China
Africa
Explore chapters and articles related to this topic
Professional regulation
Published in Robert Jones, Fiona Jenkins, Managing and Leading in the Allied Health Professions, 2021
Over the next few years the register will grow considerably since its legislation does not restrict the number of professions it may regulate. There are many groups that have expressed an interest in being regulated by HPC, for example: Applied psychologists.Dance movement therapists.Medical illustrators.Clinical perfusionists.Clinical physiologists.Clinical technologists.Healthcare scientists.Sonographers.Sports therapists.Sports rehabilitation therapists.Psychotherapists.
Instrumentation and Operating Theater Set up in Minimally Invasive Cardiac Surgery
Published in Theo Kofidis, Minimally Invasive Cardiac Surgery, 2021
In this video (Figure 4.1) Dr Glenn Branhart talks about minimally invasive cardiac surgery, which requires expertise on many different levels. Good communication between the surgeon, anesthesiologist and the perfusionist is very important for a successful outcome, which will reflect the level of cohesiveness of the team. Apart from good team work, which is a fundamental component of success, a good start up always needs a good set up.
Cardiac surgery
Published in Roy Palmer, Diana Wetherill, Medicine for Lawyers, 2020
The early cumbersome and dangerous HLMs have been replaced by smaller and safer models in which all components, except for the chassis and pumps, are disposable. They are no longer operated by doctors but by ‘perfusionists’ who are specially trained technicians examined and accredited by the College of Clinical Perfusion Sciences (affiliated to the University of London). During the period of CPB, responsibility for the patient’s life is in the hands of the perfusionist rather than the surgeon or anaesthetist. In the NHS, perfusionists are indemnified by the employing Trust but in the private sector they require private indemnity arrangements, as do medical practitioners, e.g. from the medical defence organizations.
Withdrawal of ECMO Support over the Objections of a Capacitated Patient can be Appropriate
Published in The American Journal of Bioethics, 2023
It should also be noted that ICU care is not passive. When the patient is receiving ICU interventions, those interventions are not on autopilot. The intubated patient, the patient on continuous renal replacement therapy, the patient on ECMO need constant monitoring and adjustments to treatment. Doctors, nurses, respiratory therapists, perfusionists, etc. are always vigilant. The ventilator rate, inspiratory time, plateau pressure, etc. must be adjusted to ensure excellent care. The ECMO oxygen concentration, sweep gas rate, pump rate, anticoagulation, etc. must be monitored and adjusted regularly. Caring for an ICU patient is a highly active process that requires tremendous expertise and unbroken attention. It would be impossible to continue a patient on ECMO without the continuous care of the ICU team.
Comparison of free arterial and saphenous vein grafting in outcomes after coronary bypass surgery
Published in Scandinavian Cardiovascular Journal, 2022
Vijoleta Abromaitiene, Jacob Greisen, Hans Henrik Kimose, Zidryne Karaliunaite, Carl-Johan Jakobsen
Aiming at a minimal 3-year observation time, the primary cohort consisted of all consecutive adults undergoing CABG between 2000 and 2016 in the three cardiac surgery centers (Aalborg, Odense and Aarhus University Hospitals), reporting to the Western Denmark Heart Registry (WDHR). WDHR is a mandatory internet-based registry of all cardiac procedures in the western part of Denmark. Registration is completed by the attending surgeon, anesthesiologist and perfusionist. Individuals were identified by the unique Central Personal Registration (CPR) number assigned to all people, who have been or are currently residing in Denmark. The Danish Civil Registration System (DCRS) contains basic personal information, civil and vital status including the date of death of citizens with a valid CPR number. The WDHR is updated daily and thus contains information on all patients with a valid CPR number. The study was approved by the Danish Data Protection Agency (1-16-02-830-17). Written consent is not required for registry-based studies according to Danish legislation.
Mechanical circulatory support in cardiogenic shock: a critical appraisal
Published in Expert Review of Cardiovascular Therapy, 2022
Giulia Masiero, Francesco Cardaioli, Giuseppe Tarantini
VA-ECMO is effectively a modified cardiopulmonary bypass circuit that provides continuous, non-pulsatile CO. It removes CO2 from and adds O2 to venous blood via an artificial membrane, bypassing the pulmonary circulation. The ECMO provides significant hemodynamic support (up to 8 l/min) increasing LV afterload and wall stress which in turn can increase myocardial oxygen consumption and therefore limit any cardio-protective benefit [43]. The implantation procedure needs a full collaboration between cardiologists, surgeons, anesthesiologists and perfusionists. Systemic anticoagulation with heparin is required to achieve an activating clotting time of 150 to 180 seconds [44]. Contraindications to ECMO include significant aortic valve regurgitation, severe peripheral arterial disease, bleeding diathesis, recent stroke or head trauma and uncontrolled sepsis [43]. At present, only small observational studies have examined VA-ECMO use in severe refractory AMI-CS patients showing high mortality rate even greater than 50% in some cases [45–47]. A recent propensity-score matched analysis among AMI-CS patients, including 5730 subjects receiving Impella and 560 treated with VA-ECMO, showed a lower rate of in-hospital mortality, respiratory failure, and vascular complications in patients treated with Impella [48]. At present, despite the lack of randomized data regarding the use of VA-ECMO in CS patients, it can serve as a bridge-to-recovery, bridge-to-bridge, and bridge-to-transplant for patients with refractory shock [8,10]. The ongoing ECLS-SHOCK and EURO-SHOCK Trials may add important data in this field [49,50].