(1) A fully licensed perfusionist may perform
those functions and services which are necessary for the support, treatment,
measurement or supplementation of a patient's cardiovascular, circulatory or
respiratory systems or other organs, or any combination of those organs or
systems; or which ensure the safe management of that patient's physiological
functions through the monitoring and analysis of those bodily
systems.
(2) The functions and
services which may properly be performed by a fully licensed perfusionist
include, but are not necessarily limited to, the following:
(a) use of extracorporeal circulation and
associated therapeutic and/or diagnostic technologies;
(b) use of long-term cardiopulmonary support
techniques, including extracorporeal carbon dioxide removal and extracorporeal
membrane oxygenation and associated therapeutic and/or diagnostic
technologies;
(c) use or
performance of counterpulsation;
(d) use or performance of ventricular
assistance;
(e) use or performance
of autotransfusion;
(f) use or
performance of blood conservation techniques;
(g) use or performance of myocardial
preservation and/or organ preservation techniques in connection with the
performance of procedures involving cardiopulmonary bypass;
(h) use or performance of extracorporeal life
support services or techniques;
(i)
use or performance of isolated limb perfusion services;
(j) use or performance of techniques
involving blood management, advanced life support and other related
functions;
(k) administration of
pharmacological and therapeutic agents through the extracorporeal circuit or
through an intravenous line pursuant to an order from a duly licensed
physician;
(l) administration of
anesthetic agents through the extracorporeal circuit or through an intravenous
line pursuant to an order from, and under the direct supervision of, an
anesthesiologist;
(m) use or
performance of physiologic monitoring;
(n) use or performance of central hypothermia
or hyperthermia;
(o) use or
performance of hemoconcentration, hemodilution or hemofiltration;
(p) performance of anticoagulation
monitoring;
(q) peformance of blood
gas and blood chemistry monitoring and/or analysis;
(r) performance of hematologic monitoring
and/or analysis; and
(s) the
observation of signs and symptoms related to perfusion services, the
determination of whether such signs or symptoms exhibit abnormal
characteristics, and the implementation of appropriate reporting of the
same;
(t) the implementation of
perfusion protocols, initiation of emergency procedures or implementation of
changes in such emergency procedures in connection with any of the functions or
services described in 267 CMR 4.01(2)(a) through (j); and
(u) participation in clinical research
protocols.
(3) All
functions and services performed by a fully licensed perfusionist shall be
performed pursuant to the orders of, and under the supervision of, a licensed
physician.
(4)
In
lieu of a patient-specific order from a licensed physician, a fully
licensed perfusionist may perform any or all of the functions and services
enumerated in 267 CMR 4.01(1) or (2) pursuant to a written perfusion protocol
which has been adopted or approved by the health care facility in which that
licensed perfusionist performs perfusion functions or services, as long as:
(a) The protocol has been developed by a
fully licensed perfusionist, a licensed physician who is actively engaged in
the practice of cardiovascular surgery, and an anesthesiologist, a licensed
physician who is actively engaged in the practice of cardiovascular
anesthesia;
(b) The protocol
adequately addresses the conditions and circumstances under which licensed
perfusionists may perform the particular perfusion function(s) or service(s)
covered by the protocol, and the manner in which such functions or services
will be performed;
(c) The protocol
is reviewed and updated annually by the individuals who developed the protocol;
and
(d) The protocol is made
available to the Board for review immediately upon request from any duly
authorized representative of the Board.
(5) A fully licensed perfusionist may
implement perfusion protocols, make changes in such protocols, and/or institute
emergency procedures, based upon his or her observations and analysis of signs
and symptoms related to the implementation of perfusion services.
