Circuit Surfers

The Currents, Eddys & Riptides- of Open-Heart Surgery

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Week 2: Our Warriors: Meet our Hispanic Brothers- Jaime & Jesus

Editor’s Note: Say HELLO to Jaime & Jesus.  They work at Los Bravos Mexican Restaurant.  They came to America- found opportunity- and cook great food. Now they repay us- and they are giving us our opportunity to at least get take out food, and they are very brave and exemplary in doing it. Jesus- on…

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Are You Really Safe? Let’s Talk about the N-95 Mask

Editors Note: – I’m getting fitted for one of these on Tuesday.  Ostensibly as a prep for possible ECMO cases that might come down the pipeline. Watching a few discussions regarding this strategy and reconciling that with my previous experiences with ICU respiratory isolation cases- (H1N1) makes me realize that efficacy of this strategy is…

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Covid 19: ITALY Will Prevail !

Editor’s Note: All I can say is that I have known Giuseppe Salerno since I started this blog.  I love this man- because he is so very straight up and just a very decent human being. He cares- and that stands out in all things G (my short name for Giuseppe). We have never met-…

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Corona Virus: Surviving COMES With a Price?

Editor’s Note: I have to say that when I first started hearing about and thinking about the coronavirus, I pretty much categorized that into what I was most familiar with – which was the swine flu (H1N1). That particular epidemic I have pretty significant familiarity with, probably 250 to 300 hours of ECMO on swine…

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LivaNova: Coronavirus Update: 10-Mar-2020

Editor’s Note: Please See Product UPDATE: Plz Visit CoronaVirus.Gov–  Just want to get it out there- God Bless Frank   Click Image Above to View CoronaVirus.Gov From LivaNova: To North American Sales, Service, Marketing and Clinical Teams: Currently, the statements from yesterday’s update remain valid. Our manufacturing facilities in Saluggia and Mirandola are open and…

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CoronaVirus.Gov

Editor’s Note: Due Diligence:  Plz Visit CoronaVirus.Gov–  Just want to get it out there- God Bless Frank Click Image Above to View CoronaVirus.Gov

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Another Type of Heparin Allergy? Alpha-Gal = Meat Allergies…

Editor’s Note: I had an interesting discussion with my colleague yesterday, in regards to a heparin sensitive patient about to undergo cardiopulmonary bypass surgery. Of course I forwarded a link for clinical information/recommendations on Angiomax and Agatroban- but he informed me it wasn’t necessary as it was a different sort of allergy. This is/was not…

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Don’t Let Them Do It! Minimizing Potentially Stupid & Avoidable Mishaps…

Editor’s Note: I got a phone call from a friend of mine, a perfusion colleague… (let’s just call her JE) the other day, and it was in regards to asking me if there was any available literature or policy that was out there regarding NOT having  sterile water on your operating back table during open…

Passengers wear protective masks as theyb wait to board a train at Lo Wu Station, operated by MTR Corp., near the Lo Wu border crossing with the mainland in Hong Kong, China, on Thursday, Jan. 30, 2020. The World Health Organization called a meeting of its Emergency Committee Thursday to consider issuing a global alarm as the death toll from the spreading coronavirus rose to 170. Photographer: Ivan Abreu/Bloomberg via Getty Images

STONE Heart: Mechanisms of Injury

Editor’s Note: My colleague and I were doing case together the other day and we discussed why I typically give calcium chloride only after the heart is warm, and has been re-perfused + in normal sinus rhythm for at least 10 minutes. I mentioned the concept of stone heart, a perfusion nightmare that I have never…

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“SLOPPY” is NOT- In the Perfusion Dictionary!

Editor’s Note:   I have huge respect for the manufacturers of our ECC packs and disposables.  Most often, if a pack needs to be customized or changed- they are right on it.  However, over the past few weeks I have been working with this one disposable ECC that has been a huge disappointment in terms…

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Perfusion Policies 101: Anticoagulation Reversal

Renee Toth, BS, CCP   Editor’s Note: Renee is a colleague I work with quite often.  She is an amazing perfusionist as well as administrator, mom, and just a decent all around human being. She has a pretty scathing wit- so beware.  She offered to share a policy she has worked on for a quite…

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Management of weaning from cardiopulmonary bypass after cardiac surgery

Editor’s Note: Oddly enough, I was searching for some information regarding observed hypotensive states post CPB- associated with pump blood reinfusion, when I came upon this very cogent and well written article.  So I diverted my attention for the time being, to sharing this resource. Ill get back to the previous search later 🙂 Enjoy…

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Heater/Cooler Survey Results are In!

  Editor’s Note: Well… I started this survey back in the Fall of last year. (Click image above to view or take the survey) Since then I have been at 4 other institutions and have had the opportunity to observe how my colleagues addressed this issue.  No footprint changes regarding the relative position of the…

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Perfusion Policies 101: Gas Embolism

Editor’s Note: PERFUSION POLICIES 101 Welcome to PERFUSION POLICIES 101.  This will be a continuing series provided to assist your programs with that one puzzle piece we all run into now and then- that one time that an unexpected patient condition may give you pause… The intention here is to disseminate some basic recipes that…

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Perfusion Policies 101: Cold Agglutinins

Editor’s Note: PERFUSION POLICIES 101 Welcome to PERFUSION POLICIES 101.  This will be a continuing series provided to assist your programs with that one puzzle piece we all run into now and then- that one time that an unexpected patient condition may give you pause… The intention here is to disseminate some basic recipes that…

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IMPORTANT SAFETY NOTICE: RE; Heater Cooler Mediated Infections

Editor’s Note: I received this email from Bryan Lich, President of Perfusion.com, and I felt it was important enough to disseminate to the readership and hopefully together we can work to solve this issue.  The content of the letter is below in it’s entirety. Below is a survey to try to gather a consensus on…

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The Heater Cooler Conundrum: Has the Sky Fallen?

“If anyone has a chart or list/table that compares all of the current Heater Coolers, that would go a long way to helping institutions make informed choices as to selecting systems that have the smallest potential footprint regarding impact on laminar flow in the OR, as well as the least amount of potential pt. exposure…

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Perfusion Policies 101: Angiomax

Editor’s Note: The use of alternatives to heparin in terms of managing anicoagulation doesn’t come up often.  It’s easy to get a bit rusty when it comes to using exotic agents such as Ancrod (Hirudin), Angiomax and similar agents. So here is a brief refresher, and as always- a disclaimer here:  Use this information with…

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Desmospressin: A Primer on DDAVP

<img class="alignnone size-full wp-image-32561" src="https://i2.wp.com/perfusion.com/wp-content/uploads/2016/07/1 20 mg prednisone_circuitsurfers.jpg?resize=529%2C167″ alt=”1″ srcset=”https://i2.wp.com/perfusion.com/wp-content/uploads/2016/07/1_circuitsurfers.jpg?w=787 787w, https://i2.wp.com/perfusion.com/wp-content/uploads/2016/07/1_circuitsurfers.jpg?resize=300%2C95 300w, https://i2.wp.com/perfusion.com/wp-content/uploads/2016/07/1_circuitsurfers.jpg?resize=768%2C243 768w” sizes=”(max-width: 529px) 100vw, 529px” data-recalc-dims=”1″ /> Click on image to view source article = Desmopressin Desmopressin acetate (DDAVP) is a synthetic analog of vasopressin and like ADH, epinephrine, and insulin, releases a variety of hemostatically active substances from vascular endothelium. …

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Unexpected Air: An ECMO Discussion

Editor’s Note: I was on FB and was visiting the Malaysian Perfusion Page, monitoring a discussion regarding venous air entrainment in an ECMO circuit, and the efforts made to save the patient.  This a true emergency, and with a closed system, much more difficult to resolve. The discussion however is what captured my interest because…

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International CQI: Vaporizer Obstructing O2 Q

Editors Note: This is a new Section. We are trying to develop a database of common or not-so-common problems encountered by perfusionists during CPB. Please join us by clicking the Link Above if you have had any sort of unusual event you would like to share. Please email details if you feel that your story…

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Synchronized vs. Unsynchronized Cardioversion

Courtesy of ACLS-Algotithms.com  (Click image to view site) Editor’s Note: It’s funny how you can go an entire career doing something (CPB) and hear the same thing every day, but actually not evaluate what it means.  Yes, I have taken ACLS and studied the electrophysiology of the heart. So anyway, we have just taken off the…

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TEG vs ROTEM? A Brief Comparison AND a Survey?

Click image above to take ROTEM Survey 🙂 Editor’s Note: I was asked by a reader to do an article on thromboelastograms.  Wasn’t sure what approach to take in this regards so decided to do a brief intro and switch the focus in particular to a comparison and differentiation between the two prevalent systems, the TEG and the…

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An ECMO in OMAN: FB Discussion

Editor’s Note: I saw this discussion on the Perfusion.com Group FB page, and thought it merited a post here on ‘Surfes– to demonstrate how effective new media communication can be in real time. Please feel free to add to the discussion 🙂 Frank = Saleh Al Harthy Yesterday at 9:36am · Al Amarat, Oman –…