CVP Patient Safety and Equipment 2 — Questions and Answers
Question 1: What is the role of a centrifugal pump versus a roller pump in bypass?
- Centrifugal pumps are less likely to cause massive air embolism and generate less hemolysis; roller pumps are simpler and less expensive (Correct answer)
- They are identical in function
- Centrifugal pumps are only for pediatric patients
- Roller pumps are safer in all situations
Correct answer: Centrifugal pumps are less likely to cause massive air embolism and generate less hemolysis; roller pumps are simpler and less expensive
Centrifugal pumps generate flow through a spinning vortex and will not pump significant air, while roller pumps use occlusive compression and can pump air if the reservoir empties.
Question 2: What is tubing spallation and why is it a concern?
- The release of particles from the inner surface of pump tubing into the blood due to roller pump compression (Correct answer)
- A type of blood clot
- An oxygenator malfunction
- A monitoring artifact
Correct answer: The release of particles from the inner surface of pump tubing into the blood due to roller pump compression
Spallation occurs when roller pump compression damages the inner tubing surface, releasing microparticles into the patients blood that can cause organ damage.
Question 3: What emergency procedures should be followed if there is a power failure during bypass?
- Immediately switch to hand cranking the pump while activating backup power systems (Correct answer)
- Wait for power to return
- Turn off all equipment
- Start chest compressions on the patient
Correct answer: Immediately switch to hand cranking the pump while activating backup power systems
In a power failure, the perfusionist must immediately hand-crank the pump to maintain circulation while backup power (UPS/generator) activates.
Question 4: What is the purpose of the cardiotomy suction system?
- To collect blood from the surgical field for processing and return to the patient (Correct answer)
- To suction the patients airways
- To remove fluid from the chest cavity post-surgery
- To drain the venous reservoir
Correct answer: To collect blood from the surgical field for processing and return to the patient
Cardiotomy suction collects shed blood from the operative field, which is then filtered and returned to the bypass circuit for reinfusion.
Question 5: What infection control measures are essential for the bypass circuit?
- Aseptic technique during circuit assembly, sterile components, and antibiotic prophylaxis (Correct answer)
- No special precautions are needed
- Only the surgical team needs to observe sterile technique
- Standard hand washing is sufficient
Correct answer: Aseptic technique during circuit assembly, sterile components, and antibiotic prophylaxis
The entire bypass circuit must be assembled using aseptic technique with sterile, single-use components to prevent bloodstream infections.
Question 6: What is the standard protocol for weaning a patient off cardiopulmonary bypass?
- Gradually reduce pump flow while the heart resumes function, monitoring hemodynamics for stability (Correct answer)
- Immediately stop the pump
- Reduce flow to zero then restart the heart
- Wait for the surgeon to manually restart the heart
Correct answer: Gradually reduce pump flow while the heart resumes function, monitoring hemodynamics for stability
Weaning involves gradually reducing pump support as the heart resumes pumping, with careful monitoring of hemodynamics, rhythm, and contractility.
CVP Patient Safety and Equipment 2
What is the role of a centrifugal pump versus a roller pump in bypass?