperwork is done. So, this is how I organized my paper work for the Perfusion Department. It is based on a Quality Management System that I picked… Read More
A Guide to Good Practice in Clinical Perfusion by Gary Grist RN CCP Emeritus*
On May 27, 2005, there was an incident resulting in the death of a child undergoing heart surgery at the United Bristol Healthcare Trust. The Bristol hospital is a part of the British National Health Service (NHS). The death was… Read More
Cutting Blood Tubing…..Professionally! – By Gary Grist RN CCP Emeritus
One definition of a professional is a person who performs a task with “great competence.” But I have seen blood tubing cut with “great incompetence” by perfusionists over the years. You might think that I am judgmental if I accuse… Read More
Dogma of the Arterial Blood Gas
Modern blood gas analysis came into widespread use during the polio epidemic of the early 1950s to assess the respiratory status of patients and the efficiency of the new breathing support equipment, i.e., the iron lung. Smaller and faster testing… Read More
WHAT IS A NEVER EVENT?
A “never event” is an informal term for a serious reportable event (SRE) that could cause patient harm or death as defined by the National Quality Forum (NQF). The NQF is an organization working toward safety in healthcare among other… Read More
Better Brains
From the very beginning of my career I always worried about patient brain damage after cardiopulmonary bypass (CPB). Back then we called it “pump head” . “Pump lung” (now called adult respiratory distress syndrome or ARDS) was a common concern… Read More
Oxygen Or Nitrogen: Which Is The Lesser of Two Evils?
Comment on “Hyperoxia – A Review Of The Risks And Benefits In Cardiac Surgery”. Ever since it was discovered in the 1770s, the risks and benefits of oxygen have been hotly debated [1]. In the review article (Young RW…. Read More
Safe Use of Bicarbonate
Sodium bicarbonate (NaHCO3) is a medication often given during cardiopulmonary bypass (CPB) by perfusionists. I think this medication hurts patients more than most perfusionists realize. Giving a lot of NaHCO3 just to restore the bicarbonate level and keep the… Read More
Checklist Errors
Many decades ago, when I first started using checklists, I thought they were an annoyance that just slowed me down. I did not see much value in them. But as I aged I began to realize that I was not… Read More
Stress and PTSD in Perfusion and ECMO
I am fat. Not only that, but I have a lot of health problems as well; diabetes, sleep apnea, hypertension, hyperlipidemia, kidney stones; all comprising the full range of the “metabolic syndrome”. How did I get this way? The change… Read More
Working Conditions for Perfusionists
I am retired now, but when I was a chief I knew that morale was a key element in managing the perfusion staff. If morale is poor, staffers will hesitate to go the extra mile that is sometimes needed to… Read More
The Bicarbonate Lag Phenomenon in Neonates
—– Original Message —– Dear Gary- My chief of surgery indicated to me a couple of weeks ago that we have had some issues in the ICU with a couple of neonates having a significant metabolic alkalosis that persisted for… Read More
Blood and Fava Beans (glucose-6-phosphate dehydrogenase (G6PD) deficiency)
No, this is not an article about the favorite side dish of a bloodthirsty murderer (ala Hannibal Lecter of “The Silence of the Lambs” fame). It is about broad beans, blood and a rare perfusion complication. Favism, named after the… Read More
Who Really Invented the Heart/Lung Pump And ECPR?
A cult film is one that has special meaning for its viewers. “Casablanca” and “The Rocky Horror Picture Show” are two that immediately come to mind. Cult films attract a special following, the many fans having their own reasons on why they… Read More