How to Become a Perfusionist
In operating rooms around the world dedicated surgeons perform skillful feats that save lives, but they can’t do it alone. There’s a whole team of people in the operating room, each with a critical role to play in seeing patients through an operation. One of the most important roles on this team is the perfusionist—the person who knows how to operate the machines that keep a patient alive during serious procedures such as open-heart surgery. When an operation needs to be performed that involves stoppage of a patient’s heart or lungs, something has to keep blood circulating and oxygen flowing to vital organs such as the brain, kidneys, liver and intestines. That something is one of several different kinds of heart-lung machines coupled with the person who knows how to run it.
Perfusionists interact with surgeons and other healthcare personnel to select and operate the appropriate equipment needed for surgical procedures. During the actual surgery, perfusionists carefully monitor circulatory and metabolic parameters such as blood pressure, heart rate, respiratory rate and blood gases. They also monitor blood coagulation factors and operate machines that conserve blood and blood products. Besides the operation of the machinery itself, the perfusionist also has the critical role of keeping the surgical team and anesthesiologists informed about the patient’s circulatory status. If the patient’s circulation becomes compromised during the procedure, the surgeon will direct the perfusionist to take corrective measures and administer any needed medicines or blood products through the heart-lung machine.
The perfusionist role also extends beyond the operating room to manage extracorporeal membrane oxygenation (ECMO) machines for patients in the Intensive Care Unit (ICU) whose heart and lungs are not able to function properly. They also help place and manage ventricular assist devices in patients who are preparing for or recovering from open-heart surgery. In some health care systems, perfusionists even play a role in obtaining donor organs for heart and lung transplants. Without the critical knowledge and skills of perfusionists, many vital medical procedures simply wouldn’t be possible.
Perfusionists mainly work in operating rooms in hospitals and surgical centers during heart and lung surgery, but they also work in ICUs. Their hours vary greatly as they must answer the call of surgical and medical emergencies when needed. Many perfusionists also assist in philanthropic cardiac surgery missions, such as the Heart to Heart Mission to the Dominican Republic or Perfusion Without Borders.
Perfusionists are required to complete perfusion training programs, which take a minimum of four years. Many perfusionists choose to pursue a certificate program, first completing a four-year bachelor’s degree and then applying to the perfusion certificate program. Most perfusion education programs require candidates to fulfill prerequisite courses in college-level science and math, and prefer candidates with majors in biology, chemistry, anatomy or physiology. Other programs prefer candidates to have a background in medical technology, respiratory therapy or nursing. Perfusion training programs cover topics such as heart-lung bypass for adult, pediatric and neonatal patients, heart surgery, long-term use of heart-lung machines, monitoring patients who are on heart-lung machines, and autotransfusion (transfusion of a patient’s own blood or blood products back to himself).
Perfusion schools require completion of hands-on clinical training, during which candidates must perform a certain number and variety of clinical perfusion procedures. This kind of experiential learning is critical to the preparation of perfusionists who must be able to respond to a wide variety of situations that may occur in the operating room, seeing patients through any difficulties encountered.
Licensing and/or Certification
Perfusionists have the opportunity to pursue continuing education options in order to meet certification requirements that keep their skills and knowledge up to date. In order to become a Certified Clinical Perfusionist (CCP), candidates must pass a two-part exam administered by the American Board of Cardiovascular Perfusion. The first part is called the Perfusion Basic Science Exam, while the second part is called the Clinical Applications in Perfusion Exam.
To sit for the first exam, candidates must have graduated or be enrolled in an accredited perfusion education program, and must have completed at least 75 clinical procedures. Many hospitals will provisionally employ perfusionists who have only completed the first part of the exam and still need to complete the second part, but in order to maintain employment, perfusionists must complete the second part of the exam at some point.
Candidates for the second part need to complete 50 additional perfusion procedures after graduating from school. Certification renewal occurs every three years. In order to maintain certification, perfusionists must provide proof of completion of a certain minimum number of clinical procedures, as well as complete continuing education requirements, either online or at professional conferences.
Necessary Skills and Qualities
Perfusionists are vital members of surgical and critical care teams. Their work helps keep critically ill and medically unstable patients alive. Good perfusionists know how to keep a level head during tense situations in order to focus on what must be done to keep a patient alive. Perfusionists keep themselves healthy and fit in order to have superior stamina and mental focus, staying alert during operations that could last as long as 6-8 hours or more. The best perfusionists have a naturally scientific orientation with the ability to pay very close attention to the smallest details. Excellent communication abilities in a close-knit team environment round out the skills and qualities needed in perfusionists. It is a demanding but ultimately very rewarding career in the field of medicine.
Opportunities for Advancement
Some perfusionists choose to pursue additional education or training that enables them to assume supervisory roles in medical administration while others go on to rewarding careers as perfusion educators. Some perfusionists also choose to work for medical product manufacturing companies, developing the perfusion equipment that saves lives or working in the marketing and sales divisions of those businesses.
According to the American Medical Association, entry-level perfusionists earn between $60,000 and $75,000, while perfusion managers often earn over $100,000. Perfusionists who work in supervisory or managerial roles normally earn higher salaries. Perfusionists also work with private industry and medical device companies as regular employees or consultants at high salaries.
According to the U.S. Bureau of Labor Statistics, surgical technologists are expected to experience a 19% job growth between 2010-2020, and cardiovascular technologists are expected to experience 29% job growth between 2010-2020. The U.S. Bureau of Labor Statistics does not list job growth or salary information specifically for perfusionists, but as highly skilled technical workers with additional education and training who work both in the surgical and cardiovascular fields, perfusionists are likely to experience job growth similar to that of surgical and cardiovascular technologists. Demand for perfusionists exists due to the aging U.S. population, who experience high rates of cardiovascular disease and may increase the future volume of cardiac surgeries, with a concomitant increase in the need for perfusionists. Advances in medical technology that allow patients to survive for longer periods of time, as well as new techniques in cardiothoracic surgery should also increase demand for perfusionists.