A Day in the Life as a Clinical Perfusionist

What Does a Clinical Perfusionist Do?

A Clinical Perfusionist plays a key role in open-heart surgeries. They manage the heart-lung machine - special equipment that temporarily takes over the work of the heart and lungs during surgery.

The Perfusionist is a highly trained, specialist scientist, responsible for running these machines, which keeps blood flowing and oxygenated while the heart is stopped so the surgeon can safely make repairs. This involves carefully preparing and checking equipment, mixing a special solution to stop the heart (called cardioplegia), and making sure all monitoring systems are ready.

To allow the surgeon to work on a still, bloodless heart, the Perfusionist uses the heart-lung machine to reroute the patient’s blood. Blood is taken out of the body, oxygenated by the machine, and pumped back in, doing the job of the heart and lungs during the procedure. A special clamp is placed on the main artery, and cold cardioplegia solution is administered to temporarily stop the heart.

Perfusionists don’t only work in the operating room. They also assist in high-risk heart procedures done in specialised cardiac cath labs, and they help with emergency life support systems like ECMO (a machine that supports the heart and lungs in critically ill patients). While ECMO trained nurses manage day-to-day ECMO care, Perfusionists support the nurse specialist role, troubleshooting any technical issues they may have.

Inside the Heart of Surgery: A Day in the Life of a Clinical Perfusionist

Here's a glimpse into a typical day in cardiac theatre, with Colin Canavan, a Perfusionist in CHI.

07:30 – Morning Setup

The day begins with equipment checks and preparation of the heart-lung machine. This device temporarily takes over the function of the heart and lungs during open-heart surgery. The perfusion circuit is primed, monitoring systems calibrated, and Cardioplegia, a solution used to safely stop the heart for the duration of the operation, is prepared.

08:00 – Team Briefing

The surgical, anaesthesia, nursing and perfusion staff gather for a preoperative briefing. We review the day’s cases, discuss patient-specific considerations, and ensure all equipment and techniques are aligned. Point-of-care testing devices are quality-checked to ensure accurate results throughout the day.

08:30 – First Patient Enters Theatre

Once the patient is anaesthetised and monitoring lines are placed, a WHO surgical safety check is[SD1] performed. The chest is opened via median sternotomy, and the heart is exposed.

09:00 – Cardiopulmonary Bypass Begins

Cannulae are inserted into the heart’s major vessels. Blood is diverted to the heart-lung machine, oxygenated, and returned to the body. Cardioplegia is administered to stop the heart, giving the surgeon a still, bloodless field to operate in.

09:00–12:00 – Perfusion Management

Throughout the procedure, I monitor and adjust patient’s blood flow, pressure, temperature, and oxygen levels. In paediatric cases, where patients can weigh as little as 2kg, precision is critical. Each circuit is tailored to the patient’s size and needs, every patient having specific metabolic and physiological needs.

12:00 – First Patient Off Bypass

As the surgical repair concludes, the heart is restarted and the patient is weaned off bypass. The Anaesthetist takes over ventilation and haemodynamic control of the patient once again. The patient’s surgical wound is closed and transferred to PICU postoperatively.

13:00 – Lunch & Prep for Second Case

A short break before preparing for the afternoon procedure. Equipment is setup once the second patient’s details are reviewed, the extracorporeal circuit is primed and checked.

14:00 – Second Patient Enters Theatre

The process repeats: anaesthesia, monitoring, surgical prep, and initiation of bypass. Each case brings its own challenges, requiring close coordination with the entire team.

17:00 – End of Second Case

The patient is safely weaned off bypass, and post-op documentation begins. Equipment is cleaned and restocked for the next day.

18:00–19:00 – Wrap-Up

The day ends with equipment maintenance, stock ordering, and participation in clinical reviews. Perfusionists also support education, quality improvement, and ECMO services in critical care settings. While equipment malfunctions are rare, contingency plans are always in place, with backup devices kept close at hand. The Clinical Perfusion team works in close partnership with the hospital’s Clinical Engineering department to ensure that all specialist equipment is maintained to the highest standards of precision and reliability

Personal reflections

This is a highly skilled, demanding role that requires a deep understanding of how the body works and the ability to stay calm under pressure. The hours can be long and unpredictable due to emergency cases, but the work is highly rewarding and defined by tight co-ordination with surgeons, anaesthetists, clinical engineers and nursing teams, working towards a common goal- to ensure the best care for patients!