Departmental use of perfusion crisis management drills: 2002 survey results

Serious complications during the performance of cardiopulmonary bypass (CPB) are an infrequent event. However, when potentially fatal technical complications, such as oxygenator or pump failure, do occur, it necessitates a swift and well-co-ordinated response. Periodic performances of drills that simulate various CPB crises are a way to improve individual perfusionist proficiency during disaster situations. The purpose of this study is to determine the utilization of crisis management drills in perfusion departments. Every open-heart program listed by the American Hospital Association in the New England states (Maine, Massachusetts, Rhode Island, Vermont, New Hampshire, Connecticut) and New York were contacted by telephone. Of the 61 contacted, 59 participated for a response rate of 97%. Demographically, the survey represents 312 perfusionists and 47 227 cases annually. While 97% of the perfusion departments believed that regular practice and performance of crisis management drills would improve individual proficiency, only 17% of the programs mandated that their perfusionists perform crisis management drills as a matter of departmental policy. Reasons expressed for not having a formal written policy regarding performance crisis management drills were as follows: left up to the individuals to maintain proficiency 19 (39%), not motivated 11 (22%), confident of proficiency 9 (19%), no time 8 (17%), dubious value 1 (2%), and cost prohibitive 1 (2%). While it is nearly universally accepted that periodically practicing perfusion crisis management drills in a 'wet lab' environment would improve proficiency, only a minority of perfusion teams deem this a high enough priority to make it a matter of formal departmental policy.