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The Perfusion Crisis Manual

crisis doctor

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1K views3 pages

The Perfusion Crisis Manual

crisis doctor

Uploaded by

ghg sdd
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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INTERNATIONAL EDITION 1.

The
P ERFUSION
C RISIS
M ANUAL
CPB PROTOCOLS
Paul Sadleir SECTION 1 SECTION 2
Steve Same EMERCENCY PROCEDURES
David Borshoff ECMO PROTOCOLS
Before using this manual please visit
leeuwinpress.com.au/pcm-how-to-use
The Perfusion Crisis Manual (The PCM) has been developed as a cognitive aid written in
aviation checklist format to reduce cognitive load when managing time-critical events
during cardiopulmonary bypass and ECMO. It is the third crisis manual in the Leeuwin
Press series and is based on protocols developed at one of Australia's largest private
adult cardiothoracic surgery centers. The individual topics have been authored by cardiac
anesthesiologists and perfusionists with a collective experience of more than a century.
The protocols assume the availability of a second machine and were written with
reference to specific tubing packs (manufactured by Livanova and Medtronic) and
the Sorin S5 cardiopulmonary bypass machine. The ECMO protocols are based on the
Maquet Cardiohelp system. Use of this crisis manual is specific to our institution and
surgical practice so local idiosyncrasies in tubing pack configuration may require minor
protocol modification but general principles remain valid.
All protocols have been simulation tested during the development process. As with
The Anesthetic Crisis Manual (The ACM) and The Resuscitation Crisis Manual (The RCM),
we emphasise it is not a substitute for experience, clinical acumen and regular
simulation training, but hope The PCM proves to be a valuable support for those
involved in perfusion.
Paul Sadleir
Steve Same
David Borshoff

Dedicated to Dr John Peacock


He was there at the beginning and educated all.

© Leeuwin Press 2019

This publication is in copyright.


Subject to statutory exception and to the provisions of relevant collective licensing agreements,
no reproduction of any part may take place without the written permission of Leeuwin Press.

First published 2019

Library of Congress Cataloging-in-Publication Data

The Perfusion Crisis Manual / by Paul Sadleir, Steve Same and David Borshoff

Emergency Medicine--Handbooks, manuals, etc.


Surgery--Complications--Handbooks, manuals, etc.
Medical emergencies--Handbooks, manuals, etc.
615.781

ISBN 978-0-6482702-1-8 Paperback

Every effort has been made in preparing this book to provide accurate and up-to-date information which is in accord
with accepted standards and practice at the time of publication. The authors, editors and publishers can make no
warranties that the information contained herein is totally free from error, not least because clinical standards are
constantly changing through research and regulation. The authors, editors and publishers therefore disclaim all
liability for direct or consequential damages resulting from the use of material contained in this book. Readers are
strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that
they plan to use.

Designed and printed for Leeuwin Press by Graphic Source, www.graphicsource.com.au


CPB | CRISIS PROTOCOLS | SECTION 1
01 Aortic Dissection

02 Chamber Distension
HEART &
GREAT VESSELS 03 Failed Cardioplegia Arrest

04 Massive Haemorrhage re-do sternotomy

05 Persistent Left Superior Vena Cava (PLSVC)

06 Persistent VF post X-clamp removal

07 Poor Venous Return

08 Premature Electrical Activity

09 Failure to Rewarm

10 Gaseous Microemboli
MONITORED
PARAMETERS 11 High Aortic Line Pressure

12 High Processed EEG

13 Hyperkalaemia

14 Hyperlactataemia

15 Hypotension

16 Low Cerebral Oximetry

17 Malignant Hyperthermia

18 CPB | CRISIS PROTOCOLS | SECTION 2


36 CPB | EMERGENCY PROCEDURES
37 ECMO | CRISIS PROTOCOLS

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