Clinical Perfusionist

POSITION SUMMARY:

Boston Medical Center (BMC) has an immediate opportunity for an experienced perfusionist to join our evolving and expanding cardiac surgery service. The BMC cardiac surgical caseload is diverse and challenging, serving the most vulnerable residents of greater Boston as part of New England’s largest safety-net hospital. Candidates must be ABCP certified and eligible for licensure in the state of Massachusetts at the time of employment.

BMC currently has a team of four full time perfusionists providing cardiopulmonary bypass (CPB) support for a growing surgical team. Ancillary perfusion activities include point-of-care laboratory analyses, CPB standby for TAVR and lead extractions, occasional intra-operative cell salvage coverage for the general OR and educational contributions to a variety of students and BMC staff. The perfusion team is deeply involved in the extracorporeal membrane oxygenation (ECMO) program at BMC which is a member institution of the Boston EMS eCPR program. BMC perfusionists provide educational and consultative ECMO services with occasional bedside clinical support in collaboration with a core group ECMO Specialists.

Ideal candidates will be adept in collaborating with a variety of disciplines and able to draw on all available resources to employ best practices to every facet of clinical support. The BMC perfusion team typically has a four-day weekly schedule, and call responsibilities shared evenly amongst the team. Boston Medical Center supports healthy work-life balance and the salaried compensation and benefits package is very competitive for the area. Our hospital is easily accessible and located adjacent to the Boston University Medical School campus.

Position: Clinical Perfusionist

Department: Cardiothoracic Perfusion

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

Under the direction of the Chief of Cardiothoracic Surgery and the Chief Clinical Perfusionist, the Clinical Perfusionist is responsible for conducting extracorporeal circulation and ensuring the safe management and maintenance of all physiologic functions during any medical situation where it is necessary to support or replace the patient’s cardiopulmonary and/or circulatory function.

The Clinical Perfusionist is also responsible for monitoring homeostasis during cardiopulmonary bypass; administering blood products; administering anesthetic agents and drugs through extracorporeal circuit, maintaining accurate records and following established institutional protocols and industry best-practices in accordance with hospital policy and directives from attending surgeons.

• Provides extracorporeal support to a broad patient population under the direct order of an attending cardiac surgeon. Techniques and protocols will be followed according to BMC policy and procedure guidelines, while adhering to industry best-practices and individual patient needs.

• Reviews the patient’s medical record and documents all appropriate medical and laboratory information.

• Prepares equipment and disposables for extracorporeal support according BMC policies while catering to the needs of the patient. Ensures proper selection, handling and priming of all cardiopulmonary bypass components.

• Assembles the intraoperative autologous transfusion (IAT) equipment. Understands concepts and technology of IAT and how it can be integrated with various surgical procedures.

• Oversees all aspects of the safe operation and monitoring of the heart-lung machine and ancillary technologies associated with cardiopulmonary bypass.

• Has an in depth understanding of the concepts of myocardial protection and is able to apply them during the conduct of CPB.

• Has an in depth understanding of the concepts of renal function and hemoconcentration, and is able to apply these clinically.

• Performs administration of blood products per BMC policies.

• Administers pharmacologic agents to maintain anticoagulation, electrolyte balance and renal function per orders of attending surgeons and anesthesiologist and according to BMC policies.

• Able to analyze cerebral oximetry per BMC policies.

• Oversees all aspects of the safe operation and monitoring of extra-corporeal membrane oxygenation (ECMO) equipment and disposables associated with veno-arterial (VA) and veno-venous (VV) support.

• Able to calculate appropriate extracorporeal blood flow and arterial pressure goals specific to individual patient needs.

• Able to titrate sweep and FiO2 during CPB and ECMO to achieve optimal respiratory status.

• Regulates and controls patient temperature throughout CPB and ECMO per attending surgeon orders.

• Able to interpret a variety of laboratory assays specific to CPB and ECMO management.

• Understands the relationship of heparin and protamine to ACT and other point of care coagulation analyses, and is able to calculate doses of either medication based on treatment goals.

• Maintains point of care equipment according to BMC Laboratory services policies and procedures, in conjunction with BMC biomedical engineering and laboratory services.

• Regulates fluid management based on fluid administration, target hematocrit, blood loss, pump volume, and urine output.

• Has an in depth understanding of the concepts of intra-aortic balloon counterpulsation and is able to apply them clinically. Roles of the perfusionist may include console set-up, augmentation, timing, assisting in transportation, and troubleshooting.

• Able to set up and operate LVAD, ECMO and other long term extracorporeal support equipment.

• Follows established BMC infection control and safety procedures.

• Participates in maintaining perfusion equipment in operative condition. Has a thorough operative knowledge of the equipment. Dismantles and disposes of all non-reusable equipment after surgery. Cleans and stores all durable equipment and hardware.

• Participates in scientific studies, ensuring data collection and verification as required, in accordance with BMC initiatives.

• Participates in mandatory in-service sessions according to departmental and BMC policy. Attends departmental, institutional and external meetings as an observer or educator. May present on perfusion-related topics to hospital staff and visitors.

• Supervises perfusion students during clinical rotations according to ABCP guidelines.

• Demonstrates the knowledge and skills necessary to provide save appropriate to the age groups of adult and geriatric patients regularly served. Notifies supervisor when patients outside of regular practice require support, and seeks assistance from individuals with the knowledge of the specialized needs of such patient age groups.

• Utilizes Boston Medical Center’s behavioral standards and mission statement as the basis for decision making and to support the hospital’s mission and goals.

JOB REQUIREMENTS

EDUCATION:

• Requires a minimum of a Bachelor’s degree.

• Must have graduated from, or be currently enrolled in, an accredited Perfusion Education program, and anticipating graduation prior to hire date.

• Degree requirement may be waived for applicants who were admitted to the examination process before April 15, 1981, or have been previously certified by the American Board of Cardiovascular Perfusion (ABCP).

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED :

• Certification in Cardiovascular Perfusion by the American Board of Cardiovascular Perfusion or eligible to take the examination for certification.

• Must be licensed by the board of Registration of Perfusionists in Massachusetts. Out-of-state licensed perfusionists must obtain MA license within 90 days of employment. New grads must obtain license within 18 months of employment.

• CPR/BLS (Basic Life Support) certification required.

EXPERIENCE:

• Cardiovascular Perfusionist experience in a fast-paced academic hospital is preferred.

KNOWLEDGE AND SKILLS:

• Basic knowledge of Anatomy, Physiology, Pharmacology, Chemistry, Pathology and Mathematics.

• Work requires knowledge of perfusion equipment and its operation; basic knowledge of the circuitry and operation of ventricular assist devices and of clinical physiology necessary to conduct the best possible perfusion for any given patient.

• Must have the ability to exercise appropriate judgment to respond immediately to unexpected events, especially in crisis situations when preparation time is a factor in successful treatment.

• Excellent interpersonal skills necessary to work smoothly and effectively as a member of a close functioning team; and to interact effectively with the medical staff, nursing staff and various departments throughout the hospital.

• Ability to use considerable mental and visual strain during procedures when constant attention must be paid to monitoring signals and machine function.

Equal Opportunity Employer/Disabled/Veterans

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