(“By 1969, it is possible that AmSECT technicians may have the opportunity to become certified.”; this article reported test questions were being compiled regarding cardiopulmonary bypass, dialysis, blood chemistry, gases, and “all forms of technology that are available to us in standard textbooks and literature.”; it was anticipated an independent testing agency would be contracted to administer the examinations; an AmSECT test committee was to be formed that would generate a test from a group of questions submitted to “best test a truly knowledgeable technician.”; the test would then be approved by “x” number of doctors, and “Their stamp of approval would assure a world-wide recognition of technicians.”; the first test was expected to be administered at the AmSECT national convention in Detroit in 1969.)

(officers’ names and their offices were listed, as follows: President Edward C. Berger; First Vice-President, Liaison Calvin R. Scott; Second Vice-President, Certification and Education James Dearing; Third Vice-President, Information Rose Ann Litturi; Fourth Vice-President, Membership Wilbur Herring; Secretary-Treasurer James C. Fonduex] “Board of Directors” were, as follows: Three-Year Term Lester Coates, LeRoy Ferries, and James Burke; Two-Year Term James Tolbert, Kathryn Hargesheimer, and Dan Wiltfang; One-Year Term Ruth Stetson, Madeline Massengale, Edward Romanowski, and James B. Wade] and “Ethics Committee” [names only, no photos, as follows: Three-Year Term Emanuel Bagby; Two-Year Term Richard Stewart; One-Year Term James Twitty)

(officers’ names and their offices were listed, as follows: President Kathryn Hargesheimer; First Vice-President, Liaison Calvin R. Scott; Second Vice-President, Certification and Education James Deering (sic); Third Vice-President, Information Ed Romanowski; Fourth Vice-President, Membership Shannon Lucas, Secretary-Treasurer James C. Fondeux]; “Board of Directors” [names listed only w/o photos, as follows: Three-Year Term E. Lanier Allen, Robert L. Barnard, and Madeline Massengale; Two-Year Term James Burke, Lester Coats (sic); One-Year Term Dietz van Dura, James Tolbert, and Dan Wiltfang; Past President Edward C. Berger; Ethics Committee Three-Year Term Linda Vicker; Two-Year Term Emmanuel (sic) Bagby; One-Year Term Richard Stewart)

(there was a Preamble and four Sections; the Preamble noted the standards of ethical conduct were “derived from the application of right reason to the Technology and are intended to aid technologists in the maintenance of a high level of professional and personal ethics.”; Section 1 urged continuing education, “the best team support to the patient, the doctor, and the institution”, and respect for the “patient’s right to privacy, dignity, and safety.”; Section 2 warned against association “with someone who violates the principles of the practice of medicine and the practice of the Technology”; it further asserted the Society was to “protect the patient from practitioners of the Technology who are deficient in moral character or professional competence” and that “Technologists should uphold the dignity and honor of the professions, accept its self-imposed disciplines, and expose without hesitation those who are guilty of illegal or unethical conduct.”; Section 3 urged “habits of economy…to time as well as the care and preparation of equipment and supplies”; it further urged accurate recordkeeping and reporting, an understanding of “the legal responsibility, as well as the scientific and human responsibilities, of each member of the team to the patient and himself”; another tenet urged awareness of “all types of emergencies, both medical and mechanical, and the measures they [technologists] must apply to solve the problem at hand and/or the prevention of such emergencies; Technologists were to be “sufficiently schooled and skilled to act instead of react in times of emergency and/or stress.”; Section 4 urged Technologists to “encourage participation in activities whose goal is to improve the health and well-being of the individual as well as the community as a whole.”; the last tenet of this section urged Technologists to “strive to publicly uphold the image, goals and ideals of the Society for the betterment of the Technology and for greater public understanding of its role in health science.”)

(the AmSECT Certification and Education Committee, chaired by James Dearing, developed a proposal describing requirements for candidate eligibility, which was approved by the AmSECT Board of Directors; the proposal was then to be sent to the society’s Medical Advisory Committee; two types of certification were to be offered: one for the Extra-Corporeal Circulation Technologist and a second for the Dialysis Technologist; tenets included 1) candidate was required to complete the written examination administered by a regional Certification committeeman and “receive a qualifying score”; 2) for eligibility for examination a candidate had to have a minimum of one year’s experience and 50 clinical cases “in his area of specialization”; 3) a letter attesting to a candidate’s experience had to be submitted by a qualified physician; and 4) the candidate had to be a member in good standing in AmSECT; similar future programs for certification in other specialties were anticipated such as hemodynamics, organ preservation, and research; the pilot testing program was scheduled for early 1972; those successfully passing the examination at that time were to be considered certified and “qualified to use the title of Fellow, an elite sub-division of Active Member status”; members of the Certification Committee were: James P. Dearing, chairman and Second Vice President; Regional representatives: Helen C. Berman; Michael Dunnaway (sic); E. Lanier Allen; Emily Taylor; Edward Romanowski; LeRoy Ferries; Dietz Van Dura; Barbara Aldridge; Madeline M. Massengale; F. Michael Burgess, Judy Abels; D. Ewers; and Kathryn Hargesheimer, Ex Officio)

(James Dearing reported the proposed examination would be presented to the AmSECT Medical Advisory Board for approval during the April 1972 ASAIO meeting; the examination was to consist of 200 multiplechoice questions drawn from a pool of 500 submitted by AmSECT regional representatives and was intended to establish criteria for certification)

(current officers’ names and their offices included: Calvin Scott, First Vice President, Liaison; James Dearing, Second Vice President, Certification and Education; Ed Romanowski, Third Vice President, Information; Shannon Lucas, Membership; James B. Wade, Secretary and Treasurer; James Burke, Lester Coats, LeRoy Ferris (sic), Board of Directors; Emanual (sic) Bagby, Ethics)

(this announced the initial certification examinations in 1972 that were to be given during the 10 th AmSECT conference in New York City; they were to be open to “all persons in the profession who qualify under the Grandfather Clause”; candidate requirements for the dialysis exam had to be currently employed in renal dialysis with two years of experience and a minimum of 200 cases; candidate requirements for heart-lung perfusion had to be currently employed as a clinical perfusionist with two years of experience and a minimum of 100 cases; applications from all candidates had to include a physician’s letter on institutional letterhead; data from the “grandfather” exams was to be used “to evaluate the examination, the general knowledge of those now in the profession, and to determine areas in which education through annual and regional meetings, the newsletter, Journal and other means should be directed.”; those taking the examination would not have to attain a median score to be certified; the exam fee was $40; the application specified the candidate’s professional affiliation, educational background, clinical experience, and a statement of cases completed; the AmSECT business office was in New Orleans; completed applications had to be received by July 21, 1972; members of AmSECT’s Certification and Education Committee had submitted “hundreds of questions” that were reviewed by co-chairmen James Dearing (heart-lung) and Dietz van Dura (dialysis) to develop the examinations; the examinations were reviewed by Dr. Charles F. Gutch and Dr. E. Converse Peirce, II, who had been appointed by ASAIO as representatives to the Certification and Education Committee)

(AmSECT offered two examinations in Los Angeles during the 1973 annual conference; one examination was for heart-lung bypass and another for dialysis; requirements for heart-lung bypass were two years of experience and current employment, a minimum of 100 cases exclusive of training, and a letter from a physician-in-charge attesting to the candidate’s qualifications submitted on institutional letterhead; requirements for renal dialysis were two years of current employment and a minimum of 200 cases exclusive of training)

(this had details (section A) on election by the membership of the Chairman (5-year term), appointment by the Board of Trustees [AmSECT Board of Directors] of two other members (2-year terms), and election by the membership of Chairman-Elect the year prior to the end of the Chairman’s term (5-year term); (section B) stating “The Ethics Committee is to constantly insure (sic) that the Society members and its Officers function within the frame of its Code of Ethics, adopted standards of practice and within the guidelines of the By-laws and Articles of Incorporation.”)

(AmSECT had received many calls and letters from members and non-members who expressed an interest in taking the examination under the “Grandfather Clause” to become certified; applications had to be received by 10 Jun 1973; those determined to be qualified would be sent a set of reference readings; Mary Caizza (sic) was a member of the examination credential committee and was to make final decisions on any questionable applications; Dietz van Dura and other monitors were to oversee the examination on 14 Jul 1973 at the annual meeting in Los Angeles, which was the only time it was to be administered)

(Election results for officers, board members, committee chairs, and appointments, were listed as follows: President Charles C. Reed; Secretary Madeline M. Massengale; Treasurer LeRoy Ferries; Three-Year Board members Jeri Dobbs, J.J. Harrison, Fay Totero; One-Year Board member Rebecca Bragg; and Ethics Committee Chairman-Elect, Lawrence Smith; those on the Executive Committee for 1973-74 were: F. Michael Burgess; Jeri L. Dobbs, Dietz van Dura, and Charles C. Reed; Appointments made were listed, as follows: Dan Wiltfang, Chairman of the By-Laws Committee; Michael W. Dunaway, Chairman of the Credentials Committee; Terry Popham, Chairman of the Nominating Committee; Richard Borst, Chairman of the Awards Committee; Patricia Brueggeman, Nominating Committee member; and Diane K. Clark, Ethics Committee member; also, Louis S. Toth’s proposal for computer evaluation of the certification examination was approved; a Code of Ethics was adopted at the Corporate Business meeting; there were three photos labeled, “The Board at Work” showing F. Michael Burgess, Calvin Scott, and Marie-Juliette Casimir; Madeline Massengale and Dietz van Dura; and Kathryn Hargesheimer; the 1973-74 officers, Board of Directors, and Committee Chairmen were listed, as follows: President Charles C. Reed; Vice-Presidents Liaison Kent Vasko, DVM; Certification & Education Dietz van Dura; Information Ed Romanowski; Membership Shannon Lucas; Secretary Madeline M. Massengale; Treasurer LeRoy Ferries; Board of Directors: Marie-Juliette Casimir; F. Michael Burgess; John J. Harrison; Judy A. Tweedie; James Dearing; Calvin Scott; T. Fay Totero; Jeri L. Dobbs; Rebecca Bragg; and Kathryn Hargesheimer; Committee Chairmen: Ethics, Emily Taylor; Bylaws, Daniel Wiltfang; Credentials, Michael W. Dunaway; Nominating, C. Terry Popham; Awards, Richard W. Borst; and Executive Director, W. Alfred McCauley)

(the content of this code was identical to the 1970 Code of Ethical Conduct that had been “offered for consideration”, but this version eliminated the section headings; there were 12 tenets, eleven of which began with the word “Technologist”; one began with the phrase “The Society”; all statements used the verb “should” when describing the code indicating the tenet was a recommendation and non-mandatory)

(the examinations were to be administered on 24 July 1974 at the Fairmont Hotel in Dallas; there were two types of candidates: those qualifying under the “Grandfather Clause” and those taking exam on pass-fail basis for either heart-lung or dialysis; the Grandfather Clause Provision was to be used for the final time, and the pass-fail was to be administered for the first time; grandfather status candidates were only eligible to those who had met the criteria as of 29 July 1972; the criteria for dialysis was the candidate had to be currently employed in renal dialysis, have two years of experience, and have completed a minimum of 200 cases exclusive of training time; the criteria for heart-lung perfusion was the candidate had to be currently employed as a clinical perfusionist, have two years of experience, and have completed 100 clinical perfusions exclusive of training time; the fee for the exams was $40; criteria for the pass-fail examinations was: dialysis candidates had to be currently employed in renal dialysis, have two years of clinical experience by 30 June 1974, and have completed 200 clinical cases by 15 May 1974; for heart-lung perfusion, candidates had to be currently employed as a clinical perfusionist, have two years of clinical perfusion experience by 30 June 1974, and have a minimum of 100 clinical perfusion cases by 15 May 1974; one year of a training period could be used as part of the experience criteria; the examination fee was also reported as $50 in contrast to the $40 cited above; completed applications including the technologist’s name, professional affiliation, educational background, clinical experience, and a statement of cases completed were to be sent to Michael Dunaway by registered mail along with the fee and physician’s statement; applications had to be postmarked by 15 May 1974 and received by the Credentials Committee by 1 June 1974; incomplete applications or those received after the deadline were to be automatically rejected and no notice sent; the examinations were to be administered at 12:30 pm on Wednesday 24 July 1974; there was a bibliography of references listed as study guides)

(this article addressed whether “extracorporeal perfusion technologists (cardiopulmonary bypass technician, pump technician, etc.)” should be classified as “exempt employees” according to Title 29, Part 541 of the Code of Federal Regulations; the code had two main requirements: first, 1) a salary of at least $140/week plus 2) work “not essentially part of and necessarily incident to exempt professional duties not to exceed 20% of hours worked in work week”; 3) primary duty requiring “advanced knowledge customarily acquired by specialized study”; 4) work requiring “discretion and judgement”; and 5) work was “intellectual, varied, result not standardized” and second, salary of at least $200/week and primary work required “advanced knowledge and use of discretion and judgement”; the article asserted that without salary considerations, extracorporeal technologists “easily meet all of the other listed qualifications for exempt employment.”; it argued few extracorporeal technologists spent any time on activities “not essentially part of and necessarily incident to their exempt professional duties.”; “Extracorporeal perfusion technology itself requires the full time effort and commitment of the technologist.”; it noted the varied backgrounds of extracorporeal perfusion technologists such as Registered Nurses, Respiratory Technicians, Operating Room Technicians, Medical Technologists, former Military Corpsmen, College Graduates, or licensed Physician Assistants; it further asserted they all had “considerable advanced knowledge by specialized study including, but not limited to, anatomy, pathology, physiology, pharmacology, biochemistry, hematology, cardiology, and surgery”; extracorporeal perfusion technologists also had “the ability to prepare, set-up, and control numerous types of extracorporeal perfusion equipment”; they were also able to “quickly recognize and rapidly correct innumerable problems which may develop withing extracorporeal equipment, whether related to difficulties with the patient’s condition, with the surgical operation or with the equipment itself.”; it continued by stating “management of extracorporeal circulation requires the highest degree of discretion and judgement, because during the period of extracorporeal perfusion the patient’s life is totally dependent on the adequacy and correctness of support so provided.”; while acknowledging while the “final medical and legal responsibility for extracorporeal perfusion rests with the physician, the primary responsibility and attention of the physician are involved in other aspects of the patient’s care during extracorporeal perfusion, such as conduct of the open-heart operation itself.”; it further asserted that while extracorporeal perfusion was “under the final direction of and in consultation with the physician, the great majority of judgemental decisions regarding the conduct of the perfusion must be made, often on a split second basis, by the technologist.”; it continued by stating the work was “intellectual” insofar as “changes in the perfusion must be recognized and their meaning interpreted, followed by an analysis of possible courses of action and the selection and implementation of the proper course of action.”; it asserted the work was varied and “each individual case must be considered separately in preparing for and conducting extracorporeal perfusion.”; each patient’s condition and the specific type of therapy also had to be considered; it argued the results of open-heart surgery were “in no way” standardized; it closed by acknowledging adversities could develop but had to be satisfactorily managed so that “life (will) be preserved and future health assured.”)

(the dialysis and heart-lung perfusion examinations were to be given for pass-fail applicants only on Saturday 18 Jan 1975 in four cities: San Francisco, Chicago, New York City, and Atlanta; they were available to “all persons who qualify under the criteria established by AmSECT and its Medical Advisory Board; for dialysis, candidates had to be currently employed in renal dialysis and have two years of clinical experience with a minimum of 200 completed clinical cases; for heart-lung perfusion, candidates had to be currently employed with a minimum of 100 clinical perfusions and have two years of clinical perfusion experience; it was noted that up to one year’s experience and one-half of the required clinical cases could have been acquired in a training program; the deadline for application was 1 Dec 1974, and the examination fee was $100; applications including a physician’s letter, which had to be sent by registered mail to Guy Prater, Credential Committee Chairman]; and “Certification Examination References” were listed from the AmSECT Certification and Education Committee; there were 14 heart-lung textbooks and five hemodialysis textbooks; it was noted that hospital medical libraries, physicians and surgeons, and medical school libraries “should supply enough study material to adequately prepare for this most important examination.”)

(the first page listed the minimum standards for training programs in the following sections: 1) Organization; 2) Clinical Affiliations; 3) Facilities; 4) Faculty; 5) Students; 6) Administration; and 7) Curriculum; the second page addressed the recertification program with details on 1) filing an annual report; 2) a point system requiring that each certified member acquire 150 points during each three year time period; 3) each certified member to have primary responsibility for a minimum of 12 clinical perfusions per year; 4) loss of certification for (a) falsifying the annual report; (b) not having primary responsibility for 12 clinical (cases) per year; (c) not acquiring 150 points in a three year time period; and (d) is not actively engaged in perfusion technology for 12 consecutive months; 5) perfusionists who had lost certification due to 4 (b) or 4 (d) could regain certification “by becoming actively engaged in perfusion technology and submitting a report of his/her clinical cases after a period of six months”; and 6) availability of a method of appeal “for members losing or being in danger of losing their certification status”; a table listed points for specific activities and maximum obtainable in three years; a statement at the bottom of pg 1 noted “Adopted by AmSECT Board of Directors on November 2, 1974 and the American Board of Cardiovascular Perfusion Technology on November 3, 1974)

(Michael W. Dunaway addressed the recertification program; AmSECT had received letters from members and physicians regarding the recertification program; most agreed it was necessary, but concerns were raised over the cost and the belief each certified member would be required to attend the annual AmSECT conference; some hospitals had many on the perfusion team, which meant all could not attend the conference at the same time; the AmSECT Board of Directors modified the recertification program to allow attendance at regional or local meetings to earn points towards recertification; points earned for clinical cases were set at onehalf per case with the maximum allowed being 24 points in three years; thus, it was not necessary to attend the annual conference, publish a scientific paper, or give a talk at a national meeting; an individual could earn 50 points per year by attending two regional or local meetings, listening to an audio digest, or reading one scientific journal every month, and performing 16 clinical cases each year to qualify for recertification; he argued that “To the majority of AmSECT members this recertification program will pose no great difficulty…”; he described how attendance at meetings would be documented; he noted the recertification program might be changed if difficulties were identified; he argued certified perfusionists would be able to fulfill the requirements; “This is one of many steps, opportunity, to upgrade the field of perfusion.”; he announced certification and recertification by AmSECT for its own members should not be done; the American Board of Cardiovascular Perfusion Technology (note name with Technology appended) was to take over certification and recertification as of 19 Apr 1975; AmSECT was also to implement and fund more regional meetings to assist those wishing to remain current and being recertified)

(this was formatted per American Medical Association Guidelines for the Development of a New Health Occupation; there were some general statements on Scope of Duties; AmSECT adopted the Job Description on 28 July 1975; many titles were in use including perfusion technologist, perfusionist, perfusion technician, pump technician (pump tech), extracorporeal technologist, and extracorporeal perfusionist; the “preferable title” was Perfusion Technologist; the Scope of Duties was described in three sections, as follows: “A. Job Description, A perfusion technologist is an individual who operates the heart/lung machine required for total or partial cardiopulmonary bypass for surgical correction of various types of cardiac defects and surgical repair of diseases of the heart and abnormalities of the great vessels. It is the responsibility of the perfusionist, in consultation with the physician, to select the appropriate equipment to be used during extracorporeal circulation consistent with his own limitations and the needs of the patient.”; the variety of cases and circuitry to meet the patient’s needs was acknowledged; “The perfusionist must be innovative in preparing for the unusual surgical procedures which are in no way standardized.”; perfusionists “must have obtained considerable advanced knowledge by specialized study including, but not limited to, anatomy, pathology, physiology, pharmacology, biochemistry, hematology, cardiology, and surgery.”; perfusionists “must provide the advanced knowledge whereby the technologist can quickly recognize and instantaneously react to correct enumerable (sic) problems which may develop within the extracorporeal circuit, whether related to difficulties with the patient’s condition, with the surgical operation, or with the equipment itself. The perfusionist must know the limitations, hazards and dangers of each and every piece of equipment he utilizes in the extracorporeal circuit.”; the perfusionist was to understand the surgical procedure…”and know what the surgeon is doing both technically and physiologically…”; “The perfusionist is responsible for the management of extracorporeal circulation which requires the highest degree of discretion and judgement, because during the period of extracorporeal perfusion the patient’s life is totally dependent on the adequacy and correctness of support so provided.”; perfusionists were required to “ensure the safe functioning of such equipment by monitoring the necessary operational parameters”…and interpret any changes in perfusion so that “courses of action…in consultation with the physician in charge” may be implemented; the perfusionist may be responsible for administration on prescription of anesthetic agents “such as Halothane” through the circuit; additional additions on prescription such as “crystalloid or colloid solutions, heparin, mannitol, sodium bicarbonate, or other pharmacological agents which are necessary in order to maintain a near physiological state.”; perfusionists induce hypothermia when prescribed, “and such other duties as assigned by the physician.”; B. “operation of such equipment is confined except in extraordinary circumstances to in-hospital setting.”; “The perfusion technologist in charge of the bypass procedure should be either certified or eligible for certification by the American Board of Cardiovascular Perfusion Technology, Inc.”; those perfusion technologists without the “educational qualifications and experience to meet the certification requirements should not be permitted to perform independent perfusions but should work under the direct supervision of a perfusion technologist so qualified.”; C. “Extracorporeal circulation is never performed except in relationship to open heart surgery…Therefore, the perfusion technologist is an integral part of a highly specialized surgical team.”; “While the technologist conducts the extracorporeal perfusion under the final direction of and in consultation with the physician, the great majority of judgmental decisions regarding the conduct of the perfusion must be made, often on a split second basis, by the perfusion technologist. Final legal and medical responsibility for extracorporeal perfusion rests with the physician.”)

(this announced American Board of Cardiovascular Perfusion (ABCP) recertification application deadlines; the fee was $15; the ABCP office was in Park Ridge, IL; Diane K. Clark’s address at the Texas Heart Institute was also listed for those needing additional information)

(officers’ names and offices were listed, as follows: Executive Committee: Michael W. Dunaway, President; LeRoy H. Ferries, President-Elect; Madeline M. Massengale, Secretary; A. Earl Lawrence, Treasurer; Mary B. Hartley, Guy H. Prater, Jeanne S. Lange, Board Members-at-Large; Regional (I-XI) Representatives to Board of Directors were listed, as follows: William B. Shaffer (I); Aaron G. Hill (II); Larry W. Cavanaugh (III); David B. Carroll (IV); Bruce A. Ratcliff (V); Harry S. Uffalussy (VI); Richard G. Berryessa (VII); F. Elvis Wright (VIII); Frederick N. Ferguson (IX); Phillip K. Spohn (X); and Samuel H. McKean, III (XI); Committees with individuals’ names included: Awards (F. Elvis Wright, Chairperson; Frederick N. Ferguson and Patricia Brueggeman, members); By-Laws (James P. Dearing, Chairperson; Richard G. Berryessa and Aaron G. Hill, members; ); Continuing Education (Guy H. Prater, Chairperson); Subcommittees included Audio-Visual (Richard G. Berryessa, Chairperson; Jeanne S. Lange, Jeffrey B. Riley, and James E. Snyder, members;); Convention and Meetings (Aaron G. Hill, Chairperson; John F. Meserko and Howard L. West, members); Liaison to ABCP (Madeline M. Massengale, Chairperson); Regional Guidelines (Mary Lewis, Chairperson; Larry W. Cavanaugh and Frederick N. Ferguson, members); Special Projects (Guy H. Prater, Chairperson); Publications (Mary B. Hartley, Chairperson; Pati Ann Gaich and Madeline M. Massengale, members); Convention (Jeri L. Dobbs, Chairperson; Samuel H. McKean-1975; Joe A. Guzman-1976; Rebecca B. King-1976; Diane R. Mollison-1977; Harry S. Uffalussy-1977; and Mary B. Hartley-1978, members); Ethics (Calvin R. Scott, Chairperson; Jeri L. Dobbs and Bobby L. Kightlinger, members); Liaison to ABCP (Michael W. Dunaway and Madeline M. Massengale); Long Range Planning (Charles C. Reed, Chairperson; Michael W. Dunaway and LeRoy Ferries, members); Membership (Diane R. Mollison, Chairperson); Nominating (Jay Donoway, Chairperson; Nancy L. Achorn; Jane K. Callaway; Robert M. Dyga; and Susan M. Haubert, members; Product Liaison (Emily P. Taylor, Chairperson; Jeri L. Dobbs and Guy H. Prater, members); Publications (Mary B. Hartley-Journal Editor and Pati Ann Gaich-Newsletter Editor); names of 11 Regional Chairpersons 1976-1977 were: Susan M. Haubert (I); Matthew J. O’Connor (II); Richard Jurevic (III); Bobby L. Kightlinger (IV); E. Michael Tann (V); Diane R. Mollison (VI); Ronald J. Slaugh (VII); James O. Fines, III (VIII); Frederick N. Ferguson (IX); Joel Davis (X); and Jeri L. Dobbs (XI); Associate Editors of the AmSECT Journal were: Jon Austin; F. Michael Burgess; Larry Cavanaugh; Diane Clark; James Dearing; Jeri Dobbs; Nick Haiduc; Aaron Hill; Angelo Iatridis; Shannon Lucas; Joseph Mandl; John Merserko (sic); Jeffrey Riley; Calvin Scott; Richard Steward; and Steven Murphy (Medical Illustrator); there was a note that a Standards of Practice Committee, which was a new committee, had been created “for the purpose of establishing minimal standards of practice for perfusion” with the initial work “to assess perfusion records throughout the U.S.”; members were requested to send a copy of their perfusion record to Aaron G. Hill at the University of Rochester Medical Center)

(there was a one-sentence Preamble stating the code was intended to provide members “with a level of expected professional and personal ethics”; nine tenets (down from 12 in the Oct 1973 version above) addressed the “dignity and honor of the profession, respect for patients’ “rights of privacy and dignity”, admonition to uphold the “image, goals and ideals” of AmSECT, continuing education, certification, conduct for television interviews or other methods of mass communication, conflict of interest for perfusionists commissioned for sales of equipment or supplies, acknowledgement of perfusionist expertise to manufacturers or vendors, and consultation fees commensurate for services rendered; there was also an excerpt from “Medical Ethics” (a book?); Calvin R. Scott was the Ethics Committee Chairperson)

(Madeline M. Massengale reported the American Board of Cardiovascular Perfusion (ABCP) had notified AmSECT would not normally assign certification points for specific functions or categories; the AmSECT Continuing Education Committee was requested to submit recommendations to the ABCP for specific functions or changes in category assignment; the ABCP would then pass, reject, or revise the committee’s recommendations; recommendations were not to be made without prior receipt of a program; all programs were to be submitted to the chairperson of the AmSECT Continuing Education Subcommittee for Liaison to the ABCP; it was reiterated that assignment of points would not be granted without prior receipt of a program)

(Richard H. Jensen 1965-1967; James B. Wade 1967-1969; Edward C. Berger 1969-1970; Kathryn Hargesheimer 1970-1973; Charles C. Reed 1973-1975; Michael W. Dunaway 1975-)

(AmSECT formed the Standards of Practice Committee “to review current practices and make recommendations.”; the recommendations were to improve the “uniformity and quality of perfusion services to the open heart patient”; at the 1976 conference, President M. Dunaway directed the committee to consider perfusion records because they were “a weak point” in legal actions against perfusionists”; it was suggested protection of the patient and the perfusionist would be enhanced with more uniform and complete records; the committee reviewed many perfusion records “from all over the country”; “The recommendations are made for content of the perfusion record only. We make no judgement as to how this data is obtained, the method of measurement, where it is to be recorded, or in what form it is to be tabulated.”; the recommendations were submitted and approved by the AmSECT Board of Directors at the conference in Chicago (1976); members of the committee were: A. Hill, Chairperson; R. Berryessa; J. Dearing; J. Lange; and E. Taylor (all CCPs); the content of the pump record was specified, and the record was to be permanent; the recommendations were considered to be the minimum standard)

(this was presented at San Diego corporate meeting by LeRoy Ferries, AmSECT President 1977-1978; in one paragraph, he reported he had received a letter on 4 Apr 1978 from Dr. Richard L. Egan, Secretary of the American Medical Association (AMA), informing AmSECT the AMA Council on Medical Education had approved AmSECT’s application for recognition of Extra-Corporeal Technologists; the application was co-sponsored by the American Association for Thoracic Surgery and the Society of Thoracic Surgeons; all three organizations plus the American Board of Cardiovascular Perfusion were invited to work with the AMA Council on Medical Education to develop a set of Essentials and accreditation procedures for educational programs; President L. Ferries, President-Elect M. Massengale, and AmSECT’s Executive Director met with Dr. Parks of the AMA to learn about AMA policies and guidelines and the procedures for drafting the Essentials document; the draft document was to be presented to the Joint Review Committee of the four sponsoring organizations)

(Sue Brown was the ABCP Executive Secretary; criteria for eligibility to take the written and oral examinations were described, as follows: 1) after Mar 1978, the certification examination was to be given in two parts at two separate times: the written exam in July and for those passing the written part, the oral examination was to be given at the next annual AmSECT conference; 2) in 1979, the written examination was to be given in Chicago on Saturday, 6 Jan 1979; those successfully passing the written part would be eligible to take the oral examination on Sunday, 4 Mar 1979 at the annual AmSECT conference in Houston; 3) the deadlines for application and caseload requirements were 15 Oct 1978; the deadline for working time experience was 1 Mar 1979; 4) the application fee was $100;; specific candidate eligibility criteria for the two examinations were described, as follows: Written Examination 1) must be employed as a clinical cardiovascular perfusionist; 2) graduates of an accredited Cardiovascular Perfusion Training Program had to have (a) written recommendation of the Program Director and (b) a written satisfactory clinical competence evaluation by the program’s Clinical Competency Committee; 3) all other applicants had to have one year of clinical perfusion experience after completion of training; Oral Examination 1) must have achieved a passing score on the written examination; 2) graduates of an accredited perfusion training program had to have six months clinical experience and 50 clinical perfusions after graduation; 3) all other applicants had to have two years of clinical perfusion experience and have conducted 100 clinical perfusions after completion of training)

(he was from Chattanooga, TN, and had died 29 Jun 1978 from a pulmonary embolism; he was 29 years old)

(dated 19 Sep 1978 by Charles C. Reed to J. Dobbs regarding perfusionist recertification; C. Reed was President of the American Board of Cardiovascular Perfusion at the time; he noted recertification had been proposed for graduate medical education in 1940; he also quoted from a 1973 US Health Education and Welfare report that recommended specialty boards periodically evaluate and recertify physicians they had certified; one rationale was in defense of malpractice litigation; Reed wrote, “Recertification is one way of demonstrating that a specialist is judged currently competent by contemporary national standards.”; he further noted that all 22 Medical Specialty Boards had begun to implement either mandatory or voluntary recertification in 1977; part of recertification was continuing medical education; he further argued that hospitals had a strong incentive to require “up-todate credentials (Recertification)…for staff membership and privileges.”; he also noted reimbursement to hospitals might require providers be certified/recertified; he argued a major purpose was to “assure protection of the public”; he further argued that “if we do not do it, someone (the government) will do it for us.”; he stated that to be recertified as a perfusionist, one had to accumulate points for various activities; he argued attendance at the national meeting once every three years was “not such an outlandish thought”; he recounted other ways to accumulate enough recertification points; “If Recertification is simply just a get-your-ticket-punched-every-three-years situation, then it is meaningless.”)

(she had a BA in Biology and had worked as a research assistant in pharmacology and then respiratory medicine at SUNY Upstate Medical Center, Syracuse, NY; she also had taught science in a junior high school; in 1974, she answered an ad for part-time work as a “heart-lung machine technician”; she relocated to Seattle where she worked full-time at the Mason Clinic)

(this draft was dated 27 Oct 1979; the Preamble had one section with the objective stating the medical and health professions were cooperating “to establish, maintain and promote appropriate standards of quality for educational programs in health professions and occupations, and to provide recognition for educational programs which meet or exceed the minimal standards outlined in these ESSENTIALS.”; the objective statements did not mention perfusion and may have been generic for all AMA essentials; in Description of the Profession, the cardiovascular perfusionist was described as follows, “a skilled person, qualified by academic and clinical education, who operates extracorporeal circulation equipment during any medical situation where it is necessary to support or temporarily replace the patient’s circulatory or respiratory function.”; the description further states the perfusionist is “knowledgeable concerning the variety of equipment available…and is responsible in consultation with the physician to select the appropriate equipment and techniques to be used.”; it also mentioned perfusionists might have administrative duties; a second paragraph addressed the perfusionist being “educated to conduct extracorporeal circulation and to ensure the safe management of physiologic functions by monitoring the necessary variables.”; it also specifically mentioned “administration, on prescription of blood products, anesthetic agents or drugs through the extracorporeal circuit” and hypothermia and hemodilution; the last sentence in the description stated, “Final legal and medical responsibility for extracorporeal perfusion rests with the physician.”; the major part of the draft was entitled, Requirements for Accreditation and included Sections I-VII, as follows: Sponsorship; Curriculum; Resources; Students; Operational Policies; Continuing Program Evaluation; and Maintaining Accreditation; the last section in the draft was entitled, Administration of Accreditation with details for applications to be sent to the AMA’s Department of Allied Health Evaluation in Chicago; a review committee within the Committee on Allied Health Education and Accreditation (CAHEA) was responsible for evaluating perfusion programs by reviewing applications and performing site visits)

(this report had survey results from 100 questionnaires with the following categories (number of questions in parentheses): Professional Responsibility (7); Professional Activity (8); Membership Benefits (4, with Likert scale ranking the value of the newsletter and journal); Meetings (3); and Continuing Education (7); the report noted that collected data could be used to “make significant directional changes in our Society”)

(these were survey results reported by the AmSECT Continuing Education Committee; there were 22 categories, as follows: anticoagulation management; acidbase and blood gas management; selection of equipment; fluid balance; pharmacology; temperature; cardioplegia; hemodynamic management; monitoring; intra-aortic balloon pump; autotransfusion (Atx); pediatric perfusion; supportive bypass; surgical assisting; dialysis; pacemakers; cath lab; non-invasive technology; research; inservice instruction; department management; and staff development; respondents were asked to report whether they performed the duties routinely, seldom, or never; numbers and percentages were reported in the results; the survey had been distributed at AmSECT’s 18th International Conference in Philadelphia in Mar 1980; the number of completed surveys used to tabulate results was not reported)

(there were two photos with officers: G. Cate (Executive Director); M. Hurdle (Secretary); G. Reeder (President-Elect); B. Pelley (Treasurer); and S. Newton (President); Board of Directors: F. Hurley (Regional Representative); M. Hurdle (Secretary); G. Cate (Executive Director); P. Cappola (Regional Representative); P. Palmer (Regional Representative; D. Engquist (Regional Representative); G. Reeder (President-Elect); B. Bartel (Regional Representative); D. Baxter (Regional Representative); S. Newton (President); P. Sabatelli (Regional Representative); R. Teixeira (Regional Representative); J.B. Denman (Regional Representative); R. Richards (Regional Representative); and B. Pelley (Treasurer))

(there were three statements, as follows: “1) Our primary responsibility is to the well-being of the patient. 2) Members are expected to uphold the Code of Ethics. 3) Reports of unethical behavior will be pursued to a conclusion through the Mechanics of the Code of Ethics.”; the Code had seven tenets, five of which had appeared in the 1976 Code; two of the tenets were new and were no. 5, “A member’s public statements should not adversely affect the Society.” and no. 6, “A member shall at all times hold the well-being and interests of the patient to be paramount and shall not subordinate same to the member’s interests nor act in such a way as to bring the member’s interests into conflict with the patient’s interests.”; on no. 7 regarding consultant work, a phrase was added to the 1976 tenet stating such work “shall be in the best interest of the patient.”)

(there were seven tenets as published in Nov 1983 (above); this version was reprinted in subsequent issues)

(“The purpose of AmSECT is to engage in activities that will encourage, promote, and expand the profession of perfusion and the technology utilized, in the interest of providing better patient care.”; there were six categories of goals, as follows: Professional Development; Technology Expansion; Representation; Membership Expansion; Administration; and Financial; this Mission Statement was reprinted in subsequent issues)

(she was a Registered Parliamentarian and advised AmSECT on proper meeting procedures during Board meetings)

(Freytag had a BS degree in Biology/Pre-Med from Purdue University; in 1976, he was trained at Methodist Hospital in Indianapolis, IN; he worked at St. Vincent Hospital in Indianapolis; he served as Secretary of Region V and had chaired many local meetings; he was named Perfusionist of the Year in 1981; he coordinated the production of AmSECT’s self-study modules; he was an onsite evaluator for CAHEA)

(she recounted her impressions of AmSECT meetings and some of the history of research work done with her husband Dr. John H. Gibbon, Jr. to develop the heart-lung machine)

(this listed officers’ names and had photos of officers: Frank Hurley (President); Michael B. Hurdle (President-Elect); L. Douglas Baxter (Secretary); and Bruce Bartel (Treasurer); the names of regional representatives were as follows: Susan Haubert (I); Robert L. Ruotolo (II); Sandra S. Witherington (III); Beverly G. Parault (IV); Munier Jallad (V); Terry A. Lowinger (VI); Ronnie D. Richards (VII); Thomas A. Rawles (VIII); David Engquist (IX); Roy Teixeira (X); and Phyllis Palmer (XI))

(in 1977, Bretz had started as an operating room technician in Orange County, CA; he was trained in Houston by Perfusion Associates, Inc.; after graduating, he worked briefly at St. Thomas Hospital in Nashville, TN, but returned to Houston in 1979 and was employed by Perfusion Associates, Inc.; in 1980, he co-founded Houston Life Support Systems, Inc.; he was also active in organizing Region VIII meetings; membership in the region increased during his leadership years)

(Prater began creating art in high school; he also took formal art courses at the University of Texas and had studied under two artists; he did some medical illustrations; he also had an interest in pottery, jewelry, and sculpting; in 1975, he was asked to sculpt the TMP Award of Excellence that was given annually by AmSECT to the perfusionist whose work exemplified creativity and intellectual honesty; the heart was cast in bronze and had been given each year since 1976; he received awards for his art and exhibited frequently; he made unique pieces of jewelry, some for AmSECT members; his favorite type of work was character studies and animals; he noted, “There are a number of talented—brilliant—people in the Society.”)

(Colby had been trained as an Operating Room Technician during WWII; after discharge in 1945, he applied for a job at the Veterans Administration Hospital in Hines, IL; he participated in closed mitral commissurotomy operations using a Lopez-Bello-Orman heart-lung machine; in 1959, he attended a meeting at Mt. Sinai Hospital in Chicago; he remembered seeing LeRoy Ferries and Jerry (sic, James) Wade at the meeting; in the early 1960s, he attended another meeting in Cleveland with other early open-heart surgery team members; in 1967 and 1968, the Hines Veterans Hospital team went to the Dominican Republic to perform open-heart surgery; in 1968, he was nominated Employee of the Year in the Chicago area; he was the perfusionist during the third heart transplant in the Chicago area; he attended nearly every annual AmSECT conference; in the 1970s, he helped establish the heart surgery program at Foster McGaw Hospital of Loyola University in Maywood, IL; the school became accredited, and he was named program director where he remained until his retirement in 1984)

(Hill shared tips on being an effective public speaker)

(this report was prepared by AmSECT Executive G. Cate; in the summary, he noted the interpretation of the results could be subject to differences; the survey was conducted by telephone interviews with 20 active members during three weeks in Sep-Oct 1984; those chosen to be interviewed were selected on a random sample; findings included: 1) respondents’ profiles; 2) respondents were generally pleased with AmSECT but were concerned about the future of perfusion; 3) queries about professional development revealed areas of “potential value for future program planning”; 4) member contact with the National Office received good ratings; and 5) results from open-ended questions would need to be reviewed individually)

(this interview focused on the subject being female and a cardiac surgeon)

(this interview focused on his work with hypothermia and resuscitation)

(he spoke about organizing regional meetings twice a year; he had been a member of AmSECT since 1978; he was trained at the Tucson Heart Institute)

(she served along with AmSECT Executive Director, George Cate; a major focus of her job was to organize the annual conference; a table compared the growth of AmSECT between 1979 and 1984: membership increased to 1,400 from 889; conference attendance increased to 1,100 from 850; exhibit booths increased to 93 from 60; the annual budget rose to $650,000 from $125,000; and corporate sponsorship increased to $66,000 from $29,000)

(he noted good communication and organizational skills were required as a Regional Chairman; he was trained on-the-job and had been an AmSECT member since 1979; he worked at a large program (900 case/year, of which 100 were pediatric); he spoke about the success of past regional meetings)

(these two perfusionists had participated in the second total artificial heart implant in patient William Schroder; the surgeon was Dr. William DeVries; they also were on the team for another artificial heart implant in patient Murray Haydon; the focus of the interview was on the procedure)

(this article was based on a paper Scott had prepared when he was a student at Howard University in Washington, DC; it told of the emergency operation by Dr. Daniel Hale Williams (1856-1931); he was credited for being the first surgeon to open a patient’s chest and repair a knife wound to the pericardium; the patient recovered and lived another 50 years; Williams became Surgeon-in-Chief at Freedmen’s Hospital Training School in Washington, DC, which was later renamed Howard University Hospital; his career also took him to other hospitals including being named attending surgeon at St. Luke’s Hospital in Chicago; he was a charter member of the American College of Surgeons, which was founded in 1913; he was also a founder and the first vice president of the National Medical Association; his home in Chicago was designated a National Historic Landmark in 1975)

(an excerpt of the article recounted LeRoy’s involvement with his mid-Western colleagues to start AmSECT; he served on the AmSECT Board as a Director and held the offices of Treasurer, President-Elect, and President; he also was a founder of the American Board of Cardiovascular Perfusion (ABCP); he spoke of early work on the ABCP, “As a group of peers, we perceived the need for and value in establishing education programs, and a way of testing the knowledge of perfusionists. So we designed criteria, and prepared and validated an exam that would measure the knowledge base of perfusionists of that time. From that base has evolved the certification process we have today.”)

(this included officers’ names and photos, as follows: Michael B. Hurdle (President); William B. Pelley (President-Elect); L. Douglas Baxter (Secretary); and Bruce Bartel (Treasurer); it also listed the names of regional representatives, as follows: Susan L. Haubert (I); George Galbraith (II); Sandra S. Witherington (III); Beverly G. Parault (IV); Bradford Smith (V); Terry A. Lowinger (VI); Ronnie D. Richards (VII); Thomas A. Rawles (VIII); David Engquist (IX); Jennifer Hershon (X); and Richard Schultz (XI))

(this was authored by Mark G. Richmond, Executive Director ABCP; it addressed use of an outdated certificate by a perfusionist who was claiming to be certified; the purpose of the letter was to publicize how the ABCP handled the complaint: after investigation, it was determined the perfusionist photocopied the seal from another perfusionist’s current certificate; the perfusionist was invited to meet with the ABCP to explain his conduct but declined; the ABCP determined the individual who forged the recertification certificate was ineligible for recertification; while stronger action could have been pursued, the ABCP declined to do so after assurance the perfusionist had ceased to be a clinical perfusionist)

(this expressed appreciation to the ABCP for “its decade of service to perfusionists, the public, and the American healthcare system”; it was signed by Michael B. Hurdle (President); L. Douglas Baxter (Secretary); Bruce Bartel (Treasurer); William B. Pelley (President-Elect); and George Melton Cate (Executive Director); names of the AmSECT Board of Directors were also listed)

(this article focused on his past work at Texas Heart Institute and the School of Perfusion he had established there; the rationale for writing Cardiopulmonary Perfusion in 1975 was to give perfusion students one source instead of having to purchase several textbooks with relevant chapters; he also spoke about malpractice and regional differences in costs for cardiac surgery)

(he suggested the term “perfusionist” began to be used in 1972 and was from England; he noted he had been able to recruit physicians to present papers at the annual AmSECT conference; he criticized AmSECT for becoming complacent and for not striving for excellence as it had in the past; he also spoke about contract perfusion and cited the example of it being unethical for a physician to own a drugstore; he criticized the ABCP for not adhering to its rules and regulations and urged AmSECT to take a more active role; he noted he got many calls about malpractice; he recounted his visit to China and how equipment for open-heart operations there used equipment similar to what was an American operating room in the 1950s)

(interview with John R. Cooper, MD; he was a staff anesthesiologist at the Texas Heart Institute (THI) and a member of AmSECT’s Professional Advisory Board; he spoke about the shared responsibilities for cardiopulmonary bypass as practiced at THI; he also spoke about cardiovascular anesthesia, trips to foreign countries as part of cardiac surgery team, and being on the advisory board for AmSECT)

(AmSECT and the Division of Medical Sciences at the National Museum of American History were cooperating to preserve the history of medical technology; AmSECT was to assist and consult on collections related to early prototypes of oxygenators; the curator, Dr. Barbara Melosh, was shown in a photo with Frank Hurley, AmSECT’s Immediate Past President; information on donated materials was to include the owner; weight and dimensions; where used and by whom; manufacturer; and historical significance; they also sought supporting data such as photographs, reprints of published articles, experimental protocols, and manufacturers’ catalogs)

(this article focused on his testimony before the Mississippi state legislature on insurance issues; he was Chief Perfusionist at the University of Mississippi Medical Center in Jackson, MS; his background was as an engineering technician, artificial heart technician, and instrumentation specialist; he fabricated early artificial hearts for Dr. T. Akutsu in 1969; in 1976, he was asked to train on-the-job as a perfusionist; he was a CCP)

(she was AmSECT’s first Secretary and had been Chief Perfusionist at Cleveland Clinic Foundation, 1955-1973; she worked with Dr. Willem Kolff on oxygenator development)

(notice of deaths of Mary Gibbon Thompson and D.J. (Jim) Bentley)

(this listed the officers’ names and had photos, as follows: Bruce Bartel (Treasurer); Bradford Smith (Region V); Frank Hurley (Region VI); Richard Schultz (Region XI); Ron Richards (Region VII); Dave Engquist (Region IX); Paul Cappola (Region II); James O. Fines, III (Region VIII); Jennifer Hershon (Region X); George D. Galbraith (President-Elect); William B. Pelley (President); Douglas Baxter (Secretary); Sandra Witherington (Region III); not shown Susan Haubert (Region 1) and Beverly Parault (Region IV))

(reprinted from J ExtraCorp Technol, vol. 10, no. 2, 1978].)

(this profiled Jeanne S. Lange, who was the Chair of the Perfusion Program Directors’ Council (PPDC); she began as a nurse practitioner and had taken undergraduate and graduate courses in nursing and management; since 1973, she had been the program director for the Program in Extracorporeal Technology, College of Health Related Professions, at the State University of New York Health Science Center in Syracuse, NY; since 1977, she was an Assistant Professor at the university; other leadership roles were: AmSECT Region II (Director) and ABCP oral examiner; the PPDC was formed in 1976 and met annually at the AmSECT conference; the priority of the PPDC was to safeguard the clinical evaluation process from subjectivity; one PPDC initiative was to provide courses for perfusion educators under the auspices of SUNY Upstate in Syracuse; courses would cover educational psychology, tests and measurement, and teaching methods; she noted 117 students were expected to graduate in 1986 nationwide, and in 1987 the number was expected to be 135; she expressed there was no need for new perfusion educational programs; prospective students at her program were chosen based on their academics, motivation, and appropriateness of career choice; she noted strong support from a cardiac surgeon when the program at SUNY Upstate was established in 1972; the first student began in 1974)

(contributors were Charlie Reed, Madeline Massengale Beall, and LeRoy Ferries; they recounted the inception of the Gibbon Award and spending time with Mrs. Gibbon at her farm outside Philadelphia)

(her background was as a Laboratory Technician II (Clinical Perfusionist and Administrative Assistant) at the University of California Medical Center Hospital in San Francisco; she also worked as a perfusionist in California and Denver; at the time of the interview, she was a Clinical Specialist (Perfusion) at the Veterans Administration Medical Center in Houston and a Consultant for CPI in Annapolis, Maryland; she held a diploma from Johns Hopkins Hospital School of Nursing and earned a Bachelor of Science degree from the College of St. Francis, Joliet, Illinois (at the off-campus site in Denver); she was married to Dr. Arthur Beall, Jr.; many topics were discussed during the interview; one excerpt was a reply to the question, “What do you think has most changed perfusion?”; she cited perfusion schools because, “They have established a more uniform standard of knowledge, and, overall, a generally higher standard.”; she recounted that when she entered the field, perfusionists came from many different educational and socioeconomic backgrounds; this meant there was a “rich variety of personality characteristics”; she stated she was not one of the founders of AmSECT as many had thought; in fact, her membership number was 104; she expressed that on-the-job training was “quite good” but “it did not provide a uniform level of knowledge”; she noted one influence for establishing perfusion schools was that in the late 1960s surgeons did not learn as much about heart-lung machines because they were more involved in the coronary artery bypass operation; whereas surgeons previously had the responsibility for operation of the heart-lung machine, the task had been deferred to perfusionists; it was mandated that perfusionists had to attain a level of education to match their new responsibilities; the last part of the article listed her involvement with AmSECT elected offices, other assignments and committee work, and awards)

(the survey was conducted by the AmSECT Perfusion Practice Committee “to furnish the background to help establish guidelines”; George Justison was Chair of the committee; 678 Chief Perfusionists were sent questionnaires, and 257 (40%) responded; number of responses by region were listed; sections with number of questions in parentheses included: Manpower (25); ECC Components (16); Perfusion Technique (6); and Other Subjects (11))

(the AmSECT Board of Directors approved this position statement at their fall meeting held 15-16 Nov 1986; it called for the accrediting agency to clarify and enforce guidelines establishing the minimal competency of instructors in perfusion training programs; it noted that there had been reports of senior students serving as clinical instructors in some programs; it called for all instructors to be certified; it suggested that all graduates should have a Bachelor’s degree upon completion of training; it called on employers to cease hiring and training their own perfusionists because such practice circumvented the educational process and resulted in “dead-end” jobs with those so trained unable to move upwards or laterally; it reiterated support for the 1981 ABCP deadline; it expressed that postgraduate education should be established at the Master’s and Doctorate levels to further upgrade the profession; it called for all perfusionist to maintain continuing education, whether they were certified or not; it called for a system to recognize individuals who were currently practicing but were not eligible for certification; it outlined other job duties of perfusionists besides operating the heartlung machine, which included autotransfusion; counterpulsation; extended extracorporeal bypass for support of respiratory and circulatory functions, left and right ventricular support, “and a host of other supportive and related technologies”; it concluded by stating the position statement was a first step in establishing minimal standards of education for the practicing perfusionist; it argued it was time for perfusionists to make the necessary changes “for the betterment of the profession as well as for the safety of the our patients”; the last paragraph stated AmSECT was prepared to discuss its position statement with accrediting agencies, certifying agencies, governmental agencies, or any other interested institution or society)

(this reported survey results from a questionnaire sent to current and past CCPs in spring 1985; 1,350 survey forms were sent out, and 744 usable forms were returned (55% response rate); there were three sections, as follows: demographics; perceptions on the importance of certification; and those who had lost certification (of 300 perfusionists in this category only 12 surveys were returned making it impossible to draw any conclusions from this group); a full report of the survey results was available for $50 upon request to the ABCP National Office)

(this was a tribute to David Engquist, deceased 25 Apr 1987; Engquist had been the Region IX representative to the AmSECT Board; he also was a founder of the AmSECT Bylaws Committee)

(this was a group photograph of Ed Berger, Maddie Massengale, Calvin Scott, LeRoy Ferries, James P. Dearing, Frank Hurley, William B. Pelley, Michael B. Hurdle, and Larry Cavanaugh)

(this had 1987-88 officers’ names and photographs, as follows: Secretary Sharon Marquis; President George D. Galbraith; President-Elect L. Douglas Baxter; Treasurer Bruce Bartel; it also included a list of committee chairs and regional representatives)

(this was a profile of Scott Hardin; he compiled “Articles of Interest” for Perfusion Life; he was a former Associate Editor for the Journal of ExtraCorporeal Technology)

(the AmSECT National Office was located on Isaac Newton Square South in Reston, VA; the article recounted early work by Newton; cardiac surgery or extracorporeal circulation not addressed)

(this article had interviews with Philip D. Beckley and Brian R. Paules, perfusion program directors; there were photos of each; Beckley was an Assistant Professor and Director of the Circulation Technology Division, School of Allied Medical Professions at Ohio State University, where he had worked since 1978; he had a BS degree in Allied Health Professions and an MS and PhD in Physiology; he was chairman of the AmSECT Research Committee; he received the Fellowship Award for a paper presented at the 24th annual conference; Paules was Program Director of the School of Perfusion Technology at Harper Hospital in Detroit, MI, and had been employed there since 1978; he earned a post-baccalaureate certificate as a Circulation Technologist from Ohio State University, Circulation Technology Division; he also had a BS in Genetics; he served as Secretary/Treasurer for the Perfusion Program Directors’ Council and was a member of the Joint Review Committee for Perfusion Education (JRCPE); he was Site Examiner for the JRCPE and a member of the National Society for Cardiopulmonary Technology; the interview covered areas such as their respective programs and contrasts between university-based and hospital-based perfusion programs)

(the anonymous writer paid tribute to Dearing)

(Dearing died 26 Sep 1987; the author of the tribute was his brother; he recounted his brother’s background as a respiratory therapist at the Clinical Center of the National Institutes of Health (NIH) beginning in 1961; he was recruited to be a pump tech; he used a Kay-Cross disc oxygenator; setup started at 5:00 am, surgery started at 8:00 am and would often last 810 hours; cleanup and repackaging lasted until 8:00 to 9:00 pm; he was self-taught regarding anatomy, physiology, chemistry, and hematology and was considered one of the most knowledgeable perfusionists at the time; in 1967, he and surgeon Dr. John Vasko, a fellow at the NIH, moved to Columbus, OH to establish the first Baccalaureate program in perfusion technology at Ohio State University; the first students began in 1969 and graduated in 1971; in 1974, he moved to Charleston, SC, to become program director of the perfusion program at the Medical University of South Carolina; he became a full professor at the university in 1987; he held many leadership positions in AmSECT beginning in the 1960s as Second Vice President (Certification and Education); he was AmSECT’s president in 1981 and also editor of the journal, Vice President of the American Board of Cardiovascular Perfusion; he received many awards including the Polystan and TMP awards for education, life membership, and the Gibbon Award; he authored or co-authored more than 40 scientific articles and wrote a book chapter in Norman’s Cardiac Surgery; he authored the first certification examination for perfusionist and dialysis technicians; he authored self-study modules for AmSECT; he wrote the Essentials and Guidelines for CAHEA approval that led to recognition of the clinical perfusionist; he made many national presentations and was the first perfusionist to speak at the Pathophysiology meeting in San Diego; memorial funds were established through AmSECT and the Medical University of South Carolina; the tribute closes, “Jim, you are sorely missed.”)

(the purpose of the AmSECT Perfusion Quality Committee was “to promote, encourage, and expand the development of protocols in the practice of perfusion”; the goal was to aid perfusionists “without dictating methods or protocol which necessarily are within the domain of practitioners at their respective institutions”; other goals included dissemination of safety alerts and educational material to aid teams in formulating guidelines for their particular clinical settings”; the committee prepared a questionnaire that was distributed to AmSECT members “to solicit input on the issue of perfusion standards”; the survey allowed for anonymous input; Part 1 had 20 questions on protocols, orientation for new employees, continuing education for staff, emergency drills, equipment information on file, quality assurance, perfusion records, and product alerts; Part 2 had 14 questions on the value of quality assurance/perfusion standards, means of dissemination of safety information, types of standards (goal-oriented v. task-oriented), and authorship of standards)

(he pointed out some contradictions in the field such as the direction of perfusion, scope of practice, and a manpower shortage; he stated the manpower shortage was the most pressing issue; he listed some issues perfusionists agreed upon: 1) the manpower shortage; 2) desire not to lower the professional status of perfusionists; 3) many proposed solutions; 4) quality of patient care was a paramount concern; and 5) economic security was important for perfusionists; he also suggested past leaders in the profession did not plan for the growing manpower requirements; he raised the specter of a return to on-the-job (OJT) training in “the absence of viable education alternatives sponsored and supported by a committed perfusion community”; “Future direction is built upon an understanding of past accomplishment and present potential.”; he cited four trends: first, relaxing of state regulations justifying hospitals to offer new health services, of which cardiac services was one; as a result, service organizations offering increased efficiencies had proliferated; second, less invasive therapies such as PTCA and laser techniques requiring OR standby had increased 150,000 in 1988; third, there had been a large increase in the number of cardiac surgeons; he cited Dr. Gerald Rainer’s admonition that the number residency positions be reduced; community-based cardiac surgery programs had strained the ability of perfusionists to keep pace; the fourth trend was the expansion of perfusionists’ job duties such as cardiac support and blood management; some other allied health professionals such as nurses or respiratory therapists had begun incursion into these new modalities; he warned that others besides perfusionists who were responsible for operating LVADs or CPS systems in the cath lab could begin to operate the heart-lung machine in ORs; he then addressed perfusion education and offered some guideline statements, as follows: 1) “Perfusionists should develop a more global view of their function in cardiac medicine.”; 2) “Perfusion Department Managers should offer their institutions as clinical rotations to accredited training programs.”; 3) “Perfusion Department Managers should investigate the possibility of starting a new perfusion training program.”; 4) “AmSECT should embrace the concept of Perfusion Assistants and offer its’ membership and educational support.”; 5) Perfusion Program Directors should recognize their responsibility as manpower planners.”; and 6) “The American Board of Cardiovascular Perfusion should provide less stringent access to its’ examination process.”; he concluded that educational processes had to be permitted to evolve; “The profession can ill afford to cast adrift at a time when so many perfusionists’ futures are at stake.”; consensus among perfusion organizations was needed; he suggested the possibility that “former standards and practices of perfusion education may not meet today’s needs”; he closed by reiterating the current manpower situation had to be addressed; he predicted that “perfusion can remain a strong progressive profession for the next decade. Contemporary decisions, however, will dictate future function.”)

(it included what was thought to be a depiction of the top view of a “disc oxgenator through a Brown-Harrison heat exchanger to a roller pump (with a nasty barb on it) to a bubble trap-filter and then to an oddly shaped patient”; because renal technicians were members of AmSECT, a large “R” was shown; the author sought out confirmation from Calvin Scott; Scott wrote to Pierre J. Morin, one of the people who helped design the emblem; Morin wrote a letter stating the emblem was first used at the Montreal meeting in 1967; it was designed by Ian Ross, Roger Samson, Jacques Lussier, and Pierre Morin; they wanted to incorporate both fields of activity; his explanation was the left side was a bubble oxygenator with stylized helix and roller pump transferring blood from the artificial lung to the patient; the “patient” was depicted as “a dark ring in the center with an arrow to indicate a man in general”; on the right side was a stylized finger pump transferring blood from a stylized coiled kidney to the recipient “patient”; Ian Ross’s brother was an architecture student who balanced the composition of the design and graphics)

(he recounted the first successful ECMO case by Dr. J. Donald Hill from the early 1970s; this was followed by the NIH-sponsored multi-center randomized trial of ECMO in the mid-1970s; because of inconclusive results, adult ECMO was mostly abandoned in the US; he then recounted the infant case by Drs. Bartlett and Gazzaniga; the patient’s name was “Hope”; between 1980 and 1986, 715 patients underwent ECMO at 18 centers; the survival rate was 81%; at the time of this article there were 50 neonatal ECMO centers; he then reviewed what ECMO meant for perfusionists by asking, “Is it another chore, burden, or is it a blessing?”; he suggested it was an opportunity; he listed programs that had perfusionists on the ECMO team; he acknowledged that ECMO was labor intensive but argued it was an opportunity for perfusionists to expand their horizons; he then asked why some perfusionists did not get involved with ECMO; reasons included being too busy and others had expressed having no interest in the technology; he cited the American Board of Cardiovascular Perfusion that did not award recertification points for ECMO cases in the same way as cardiopulmonary bypass cases; he noted some nurses and respiratory therapists were performing ECMO because they were licensed to give medications; he cited the designation “ECMO Specialist” being credentialed; he argued that ECMO certification was a natural extension of perfusionist certification; he warned that if perfusionists did not act, nurses could control ECMO certification; he cited thoracic surgery certification that required certification first in general surgery; he closed by stating, “Perfusionists must avoid being uninformed, stagnant, and unprepared to receive and interact with new and unseen technologies.”; he reiterated the need for the certifying body to expand the knowledge base; “Failure to grow and expand with the times is destined to not only reduce what has been gained thus far or lose it altogether.”)

(Hudson had worked for Newton in Las Vegas, NV)

(he recounted the history of certification as initiated by AmSECT in 1968; the first examination was given in 1972 to evaluate the knowledge base of practicing perfusionists; the requirement to take the examination was to have been a “pump tech” for at least two years and having conducted 100 clinical cases; AmSECT acknowledged in 1970 it could not continue to certify its own members due to a conflict of interest; an autonomous board, the American Board of Cardiovascular Perfusion (ABCP), was formed in 1975, and it adopted all the criteria for those to take the exam as had been used by AmSECT; most applicants taking the examinations were on-the-job (OJT)-trained between 1972 and 1981; the first pass/fail examination was given in 1974; both AmSECT and the ABCP recognized the need to create an accreditation process for training programs to ensure a minimum standard for education for those wishing to sit for the examinations; in 1979, the ABCP issued a notice that OJT-trained perfusionists would no longer be eligible to take the examinations after 15 Mar 1981; the rationale for this dictum was “to improve the profession and act as protection of the public”; AmSECT supported this position; however, as with AmSECT originally certifying its own members being considered a conflict of interest, it believed that the ABCP accrediting schools was also a conflict of interest; therefore, AmSECT worked with the American Medical Association (AMA) to form the Joint Review Committee for Perfusion Education (JRCPE); as of Sep 1986, all accredited training programs in the US were accredited by the AMA’s Committee on Allied Health Education and Accreditation (CAHEA); when certification was established, many were concerned all practicing perfusionists would certified; most perfusionist advertisements had begun stipulating that applicants for jobs had to be certified or certification-eligible, and some even stated they had to have graduated from an accredited school and therefore be board-eligible or certified; in recent years, some advertisements had dropped the requirements for job applicants to be certified or certification-eligible; Baxter acknowledged that there were many “good perfusionists who are unable to meet the ABCP requirements to sit for the exam”; he closed by asking, “do we want to encourage a rebirth of OJT by not requiring certification for future perfusionists?”)

(she was the AmSECT historian; she recounted the early meetings in the 1960s to form a group of clinical “pump techs” to exchange information; Ace Adams was one of the early participants; they decided to form “The Society of Pump Oxygenator Technicians” but the name was changed to “The American Society of Extra-Corporeal Circulation Technicians” in 1964; AmSECT was incorporated in Minnesota in 1968; she noted that members all had been trained onthe-job (OJT) but had some medical background; early common goals included certification and education programs and recognition of “pump technicians” as professionals; a Medical Advisory Board comprised of doctors was formed; the group made overtures to the American Society for Artificial Internal Organs and the American College of Surgeons, but with disappointing results; in 1975, the American Association for Thoracic Surgery (AATS) appointed Dr. Arthur C. Beall, Jr. to learn about AmSECT and make a recommendation to its council; the report led to AmSECT’s application for formal recognition to the American Medical Association’s (AMA) Committee on Emerging Health Manpower; the AATS and the Society of Thoracic Surgeons cosponsored AmSECT’s application; in Mar 1977, the AMA Council on Medical Education approved AmSECT’s application for recognition of the “Extracorporeal Technologist”; the three collaborating organizations then were tasked with drafting an “essentials” document specifying minimum standards for training programs; the term “Perfusionist” replaced “Extracorporeal Technologist”; the Joint Review Committee for Perfusion Education (JRC-PE) became a reality and schools became accredited by the AMA’s Committee on Allied Health Education and Accreditation (CAHEA); the first two programs were accredited in 1981; as of the writing of this article there were 20 accredited programs with one-half of them conferring a Baccalaureate degree upon completion; while only six programs required a Baccalaureate for admission to the program, they favored applicants with a degree; some programs were exploring the possibility of offering MS or PhD degrees; controversy existed as to whether there was a manpower shortage; some hospitals had reinstituted OJT, but this was viewed as antithetical to the goals of AmSECT; it was noted that those trained in such a manner would not have opportunities for mobility or advancement; most employers mandated certification for prospective perfusionist employees; another development was the perfusion assistant who assisted the clinical perfusionist; another issue was abandonment of perfusion procedures such as ECMO, CPS, and VADs, which in some settings was being implemented by other allied health occupations; contract perfusion groups were opposed to loss of ancillary jobs and were aggressively fighting against it; she posited parallels with nursing insofar as jobs could become stratified; upper level jobs would be perfusion managers, executives, chiefs, leaders, and administrators who would have higher degrees; mid-level practitioners would be similar to the former “pump technicians” with associate degrees and would be analogous to diploma nurses; they would work under the supervision of a perfusionist; she suggested that a “Board of Pump Technicians” might be developed to credential mid-level practitioners; the lower level would be the perfusion aide, assistant, or apprentice who would enter the field with little formal education; as an example, they could be trained to operated autotransfusion equipment; the analogy in nursing to this category would be the nursing care technician; she closed by urging perfusionists to participate in deciding the future of the field)

(this had group photographs labeled pre: Paul Cappola, Frank Hurley, Richard Schultz, Ronnie Richards, Beverly Parault, Susan Haubert, John Patterson, George Beshere, Jr., Jennifer Hershon, James Shadowens, Treasurer Bruce Bartel, President Doug Baxter, Secretary Sandra Witherington; and post: Craig Vocelka, Frank Hurley, Jim Shadowens, Paul Cappola, Ronnie Richards, Susan Haubert, John Patterson, George Beshere, Jr., Charles Belcher, Jr., Treasurer Bruce Bartel, President-Elect Pat Courtney, President George Galbraith, Secretary Sandra Witherington)

(Hill reflected on the early years of AmSECT when there always seemed to be a crisis; he was Chief Perfusionist at Fairfax Hospital in VA and had a staff of six perfusionists; they performed 1,100 cases annually and left ventricular assist devices and heart transplants; he served on AmSECT’s Perfusion Quality Committee and had been a director of the American Board of Cardiovascular Perfusion; in his youth, he read the encyclopedia “from A to Z” and wanted to become a nuclear physicist; he actually wanted to build a cyclotron in his upstate New York town, but that aspiration was never realized; he was fascinated with explosives; he studied chemistry at Cornell and the University of Rochester; he worked in quality control at Eastman Kodak but did not find the work challenging; he got a job in biomedical research; he helped develop a cardiac mapping device; he was introduced to perfusion in the animal laboratory; this was his entry to become a perfusionist; he traveled to several centers to learn more about perfusion; he studied under Rose Litturi and John Taborosi at the Cleveland Clinic, Jim Dearing at Ohio State University, and Charlie Reed at Texas Heart Institute; he believed the Journal of Extra-Corporeal Technology was responsible for the growth of AmSECT; he praised Emily Taylor for “doing an incredible job in keeping the Journal going”; he organized educational programs focusing on topics such as fluid and electrolyte balance; he cited other outspoken leaders of the time such as Charlie Reed, Jim Dearing, Mike Dunaway, and Earl Lawrence; he served on the AmSECT Executive Committee, Bylaws Committee, and Ethics Committee; he referred to AmSECT’s struggles to obtain recognition from the American Medical Association as an “identity crisis”; he was in favor of more collaboration with the anesthesia and thoracic surgery societies because of mutual vested interests; he was in favor of a four-year degree program for perfusionists; the article noted he was an avid volleyball player and played golf and chess; he was married in 1966, and he and his wife had two daughters; they first tried farming and raised veal calves to supplement his perfusion salary; he closed by stating perfusion had many opportunities; “You can take perfusion and get from it what you want.”)

(he was a CCP in Las Vegas, NV; he was the founder and CEO of Las Vegas Heart-Lung Perfusion, Inc.; he was AmSECT president 1983-1984 and had initiated the Management-By-Objectives strategies at AmSECT; he was the liaison to the Society of Thoracic Surgeons and the American Association for Thoracic Surgery; he was named AmSECT’s Perfusionist of the Year in 1983; in this article, he speculated on perfusion in the year 2000; he noted newer applications of extracorporeal circulation such as ventricular assist devices (VADs); he stated perfusionists’ salaries were at an all-time high, but workdays were long and took a personal toll on some; he wrote some surgeons and cardiologists had trained staff nurses, respiratory technicians, and cath lab personnel to operate cardiopulmonary support systems; he likened this development as setting perfusion back into what occurred in the 1960s; he stated cardiologists did not know much about perfusionists’ skills; he noted a decline in cardiac surgery cases in the early 1990s due to percutaneous translumenal coronary angioplasty (PTCA) and tissue plasminogen activator (TPA) drugs; he speculated that with the decline in open-heart surgery, perfusionist manpower shortages had been met; he noted perfusion assistants also had helped with the manpower situation; lobbying by AmSECT and the American Board of Cardiovascular Perfusion prevented the use of unqualified personnel; he predicted legislation by 1992 that would require perfusion services only from board-eligible or board certified perfusionists; he speculated about laser procedures that would eliminate the need for coronary heart surgery; he wrote of Cardiovascular Centers of Excellence that would decrease the need for cardiac surgeons and perfusionists; he closed with three statements regarding challenges the field faced in the late 1980s and early 1990s: 1) the manpower threat of 1989 and 1990; 2) the “changing of the guard” from the cardiovascular surgeon to the interventional cardiologist; and 3) lobbying for necessary state and federal legislation needed to ensure quality perfusion for patients nationwide)

(Hargesheimer had attended her first regional meeting in 1967; she met Rose Litturi, who was the AmSECT secretary; after leaving a job with the US Department of Agriculture, Hargesheimer trained as a surgical technician; after six months she went to Tulane University to train on-the-job to be a pump technician; she started work there on 20 Jun 1966; by August 1966, she was functioning on her own; she worked for Dr. Oscar Creech; in 1968, she attended the AmSECT conference in San Francisco as the Region IV representative; the group developed Articles of Incorporation; at the 1970 conference, she was elected president for a one-year term; in 1971, she was re-elected for a two-year term; there was some skepticism from members on the value of being an AmSECT member; certification had been promised for years; she assembled a Medical Advisory Board; she recruited Dr. Edward Hyman, who had been a founding member of the American Society for Artificial Internal Organs (ASAIO); she requested help to create an examination; she wrote to many ASAIO physicians such as Drs. Willem Kolff, Adrian Kantrowitz, Pierre Galletti, Richard DeWall, Charles Gutch, E. Converse Peirce, Donald Lyman, and Benjamin Burton; she characterized them as “humble and down to earth”; in 1972, the ASAIO meeting was in Seattle, and AmSECT held a luncheon for the Medical Advisory Board to discuss certification; the matter was deferred, but she argued certification existed for disciplines in medicine, even dieticians; “I think it is about time you acknowledged your children.”; the physicians agreed, and Drs. Peirce and Burton were appointed to set the criteria and gather a database; the first examination was given in New York City at the Waldorf Astoria Hotel on 29 Jul 1972; in 1975, the American Association for Thoracic Surgery and the Society of Thoracic Surgeons helped AmSECT apply for recognition from the American Medical Association; she believed the groundwork with ASAIO helped secure recognition; she acknowledged others in AmSECT who helped: Jim Dearing, Mike Dunaway, and Maddie Massengale; she currently worked at East Jefferson Hospital in Metairie, LA; as the only perfusionist for 12 years, her caseload was 270 hearts a year; she noted current perfusionists did not seem enthusiastic about ECMO or CPS; she urged perfusionists to get involved; she closed by expressing fondness for the fellowship in AmSECT)

(he noted he had experience working in both contract and institutional-based roles; he disclosed he believed in the expansion of extracorporeal technology within hospitals; he was trained at Ohio State University 1972-1974; that experience provided graduates with the ability to become “teachers and managers of life support systems, services, and allied health personnel”; he defined a contract perfusionist as one who was paid a fee-for-service by hospitals or physician groups; both organizations billed for perfusion services; other perfusionists worked for hospitals, clinics, foundations, or universities; he noted many hospitals were contracting for many services such as laundry, waste removal, administrative management; he speculated that contract perfusionists comprised 40% to 50% of perfusion services; the advantage for hospitals was for administrators to define and plan future costs, which was appealing with DRG reimbursement; he noted that 500 new open heart centers had been established in the last five years; certificates of need were no longer necessary to start an open-heart program; one result was maldistribution of perfusionists; he noted the previous year he had given the James P. Dearing Memorial Lecture in Charleston, SC; he spoke of the “signs and symptoms of our professional domain ‘erosion’”; he cited the breakaway of dialysis technicians from AmSECT in 1974; he noted in the early 1970s many perfusionists worked in cardiac catheterization laboratories and had duties for intraoperative monitoring and diagnostics; at the time of the article, biomedical engineering technicians (BMET) and certified cardiovascular technologists (CVT) personnel were performing what perfusionists used to do; he also noted some perfusionists had trained nurses to perform intraoperative autotransfusion; another example was nurses and respiratory therapists trained to initiate and manage ECMO; he noted the development of use of perfusion assistants; he suggested there were 350 to 500 perfusionists who had been trained on-the-job (OJT) but were not certification-eligible; he doubted that petitions to the American Board of Cardiovascular Perfusion (ABCP) for grandfathering would be honored; he stated the Society of Thoracic Surgeons’ executive committee was “angry” over the perfusionist shortage and was ready to disavow their support of the Committee on Allied Health Education and Accreditation (CAHEA) and the ABCP; there was the possibility of condoning OJT to address the perfusionist manpower maldistribution and salary challenges; he argued only contract perfusionists were fighting to keep clinical competencies and were embracing newer technologies; despite the challenges he had outlined, he believed “this is a great time to be a perfusionist”; salaries had gone up 20% in the last three years; he noted that with 285,000 open-heart cases per year and 2,500 perfusionists, the average case load for a perfusionist was 114 cases/year; another advantage of contract perfusion was sharing of protocols and techniques; he alluded to ethical issues of contract perfusionists selling or distributing perfusion equipment; he listed several reasons why contract perfusion was appealing; he closed by advocating professionalism and the many ways it could be fostered)

(the article recounted how surgical residents operated the heart-lung machine in the 1950s, but by the 1960s surgeons and residents did not have the time; in some settings, a cardiologist ran the pump; by the 1970s there were some cardiac surgeons who had no experience with heart-lung machines; the American Board of Thoracic Surgery (ABTS) did not believe surgeons needed to have experience operating heart-lung machines; in 1975, Beall was appointed to the long-range planning committee of the American Association for Thoracic Surgery (AATS); AmSECT was seeking recognition from the American Medical Association (AMA) as an emerging allied health profession; he prepared a report and recommended the AATS and the Society of Thoracic Surgeons (STS) sponsor AmSECT’s application for recognition; in Mar 1977, such recognition was achieved; Madeline Massengale was chair of the AmSECT committee charged with writing essentials for accredited perfusion schools; Beall was the AATS advisor; the first schools were accredited; Beall and Massengale married; Beall had been born and raised in Atlanta; he was Chief of Surgical Services and Cardiac Surgery at the Veterans Administration Hospital in Houston; he also was a Professor of Surgery at Baylor College of Medicine; he noted that the ABTS now required residents to have some knowledge of cardiopulmonary bypass; he and Massengale organized a course on perfusion principles for thoracic residents; he noted both the AATS and STS were concerned about the shortage of perfusionists; more thoracic surgeons were being trained than perfusionists; there were 20 accredited perfusion programs versus 111 thoracic surgery residency programs; he stated the number of coronary artery bypass operations would exceed 300,000 in 1989, which was an increase from 285,000 cases the previous year)

(the foreword from Galbraith addressed the American Board of Cardiovascular Perfusion’s (ABCP) 1981 deadline whereby only graduates of accredited perfusion programs were eligible to sit for the certification examinations; AmSECT supported the deadline at the time and was stated to have not changed its position; the issue of the number of practicing perfusionists who would not be eligible ranged up to 400; the ABCP had an alternative process whereby those who could demonstrate equivalency would be eligible; however, few who had applied had been accepted by the ABCP to take the examinations; Galbraith noted that Board-eligible or certified perfusionists was a de facto requirement by employers; the ABCP had recently reassessed the alternative process and communicated their deliberations; the full text of the communication was reproduced in the article; Cavanaugh’s response letter dated 6 Oct 1989 with the text of the communication on the alternative process had been sent to Galbraith; the ABCP acknowledged some changes had to be made; the ABCP reiterated it would continue to act in the best interests of education and certification of perfusionists; Cavanaugh asked that Galbraith explain the ABCP’s intention and position in their efforts to meet perfusion service demands; the text was entitled, “The Future of Alternative Certification of Perfusionists by the American Board of Cardiovascular Perfusion”; it restated that the ABCP was maintaining standards for the alternative process for perfusionists wishing to become certified but lacking the educational requirements established by the ABCP; the ABCP’s Credentials Committee reviewed and judged the validity of individuals who sought eligibility to take the examinations; in 1989, during a meeting of the Board of Governors held in Atlanta, the ABCP was asked about the alternative process, and the ABCP stated no changes were anticipated; the ABCP at its winter meeting agreed to provide the Board of Governors a statement regarding the nature and regulations of the alternative process; the ABCP decided that after 1 Oct 1990, no applications from individuals for the alternative process would be accepted; those who were being considered were given until summer 1992 to submit their qualifications, but the alternative process would cease after 1992; a list of reasons the ABCP made this decision were listed: 1) the alternative process was difficult to administer because verification of equivalence was difficult to document; 2) 50 individuals in the last five years had made application under the alternative process; of that group, less than 10% were admitted to the examination; 3) the alternative process had created false hopes and ill will from those seeking liberalization of the certification requirements and from those in favor of maintaining high quality standards for certification; 4) the process demonstrated that equivalency was undeliverable—that is, “one cannot demonstrate equivalent education without having attained that education”; this constituted a “tenuous position” for the ABCP with cooperating organizations and with individuals submitting themselves to the alternative process; 5) it suggested the manpower problem and efforts to alleviate it should be directed to the schools to graduate a greater number of perfusionists; the ABCP stated its function was “not related to the current real or perceived manpower shortage” but did acknowledge it was of concern; it further stated the ABCP did not have control over the number of practitioners; it reiterated that certification was a voluntary activity; it noted that the general consensus of other certifying agencies did not support alternative processes that lacked formal education; additionally, medical and allied health professions did not recognize OJT, alternate, or equivalency standards for entry into certification processes; it characterized such positions as antithetical to the purposes of development of standards requiring formal education; it reiterated the ABCP had no responsibility for filling manpower needs; it was responsible for the maintenance and validity of the certificate; it restated that the ABCP’s position established ten years earlier mandating eligibility for certification was limited to graduates of accredited perfusion educational programs; the ABCP had concluded the alternative process had fomented confusion in the field and had taken more energy than any other function except administration of the examination; the statement closed by asserting the ABCP would “accept its responsibility and share the alternatives available to the larger community”)

(Richmond had pumped >8,500 cases over 25 years; he began his career in 1963 after serving in the Air Force in Germany; he studied to be a laboratory technician; he moved to Memphis, TN, and was offered a chance to train to operate the heart-lung machine; the salary was $325/month; he worked under Drs. Edward Garrett and Hector Howard; after four years, he was “hooked” on being a perfusionist; he noted in the early days the surgeons took care of the patient from admission to discharge; there were no cardiac anesthesiologists and no intensive care nurses; his job was to set up the pump and monitoring equipment, put the Foley in and prep the patient; he also scrubbed in and took veins; he transported the patient to the recovery room; sometimes he stayed at the hospital all night; he also made post-op rounds and removed stitches; the first oxygenator he ran was a Kay-Cross rotating disc; it was primed with six units of fresh heparinized blood; he did more and more for the surgeons until he decided to go into contract perfusion; he believed he had more backup as a contract perfusionist; he became involved in AmSECT in 1970 when Emily Taylor persuaded him to attend a Region IV meeting in Birmingham, AL; there was intense competition between cardiac surgery hospitals, and many perfusionists had never met one another; he formed a group so they could share experiences; he served on AmSECT committees and their board; in 1983, he received the AmSECT Award of Excellence; he was also a director on the American Board of Cardiovascular Perfusion, and a charter member of the American Academy of Cardiovascular Perfusion; he stated AmSECT was ahead of other professional groups in establishing certification and recertification processes; he expressed concern over the manpower shortage; he hoped the profession could solve the problem before surgeons or the government stepped in and took control; he helped start a new perfusion school at Episcopal Hospital in Philadelphia; he had open-heart surgery in 1980 and again in 1989; he credited his wife Janis for caring for him during his recovery; she accepted the Award of Excellence on his behalf; leisure activities included photography and gardening)

(Rivard was the AmSECT liaison to ELSO; the article cited cumulative ECMO cases (2,946) as of 26 Sep 1989 from 68 centers; the authors predicted an increase in the number of cases in the future; in Oct 1989, ELSO was established; it planned an annual conference and to establish a database of cases; other projected activities included providing logistical guidelines and education for new centers; ELSO membership was open to centers who supplied caseload data to the registry; each center was to have one vote on ELSO actions; corporate memberships were also available; ELSO was governed by a steering committee; there were also six standing committees on the conference, protocols, communication, registry, devices/techniques, and logistics/education; meetings were held in Ann Arbor, MI; details were described on the various committees; the authors noted perfusionists were integral members of ELSO, but they acknowledged many perfusionists at centers did not participate; they closed by encouraging perfusionists to become involved with ELSO)

(photo only)

(photo only)

(information on the checklist noted it was researched and developed by the AmSECT Perfusion Quality Committee; in Mar 1989, the committee requested examples of existing checklists; it collated them and also relied on a perfusion accident survey published by Kurusz (Proc Am Acad Cardiovasc Perfusion 1986, vol. 7, pg 57); the AmSECT Board of Directors unanimously approved the checklist; “We, as a committee, feel that this checklist or a reasonable equivalent can be a useful tool in increasing safety for both the cardiopulmonary bypass patient and the perfusionist.”; the one-page checklist was titled, “Suggested Pre-Bypass Perfusion Checklist”; the checklist had multiple topics with items to be checked off or marked NA (not applicable); there was a section for comments, and the form was to be signed along with the time and date)

(Horgan had intended to become a corpsman in the Marines, but the Navy recruited corpsmen in training in response to the Cuban Blockade; he was offered to be stationed either at a hospital or on a ship, and he chose a hospital in Philadelphia; his assignment was in Cardiac Surgery at the Bethesda Naval Hospital; he was trained to operate the heart-lung machine; an anesthesiologist had previously been assigned to run the pump; the oxygenator was a rotating disc, and the pump was made in the machine shop; they used custom-made connectors and cannulas, also fabricated in the machine shop; tubing was from beer distributors because medical-grade tubing did not exist; he purchased Tuffy scouring pads at a grocery store that were wetted with silicone and put in glass cylinders for debubbling cardiotomy suctioned blood; a tubing clamp was called the “Horgan clamp”; work in the research laboratory with Jim Bentley led to development of a disposable pediatric bubble oxygenator; he also worked in Dr. Kolobow’s laboratory for treatment of so-called wet lung disease; the plan was to take the technology to Vietnam, but the war ended before it could be done; he got involved in AmSECT in the late 1960s; a group of perfusionists started a journal club; Jim Dearing, who was at the NIH, was a member; in 1972, he and his wife moved to Denver; he met Maddie Massengale; she was an advocate for AmSECT; in 1974, he formed Rocky Mountain Perfusion, Inc.; his group did about 900 cases annually at three primary hospitals; he was the AmSECT representative to the CAHEA panel of consultants and was its secretary/treasurer; he served on the AmSECT Board under LeRoy Ferries; he was elected to the American Board of Cardiovascular Perfusion (ABCP) in 1978, and served as ABCP president for four years; in 1986, he was received the AmSECT Award of Excellence and Perfusionist of the Year; he stated the field’s greatest problem was to secure a place in the medical society and to protect perfusionists’ scope of practice; he noted the incursion of respiratory therapists to sit ECMO and VAD shifts, but in Denver those duties were performed by perfusionists; he criticized some new graduates who demanded high salaries, four day workweeks, and no call; he and his wife had three children; he devoted spare time to a church youth group and refereeing high school soccer; one hobby he had was to collect old-time radio programs)

(he first visited the US in 1973 when he attended the AmSECT meeting in Los Angeles; he was impressed that perfusionists were addressing education, training, and certification; he thought the same issues could be easily addressed in the UK, but that proved incorrect; in 1974, the Association of Extracorporeal Technologists of Great Britain and Ireland was established; the name was changed to the Society of Perfusionists of Great Britain and Ireland; they set up an education and training subcommittee to formalize these activities; there were no recognized academic qualifications for entry into perfusion and no formally recognized training programs; a course was developed to teach postgraduate science whereby students were paid by their hospitals; there was no funding from the National Health Service; however, the government mandated all employees to achieve a National Vocational Qualification to certify competence at a basic level; their Society of Perfusionists and the Board of the School of Clinical Perfusion Sciences (BSCPS) had a program whereby perfusionists were awarded the Certificate of Accreditation, which they hoped would be accepted by the National Council for Vocational Qualifications; requirements for being issued a certificate were acceptable academic qualification, four years’ experience practicing perfusion, and passing the society’s examination; an Advanced Certificate in Perfusion was awarded to those who satisfactorily completed the postgraduate diploma course offered by the School of Perfusion; he admitted that it seemed anachronistic to set up a postgraduate School of Clinical Perfusion Sciences without having a school for basic training; he clarified the school was not a training school per se; the standard in education was to allow successful candidates to obtain a Postgraduate Diploma (PGDip) in Clinical Perfusion Sciences under the auspices of the Council for National Academic Awards’ Sciences (CNAA), which was equivalent to a university Master of Science degree; in 1980, Professor Denis Melrose chaired the BSCPS, and in 1985 the CNAA validated the proposed course, and the two-year parttime course began; it was offered as a two-year part-time course or as a one-year fulltime course; during the first non-clinical year, the emphasis was on basic science courses taught by medical school academics and medical staff; the second year was a clinical year under the directorship of Professor K.M. Taylor; enrollees visited several clinical sites; the program required a research project in the form of a thesis; the oneyear full-time course was designed for overseas perfusionists; he noted in 1981 at the First World Congress on Perfusion held in Brighton, UK, Professor Melrose, Chairman of the BSCPS, called a meeting of some members of the AmSECT Executive Committee and the BSCPS to suggest an international committee be set up to monitor standards of education and training as practiced worldwide; however, these efforts failed; Hobbs argued there was a need for an International Board/Council of Perfusion Education with chapters in several continents; he noted the BSCPS, which had representatives from societies of cardiothoracic surgeons and anesthetists, academic institutions, and hospital administrations was the only “properly constituted and recognized Board in Europe” with a functioning School of Perfusion; he advocated establishment of a European Board/Council of Perfusion Education that would foster setting up an International Board/Council; while he acknowledged there would be problems to overcome, he expected it could be done; the primary goal was to improve patient care; such a board would also provide flexibility for perfusionists to work internationally)

(this had officers’ names and photographs with biosketches, as follows: President Pat H. Courtney, Jr.; President-Elect Sandra S. Witherington; Treasurer Bruce Bartel; Secretary Sharon Marquis; and committee chairs Darrell A. Woodman, Al Stammers, Debrah Abshier-Pacheco, and John J. Poland)

(this was a group photograph)

(the author was a freelance reporter; “Around the world, perfusion societies are striving for better education, official certification and professional recognition.”; it noted AmSECT was established 28 years earlier, but most other perfusion societies were less than 20 years old: Society of Perfusionists of Great Britain and Ireland (1974); Cercle d’Etude de la Circulation Extra-Corporelle (CECEC in Paris in 1976); Netherlands Society of Extra- Corporeal Circulation (1976); Belgian Society of Extra-Corporeal Technology (1990); Society of Perfusionists and Cardiovascular Medicine of Quebec (1988); societies had recently been established in Yugoslavia and Greece; the article quoted some leaders of the societies (President Yves Thisdale, Quebec; President Eddie VanDezande, Belgium; Chairman John Bell, Great Britain and Ireland; Secretary R.H. Boks, Netherlands; President Gerard Saubens, CECEC; purposes were primarily for education, and meetings were held at least annually in most cases; the British society published a newsletter called, “The Perfusionist” and the Dutch society published the “NeSECC Journal” monthly; other societies had newsletters; perfusionists in most countries were striving towards professional recognition; caseloads and salaries were reported; perfusionists in most countries came from varied backgrounds; the Dutch society had requirements for certification and an undergraduate degree to practice perfusion; many perfusionists in Quebec had nursing backgrounds; educational programs were being established in Toronto and Vancouver; unification by the European Economic Community that was to begin in 1992 was thought to be a way to establish an independent European Board of Cardiovascular Perfusion)

(Alvin “Ace” Adams and Edward C. Berger were profiled; Adams was a 1937 high school graduate with an interest in jazz and played the drums; he was drafted into the army in 1941 and worked as an ambulance driver and MP; after discharge, veterans were given preference for jobs; his first hospital job was in a psychiatric hospital in Mendota, WS; he performed electric shock treatments and was an assistant to a surgical nurse; he was mentored by Dr. Derwood Lepley, who was a cardiac surgeon; Adams assembled a heart-lung machine for dog experiments; when Lepley began clinical work, Adams was recruited to operate the heart-lung machine; he spoke highly of the research work; Adams trained approximately 30 perfusion technicians during his career; Lepley urged him to give back to the profession; he noted one characteristic for a good perfusionist was a “picture-straightener”; Lepley worked at many hospitals in the Milwaukee area, and Adams often had to borrow equipment from one hospital to take to another; Adams played golf with Lepley and had great respect for him; after retiring from clinical perfusion, Adams drove a flower delivery truck in Mobile, AL; he had worked for Lepley for 25 years; he retired in 1979; he noted current perfusionists did not have the challenges he faced when he had to build the extracorporeal circuit; Berger had a degree in Biology and got a job in a hospital where he was trained on-the-job; he learned perfusion in the animal lab; he was the perfusionist on the first successful open-heart case in St. Paul, MN, in Mar 1959; like Adams, Berger trained other perfusionists on-the-job; he expressed satisfaction in starting the AmSECT journal and serving as its president; he was thrilled to publish the book, “The Physiology of Adequate Perfusion”; he had great respect from the surgeons he worked for, but noted not all perfusionists had the same benefit and were treated with less esteem; his mentor was Dr. Sam Hunter; Berger retired in 1983; a declining caseload at the hospital led him to retire; he continued to write for medical companies; he praised company representatives who kept him in touch with LeRoy Ferries)

(she noted the first time she met Dearing was at the AmSECT conference in Detroit in 1969; she recounted the early days of AmSECT, which was becoming incorporated and electing officers; Dearing was working at Ohio State University (OSU) and was elected second vice-president for Certification and Education; at OSU, Dearing developed the first formal educational program for circulation technologists, which was also the first Baccalaureate level program; the first students graduated in 1971; there was some opposition to the OSU program from perfusionists who did not have BS degrees; the concept of “grandfathering” perfusionists was one result when setting up the AmSECT certification program; she noted the loss of dialysis technicians in AmSECT; she recounted efforts to get extracorporeal technologists recognized by the American Medical Association’s (AMA) Committee on Emerging Health Manpower; the rationale that had to be demonstrated was there was a need that was not being met by any other existing group; there was support for such recognition from physicians for whom perfusionists were working; she noted there were no extracorporeal technologists who also operated dialysis; she suggested the first imperative was for perfusion to define the scope of practice; this entailed job titles and job descriptions; a second imperative was to develop standards of practice; she cited the recently adopted pre-bypass checklist as one such standard; she also noted the original Minimum Standards for Perfusion Records developed by AmSECT had been rescinded 13 years earlier; a third imperative was to determine educational requirements after obtaining formal recognition by the AMA; she noted although accreditation of perfusion educational programs existed, there was lack of uniformity regarding many details such as admission requirements, length of study, final degree, or even the name; she bemoaned that many perfusion educators came from clinical backgrounds and had no advanced training in education; the fourth imperative was to classify and promulgate credentials for clinicians to demonstrate competency or proficiency in continuing mastery of the skills for the job (e.g., recertification); she noted there were 1,600 American Board of Cardiovascular Perfusion (ABCP)-certified perfusionists, but another credentialling board was the International Board of Circulation Technologies (IBOCT); this development indicated some dissatisfaction that the ABCP was not being responsive to the needs of the community; she advocated the debate be stopped because ABCP directors were all perfusionists who volunteered their time; one other responsibility/imperative in her mind was to support one’s own work; she cited Respiratory Care Therapists in CA obtaining a practice act that did not entail licensure but did include certification to allow them to perform ECMO and administer medications; she noted there were three forms of legislative recognition: registration, certification, and licensure; she closed by recommending perfusionists to get involved in the profession and the society; she noted Dearing always worked within the system of the formal organization—“despite personal injustices dealt to him by the system”)

(the article was authored by a freelance writer; it addressed perfusion hyperthermia for treatment of Kaposi’s sarcoma; an AIDS-infected patient was apparently cured after such treatment, but the National Institute of Allergy and Infectious Diseases (NIAID) disputed the results; the two surgeons who were using hyperthermia were Dr. Kenneth Alonso, a pathologist, and Dr. William D. Logan, a surgeon; during the patient’s treatment, they were perfused for 7.5 hrs with the blood heated to 420C; the doctors claimed the heat killed the virus; the perfusionist on the case was Joe Guzman; the NIAID concluded the patient who was cured had cat-scratch fever instead of Kaposi’s sarcoma, and antibiotics were responsible for the skin lesions disappearing; Alonso characterized the NIAID conclusions as “absurd”; Alonso was interviewed for this article, but Dr. Anthony Fauci declined to be interviewed; some other physicians were skeptical of the results of hyperthermia treatments; statistics on AIDS were presented; the FDA considered hyperthermia for AIDS as “bogus”; there was a sidebar entitled, “Could Perfusion Be A Part of the Cure?”; Joe Guzman was a contract perfusionist in Atlanta; the extracorporeal circuit consisted of a pump to withdraw blood from the patient’s femoral artery, the heat exchanger water was set at 46 0C, and blood was returned to the femoral vein; this caused the blood to cool to 42.20C; the blood flow was approximately 2 L/min)

(the survey polled perfusionists’ thoughts about several topical issues; the response rate was 17.5% out of 2,207 surveys sent out; results were reported by the regions; areas addressed included continuing education, AmSECT dues, terms of office, certification, and percutaneous bypass)

(she was Chair of the AmSECT Continuing Education committee; she also served on the Research and Convention Planning committees; she had been a high school teacher before becoming a perfusionist; she graduated from Ohio State University (OSU) in 1984; she credited Dr. Phillip Beckley for introducing her to perfusion; Bill Pelley introduced her to AmSECT; her first involvement was to organize continuing education sessions at the 1986 convention; she also served on the Bylaws Committee and was an Associate Editor for Perfusion Life; she applied to the OSU perfusion program; when asked what was the most satisfying aspect of perfusion, she stated it was to do the job well so the surgeon would not worry; she regretted not having entered the field earlier, but did admit her background in education had helped her; she noted four steps as an AmSECT leader: 1) determine the truth from complaints; 2) disregard any inappropriate, emotionally-based criticism; 3) maintain a perspective of the “big” picture; and 4) keep plugging; she worked for SETA, a contract group in Mobile, AL; one job duty besides clinical perfusion was working in quality assurance and quality control; when asked, she replied she was not sure what her future would be with AmSECT activities)

(Pall received the award from President George Bush at the White House; it was the highest honor in technology and was awarded annually to those who made “exceptional contributions to the well-being of the nation through the development and application of technology”; his contributions were for filtration for many industries besides medicine; he had been granted 108 patents, the most recent one of which was for a blood transfusion filter)

(Rainer graduated from the University of Tennessee Medical School in 1948; he interned in Chicago and then served as a battalion surgeon with the 3rd Infantry Division in Korea; he completed residencies in general and thoracic surgery at the VA hospital in Denver; he was a clinical professor of surgery at the University of Colorado and had published 89 scientific papers; he served in leadership positions in professional societies (president of the American College of Chest Physicians and the Society of Thoracic Surgeons); he also was a member of the AmSECT Professional Advisory Board since 1978; when asked about his activities he stated he had the support of his family; he noted after the end of WWII there was federal money for education and research; he decided to pursue private practice but to set up an academic environment at a community hospital; his first laboratory did research on an artificial heart; he addressed the surgeons’ position on assisted angioplasties and the need for surgeons and invasive cardiologists to cooperate when extracorporeal circulation was needed; when asked about perfusionist licensure he urged caution because perfusionists would have greater exposure and visibility; he expressed control over medical costs would be achieved; he thought there would not be a huge impact from the baby boomer generation for healthcare; he noted the maturation of cardiac surgery from the early more innovative years; he noted younger cardiac surgeons had little idea how cardiopulmonary bypass operated but the topic was covered on thoracic board exams)

(the scope had definitions of perfusion and a perfusionist, followed by specific duties prescribed by a physician, as follows: 1) extracorporeal circulation/cardiopulmonary bypass; 2) counterpulsation; 3) circulatory support ventricular assistance; 4) extracorporeal membrane oxygenation (ECMO); 5) blood conservation techniques/autotransfusion; 6) myocardial preservation; 7) anticoagulation and hematologic monitoring/analysis; 8) physiological monitoring/analysis; 9) blood gas and blood chemistry monitoring/analysis; 10) induction of hypothermia/hyperthermia with reversal; 11) hemodilution; 12) hemofiltration; 13) administration of medications, blood components and anesthetic agents via the extracorporeal circuit; and 14) documentation associated with described duties; other duties of perfusionists that might be included were as follows: 1) isolated limb/organ perfusion; 2) electrophysiological analysis; 3) surgical assistance; 4) organ preservation; and dialysis; there were additional descriptions regarding perfusionists’ job characteristics, which included knowledge of available equipment, consultation with physicians for choice and use of equipment, supply purchases, maintenance of equipment, department management, development of policies and procedures, quality assurance measures, staff development, and education and research; the duties enumerated in this document expanded on the original perfusion technologist job description published in 1975; this scope was reprinted in subsequent issues)

(this listed officers’ names and included a group photograph of Greg Mork, Sharon Marquis, Bruce Bartel, Sandra Witherington, George Beshere, David Holt, Ron Richards, Susan Haubert, Craig Vocelka, Charlie Belcher, Paul Cappola, Steven Thompson, Deborah Gherlone, and Christine Cushen)

(he recounted Dearing’s background as an army paratrooper, work at the NIH as an inhalational therapist, and then heart-lung machine operator; in 1968, Dearing moved to Ohio State University (OSU) and started the perfusion technology training program; in 1974, he relocated to Charleston, SC, to work at perfusion training program at the Medical University of South Carolina (MUSC); in 1978, he established the Baccalaureate program, and the first class was admitted in 1979; Dearing also helped found AmSECT and the American Board of Cardiovascular Perfusion; he authored the first written examination for perfusionist certification; he was editor of the Journal of Extra-Corporeal Technology for several years in the 1980s; he authored or co-authored >30 publications; he was given the Award of Excellence in 1979; in 1987, he was the recipient of the Gibbon Award for making “a significant contribution to the cardio-pulmonary discipline”; Beshere was admitted to the first perfusion class at MUSC in 1979; after graduation, he stayed on staff as an instructor at the program; he noted Dearing was outspoken and opinionated but always stood up for what he believed; he was analytical and a good judge of character; he demanded the best from people; he was characterized as a “puller” and not a “driver” or “pusher”; he worked long days and was committed to the perfusion program and his profession; Beshere suggested another meaning of C.C.P was Challenge, Commitment, and Professionalism; he then described what they meant for the new graduates; he advocated continuing education; he closed by describing their education at MUSC as “the best there is”; he closed by reminding them of Dearing as a role model)

(this had a photograph of ABCP Vice President Mary Winkler, AmSECT President-Elect Bruce Bartel, AmSECT President Sandra Witherington, and Secretary Reg Hobbs to the Board of the School of Perfusion Sciences of the United Kingdom)

(he was chairman of AmSECT’s International Relations Committee and had attended the 4 th European Congress on Extracorporeal Circulation Technology in Jun 1991; AmSECT reimbursed his registration fee, but he had paid all of his other travel expenses; the meeting was held in Noordwijk, The Netherlands; there were 702 registered attendees; 15 from the US attended; he recounted awards given to some presenters; Dick S. DeJong was the meeting organizer; the chairman of the scientific committee was John Steenbrink; a new perfusion organization was established: the European Foundation for Extracorporeal Circulation Technology with a goal of eliminating geopolitical differences among national perfusion societies in Europe; the group was also committed to establish a European Board of Cardiovascular Perfusion; the group was interested in collaborating with AmSECT; a fifth meeting was planned for Jun 1993 in the south of France; the local organizer was Dr. Alain Perroud, who was an anesthesiologist/perfusionist in Marseilles, France; Galbraith and DeJong discussed a perfusionist exchange program that would provide a monthly stipend of approximately $2,500 plus travel expenses; participants would be required to be graduates of a CAHEA-accredited training program or ABCPcertified; Galbraith was to make a proposal to the AmSECT Board for the exchange program; he also described the attendance of 50-100 perfusionists from outside the US to attend AmSECT’s 30th anniversary conference to be held in Washington, DC)

(Phyllis Palmer was the new editor; they claimed the journal was the only English-language perfusionist peer-reviewed journal; Palmer had been on the editorial board since 1981; the journal’s first editor was Edward Berger in 1967; M. Massengale was quoted that the journal played a key role and demonstrated perfusion was a bonafide profession; she stated recognition by the American Medical Association was due in part to the journal; Palmer emphasized the need for more case reports and technique papers; she noted limited funding existed for research studies; she credited former editor R. Vertrees for publishing lectures on basic perfusion topics, which she hoped to continue; she also emphasized students’ work and participation by perfusion training program directors; presenters at the annual meeting were offered peer review for their manuscripts, but some opted for publication in the proceedings section of the journal; one advantage of a proceedings publication is quick turnaround; Palmer named several individuals she would be relying on for editorial review; she explained the process using associate editors and a manuscript editor; she noted some authors did not return revisions; she included some tips for prospective authors, which included: 1) proofreading; 2) writing and revisiting; 3) reading it out loud; 4) submission on a diskette; 5) adherence to the instructions for authors; and 6) consultation with published sources on how to write and publish; she acknowledged that some perfusionists found peer review too harsh; she and former editors J. Riley and N. Achorn agreed that scientific standards had to be maintained; she closed by stating the journal needed the support of AmSECT members)

(the author suggested there was concern among many perfusionists about the future and job security; the first part of the article dealt with the problem; he recounted how perfusionists entered the field; he expressed minimum qualifications to enter the field had not been defined; likewise, he argued institutions qualified to train perfusionists had not been defined; he cited lack of textbooks on perfusion; he note the lack of perfusion research; he argued that scientific research and education were two signs of an active and healthy profession; he stated most research article for perfusionists were being published in other societies’ journals; the second part of the article offered solutions; he argued, “Stop imitating other medical professionals and allow perfusion to develop its own personality.”; he stated perfusionists did not have the financial impact of surgeons or the political impact of nursing; he urged perfusionists to capitalize on its attributes such as blood handling, bedside coagulation management, and cardiac and respiratory assist in addition to perfusion; he reiterated the need for perfusion research as “the very core of growth of a profession”; he argued one did not need a research laboratory to pursue a research project; examples were basic or applied, clinical or lab, academic, business, and educational; he stated, “Most of the basic science research in perfusion is still waiting to be done, begging for investigation.”; he noted the number of perfusion organizations and argued for more cooperation; he expressed perfusion was small and fragmented and needed to define its goals and a course of action; he stated the field had no “true scholarly journal”; he argued proceedings from AmSECT and the American Academy of Cardiovascular Perfusion, which published proceedings from their annual meetings; such publications were not peer reviewed; he also noted the Journal of ExtraCorporeal Technology was not indexed; he urged perfusionists to become more involved in professional activities such as teaching, giving lectures, volunteering for committee work, performing a research project, publishing, or becoming politically active; he closed by stating this article was not intended to be critical but to have perfusionists consider the future)

(in 1978, she graduated with a degree in biology; she thought she might go to medical school; she was active in AmSECT for continuing education, associate editor of Perfusion Life, and an active member of AmSECT; she first worked in a laboratory, then obtained a teaching certificate and taught high school biology in Columbus, OH; on a field trip to the dog lab, she saw perfusion and decided she wanted to pursue it; she went to school full-time for two years at Ohio State University; after graduation, she and her family relocated to VA where she found work with PSICOR, Inc.; she became Chief Perfusionist at Riverside Hospital; after having a baby, she became an educator; she worked part-time so she could raise her son; she then worked for SETA where she developed educational materials and established standards for perfusionists; this allowed her to work at home; she produced a resource called, “Practical Handbook of Quality Improvement and Quality Control for Perfusionists”; the manual was freely distributed to other organizations; she developed several symposiums on quality management that were offered at AmSECT meetings; she became an advocate for establishing standards; she expressed the positive influence of her father who taught her to strive for excellence; she put family ahead of career)

(she reported on the first meeting of the European Board of Cardiovascular Perfusion (EBCP) held 23-24 Nov 1991 in Brussels; the meeting was an initiative by the Board of Clinical Perfusion Sciences (UK) and work by a planning committee, which included: Robert Barthelemy, MD (France); Eddy Janssenswillen (Belgium); John Bell (United Kingdom); Reg Hobbs (United Kingdom); Fred van der Berg (Netherlands); Thore Pedersen (Norway); and Chairman Mark Braimbridge, FRCS (United Kingdom); the board was founded because of varying standards of perfusion education and training throughout Europe; it was also believed to be important because of relaxed trade barriers among European nations that were to go into effect in 1992-1993; delegates from all countries belonging to the European Community (EC) and the European Free Trade Association (EFTA) were invited to participate in the formation of the new board; it was thought that the board would offer benefits of governmental or hospital recognition to perfusionists; approximately 30 perfusionists attended representing Italy, Austria, Holland, Germany, Belgium, Finland, Sweden, Norway, Spain, Greece, Denmark, and Great Britain; representatives from France, Switzerland, and Portugal were unable to attend; four Americans attended to offer historical perspectives on AmSECT’s early efforts with accreditation and certification and the development of the American Board of Cardiovascular Perfusion (ABCP); the Americans were Mary Winkler, Trudi Stafford, Bruce Bartel, and Mark Kurusz; EBCP officers were elected as follows: M. Braimbridge (Chairman); R. Hobbs (General Secretary, 4-yr term); Zoi Dobrou (Assistant General Secretary, 2-yr term); R. Barthelemy (Second Assistant General Secretary, 2-yr term); E. Janssenswillen (Treasurer, 4-yr term); the newly formed board also had a Liaison Committee representative to the European Society for Cardiovascular Surgery and the European Association of Cardiothoracic Surgery, and one representative to the European Association of Cardiothoracic Anesthetists; all delegates were required to be clinical perfusionists, and the new board was to meet annually; accreditation and certification committees were formed to develop processes for accrediting training programs and for examining candidates for the European Certificate of Competence in Perfusion; committees were also established for reaccreditation and recertification; Mari Anne Lindstein Ringdal (Norway) was the chair for the Accreditation Subcommittee (3-yr term), and T. Pedersen (Norway) was secretary (2-yr term); Christer Ericson (Sweden) was chair of the Certification Subcommittee (3-yr term) and Alessandra Capelli (Italy) was secretary (2-yr term); the organization developed a mission statement similar to that of the ABCP; funding of the organization was discussed with possibilities including manufacturers’ support, perfusionist subscription, or levies on individual perfusion societies or meetings held in Europe; a design for the EBCP logo was produced by Ringdal)

(in 1983, Stammers’ background was milking cows for the study of growth hormones; he aspired to become a wildlife biologist studying deer; he obtained an undergraduate degree in biochemistry from Cornell University in 1981; he applied to nursing school in Syracuse, NY, in 1983; however, he met Dr. Edward Bove who was at the State University of New York (SUNY) Health Science Center in Syracuse; they studied pediatric perfusion in the laboratory; when Dr. Bove moved to the University of Michigan in 1985, Stammers was asked to join him but he declined; in 1985, he met Jeanne Lange, the SUNY perfusion program director; he applied and was accepted into the two-year program; Stammers was named Outstanding Student of the Year; after graduation, he joined Dr. Bove at the University of Michigan; he met his future wife, Kay, who was a nurse; in 1990, they moved to Charleston, SC, and he taught pediatric perfusion at the Medical University of South Carolina; in 1986, he became active in AmSECT when he received a $5,000 research grant to study preservation of the newborn heart; his first presentation was in 1987 and he was given the Fellowship Award; he also received the William Harvey Research Award for his studies; he also received the Researcher of the Year Award)

(this article featured the work of Sherry Faulkner as ECMO Coordinator at Arkansas Children’s Hospital; it profiled the first child survivor of mobile ECMO by the Arkansas team; their center performed 45 to 50 ECMO cases annually; they had started the mobile ECMO service 18 months earlier; eight of 12 patients survived to discharge; the article referred to an earlier ECMO article published in Perfusion Life authored by JM Toomasian and to Dr. Robert H. Bartlett, the pioneer in ECMO who was also honored with AmSECT’s Gibbon Award; Bartlett noted that ECMO became standard treatment in 1985; of 5,000 cases reported by the Extracorporeal Life Support Organization (ELSO), the survival rate was 83%; mobile ECMO was considered a significant advance in the technology; Bartlett praised Faulkner for her leadership in this area; she cited the most common reasons ECMO was used (meconium aspiration, group B strep infection, premature birth, and persistent pulmonary hypertension); Bartlett noted the manpower demands for ECMO; Faulkner cited rapid deployment of ECMO in four minutes at her hospital; she described the demanding conditions of mobile ECMO; the hospital committed resources to support the program; one area for growth was in adult ECMO; Bartlett also mentioned the IVOX device as “an exciting development”; Faulkner spoke of annual reunions of ECMO patients and their families; she closed by asking, “What better way to spend your life?”)

(this was a photograph captioned, “Dr. John ‘Jack’ Gibbon and Mary Gibbon at their experimental surgery suite in Philadelphia, in 1936”; it was reprinted from Perfusion Life, Jul 1986; (note the person on the left in the photo was Dr. Charles Kraul and not Dr. Gibbon per the original publication))

(the report was authored by Parault who was chair of the Perfusion Quality Committee; she quoted Dr. George G. Lindesmith, president of the Society of Thoracic Surgeons for the rationale to publish practice guidelines for cardiac surgeons; the draft entitled, “Clinical Function: Conduct of Extracorporeal Circulation” that arose during discussions with the Coordinating Committee for Perfusion Affairs (CCPA) in Mar 1992; there were representatives from surgical and perfusion organizations; the draft guidelines were the result of a mail survey on current perfusion practices, research material, other survey results, and historical data; Parault urged perfusionists to review and give input on the draft guidelines; the guideline document included a job description of perfusionists from the earlier AmSECT Scope of Practice published in Feb 1991; there were 14 essentials regarding 1) records; 2) pre-bypass checklist; 3) certification or board-eligible perfusionists; 4) anticoagulation; 5) gas exchange; 6) blood flow rate; 7) blood pressure; 8) safe operating levels in the circuit; 9) safety devices; 10) monitoring devices; 11) cost containment; 12) maintenance of equipment; 13) continuous quality improvement; and 14) procedures and protocols on prescription of a physician, including emergency procedures and catastrophic event management; the guidelines concluded by stating the perfusionist “shall conduct himself in a professional and ethical manner at all times”; additionally, the perfusionist was to provide “quality patient care in a cost-effective manner, maintaining patient confidentiality, and striving for professional growth as a health care provider”)

(this article featured perfusionists Roger Hindman and Ed Howard, who traveled to Russia; Hindman’s trip was organized by Sister Cities International, a program established in the mid-1950s; he went to Murmansk; cardiac surgery at the regional hospital still relied on ice bath hypothermia; Hindman’s hospital in Jacksonville, FL, donated a Pemco heart-lung machine; after some preliminary meetings with physicians from Murmansk, Hindman was invited to make the trip to Russia to ensure the heart-lung machine was able to be used; Howard, the Chief Perfusionist at Georgetown University Hospital in Washington, DC, went to Kiev, Ukraine; the Cardiovascular Institute of Kiev had its own Russian-made heart-lung machines; the center performed 2,000 open-heart procedures annually; perfusion training was on-thejob; both perfusionists paid their own expenses to travel to Russia; Howard also travelled to another Ukrainian city under disguise because it had not been opened to foreigners yet; Howard had to pretend to be deaf and mute to travel by train; Hindman was able to bring $750,000 in medical supplies that had been donated; the heart-lung machine was mishandled at the airport and was damaged; in attempting to repair the heart-lung machine, the tip of Hindman’s index finger was severed; however, he was able to repair the damages to the heart-lung machine; both perfusionists had warm memories of their trips)

(he had many accomplishments: inventor, senior athlete, author, and opera composer; he was proud of the suction control valve used to regulate the flow and direction of blood used with cardiopulmonary bypass; he had 17 medical patents; he was Hungarian-born and wanted to become a surgeon; in 1949, he escaped Hungary and worked in a US Army hospital in Austria; in 1951, he studied engineering at the University of Toronto; in 1963, he moved to CA and began working at Edwards Laboratories in Santa Ana; he developed artificial heart valves; he then moved to Hancock Laboratories and developed porcine tissue heart valves; he also worked for William Harvey Research as director of technical services where he developed the heat exchanger for the Harvey bubble oxygenator; in 1975, he started his own company, Delta Medical Industries; he was a strong supporter of AmSECT; he won some small business awards; he sold Delta Medical in 1983, hoping to retire; but in 1985 he started another company named American Omni Medical that developed improved disposable safety valves; he was somewhat critical of the Food and Drug Administration’s regulatory requirements; in 1991, he sold American Omni Medical; in retirement he studied music and wrote a four-act opera; in sports, he was a kayaker, marathon runner, and former national champion in radio-controlled car racing; he also was a leukemia survivor; he had written a business book and three novels)

(this was a historical photograph of a cat that survived occlusion of its pulmonary artery in the laboratory of Dr. John Gibbon, Jr.)

(this article had some historical information on the development of formal perfusion education in the US; the first program was at the Cleveland Clinic in 1963; the program was for six months; by 1969, other programs had been established; at the time of the article, there were 32 accredited schools with 250 to 300 perfusionists graduated each year; the purpose of the article was to discuss issues facing perfusion educators; originally, physicians operated cardiopulmonary bypass (CPB); thoracic surgery board examinations still had questions on CPB; early perfusionists came from personnel in the operating room, research laboratories, or other medical specialties; it became apparent that organized, prospective instruction was needed to improve patient care and to provide safe and reproducible clinical management; thus, the “Essentials and Guidelines” for perfusion training were developed; all early perfusionists sought to establish perfusion as a respected profession; notable contributors were: Jim Dearing, Charlie Reed, Jeanne Lange, Aaron Hill, Ed Berger, Lou Toth, LeRoy Ferries, Jerry (sic) Dobbs, Dennis Williams, and Madeline Massengale; in 1981, there were 15 accredited perfusion schools; between 1983 and 1984, 11 new programs were established that corresponded with the tremendous growth in the coronary artery bypass operation; as of Apr 1992, nine new programs had been added; the training curriculum varied depending on the hospitals where clinical training was delivered; most requirements for accepting students were liberal regarding academic prerequisites, and students came from diverse, mostly medical, backgrounds; many programs were supported by thoracic surgeons and hospital administrators; in the 1980s, perfusion education was altered as perfusionist job duties expanded to include isolated limb perfusion, emergent percutaneous bypass outside the operating room, increased use of ventricular assist devices, and neonatal extracorporeal membrane oxygenation (ECMO); blood conservation to limit homologous blood exposure also became a priority; a perfusionist shortage manifested; educational programs reevaluated their programs to address the expansion of perfusionist duties; job security became important, and public awareness of perfusionists became evident; the article then discussed “Why should we teach?”; one answer was that without it, there would be no profession; a table listed four reasons for formal perfusion education: 1) public responsibility; 2) personal responsibility; 3) impart body of knowledge; and 4) experimental v. factual technology; the first formal perfusion school was established at Ohio State University (OSU) through a grant from the National Institutes of Health; J. Dearing was involved in writing the grant application; all perfusion organizations supported education in their mission statements; the two foremost organizations were AmSECT and the American Academy of Cardiovascular Perfusion (AACP); AmSECT initially established minimum standards of training, but the American Board of Cardiovascular Perfusion (ABCP) took over the role of certifying perfusionists; standards for perfusion educational programs were established by the Accreditation Committee for Perfusion Education (AC-PE), which was formerly known as the Joint Review Committee on Perfusion Education (JRC-PE); the Committee on Allied Health Education and Accreditation (CAHEA) under the auspices of the American Medical Association approves the Essentials and Guidelines developed by the AC-PE; the Perfusion Program Directors Council (PPDC) began in the mid-1970s to encourage communication amongst schools; a second question posed was, “Who should teach?”; historically, perfusion instructors came from varied backgrounds such as thoracic surgeons, anesthesiologists, physiologists, nurses, respiratory therapists, and perfusionists; it was argued that becoming a successful didactic instructor did not always follow from successful clinicians; most clinical instructors were busy with clinical responsibilities; a table listed ideal instructor characteristics, as follows: 1) Masters or PhD degree; 2) undergraduate or graduate experience in education; 3) certified clinical instructors; 4) research orientation; 5) local and national committee participation; and 6) demonstrated professional commitment; it was noted that few clinical instructors possessed all the characteristics listed in the table; it was argued that perfusion educators were less qualified to teach than peers in other allied health environments; a third question was, “What to teach?”; the AC-PE and CAHEA guidelines identified minimum requirements for perfusion education programs; a figure listed the ideal perfusion education curriculum and courses consisting of basic education (81 credit hours) and perfusion courses (79 hours); it was noted that perfusion students came from diverse backgrounds, and their average age was approximately 30 years old; the basic science courses included anatomy and physiology, pharmacology, pathology, mathematics, chemistry, biochemistry, and the humanities (e.g., English, social science, philosophy); the authors cautioned not to transfer their own prejudices to students; perfusionrelated courses included introduction to extracorporeal circulation, operating room techniques, principles and practice, cardiovascular devices, and the pathophysiology of extracorporeal circulation; other courses that tended to not be emphasized included pediatric congenital surgery, research methodology, ethics and professionalism, hematology, monitoring, transplantation, and specialized applications such as ECMO, veno-venous bypass, and isolated limb perfusion; it listed some courses that were not recommended to be taught such as electronics, electrophysiology, computing fundamentals, statistics, and management; courses to be avoided included mechanical and/or electrical engineering, most nursing essentials, and how to perform diagnostic procedures; the next question posed was “How to teach and where to do it?”; the authors asserted that perfusion was a “hands-on” profession; the minimum requirement to take the ABCP examination was to have performed 50 clinical cases; most perfusion student had completed two to three times the clinical cases requirement by the time they graduated; one controversy in perfusion education had been identifying facilities for training; some programs were hospital-based and others were university-based; computer simulation was urged for all programs; hospital-based programs exposed students to a large number of clinical cases; university-based programs offered a wide range of educational services; the length of training in programs varied greatly—of the 32 accredited programs, 11 were 12 months, ten were 15-18 months, and the rest were two academic years; the shorter programs usually required students have a Baccalaureate degree prior to admission; degree-granting programs include general education courses; most students were in their late 20s to early 30s; a figure listed Perfusion School Entrance Criteria, as follows: 1) minimum college level prerequisites (60 credit hours, minimum 2.5 GPA); 2) Associate or Baccalaureate degree; and 3) clinical experience as an RN, RT, or PA; several programs were considering granting Masters degrees upon graduation to those students who had a Baccalaureate degree before admission to the program; one unresolved issue was on the number of students being graduated to meet the needs of society and the profession; it was noted that there had been a 100% increase in the number of graduates between 1985 and predicted in 1993 according to the PPDC; it was also noted that during the manpower shortage in the mid to late-1980s, many ancillary activities of perfusion-related clinical activities were relinquished to other allied health practitioners; examples included autotransfusion, ECMO, liver transplantation, and ventricular assist placement and monitoring; many of these tasks had been delegated to perfusion assistants; the perfusion shortage led to support for more programs from surgeons and hospitals; it was noted there were 30 to 40 applicants for open perfusion positions; thus, a perfusion degree/certificate no longer automatically led to a job; it was suggested students who excelled in school would have an advantage in securing a job upon graduation; examples included research projects, volunteerism, seminar presentations, participation in professional organizations, and a commitment to continuing education; the article concluded: 1) perfusion educational programs needed to move towards academically-based settings with strong clinical facilities; 2) perfusion educators needed to pursue advanced degrees; 3) the Essentials and Guidelines needed to be continuously evaluated and updated; and 4) perfusionists needed to establish an effective communication network; a figure listed these conclusions and future directions, as follows: 1) academically-based perfusion education; 2) extend length of perfusion training; 3) increase level of perfusionists with advanced degrees; and 4) continuously evaluate the Essentials and Guidelines)

(the subtitle of the article was, “A brief overview of the American Board of Cardiovascular Perfusion Oral Examination”; the authors were co-executive directors of the ABCP; it stated the examination process had two stages consisting of a written examination and then the oral examination; the oral examination was dependent for its validation on its acceptance by the perfusion community as being “reasonable, fair and externally controlled”; evaluation of candidates was both quantitative and qualitative, with the written part and oral parts, respectively; quantitative assessment relied on numeric values as indices of capability, while qualitative assessment relied on expert opinion based on personal conduct to determine capability; both were used by the ABCP to certify perfusionists; the qualitative assessment was considered peer review; candidates were examined by four certified perfusionists who had undergone the same format of assessments earlier and also had a minimum of three years of clinical experience; two different clinical scenarios were presented resulting in eight observed profiles for the scoring process; choices in scoring a candidate’s responses included definite pass, probable pass, probably fail, or definite fail; to successfully pass the oral examination the candidate had to convince over one-half of the examiners of a definite or probable pass; a tie, failing, or scoring less than one-half would result in failure and the need for reevaluation; passing the oral examination was the ultimate determinant of ABCP certification; oral examiners were volunteers who had to submit their qualifications before being allowed to become examiners; from the pool of those qualified, the ABCP matched examiners with diverse backgrounds with one considered an experienced examiner; a mandatory training workshop was held prior to the oral examinations to acquaint examiners with the process and to ensure a high level of reliability; examiners were also evaluated by ABCP directors during the examinations; a team leader of the eight examiners was often a former director; if undue bias was detected during the examinations, alternate examiners could be used; any examiner could ask to be excused from the process for added fairness; the oral examination was for 30 minutes and two scenarios were discussed; a second 30-minute session in a different room with different examiners also had two scenarios presented; examiners then were allotted 15 minutes to compile scores; 200 to 300 candidates were typically examined annually; the examinations were given in hotel rooms; the ABCP typically recruited approximately 120 oral examiners to conduct the examinations; oral examiners were not paid but were recognized for their contributions to the process; some become ABCP directors; the article concluded by thanking oral examiners and included the ABCP’s address for those who wished to volunteer their participation)

(Rivard was named the 1992 Perfusionist of the Year; he was the clinical coordinator at Johns Hopkins Medical Institutions in Baltimore, MD; he had focused on ECMO; he had a Bachelor's degree in zoology from the University of Maine in a pre-med curriculum; instead, he went to Northeastern University to study respiratory therapy; he became familiar with perfusion and observed cases at Maine Medical Center with the help of Chief Perfusionist Carol Zografos; when he went back to Northeastern, he applied for admittance to the perfusion school; he worked as a Respiratory Therapist while attending perfusion school; his first perfusion job was at Johns Hopkins, and he was approached to become more involved with ECMO; he became knowledgeable about it by visiting the Washington Children's Hospital and then spent 18 months setting up the ECMO program at Johns Hopkins; he split his time as ECMO coordinator and as a perfusionist; he helped develop a curriculum for a perfusion school at the hospital; he was a charter member of the Extracorporeal Life Support Organization (ELSO); when he got involved in ECMO there were 40 center, and at the time of the article there were 90 in the country; he suggested to Sandra Witherington, the AmSECT president, that a liaison position be created between AmSECT and ELSO, and he became the liaison; he noted that nationally one-half of ECMO management was handled by nurses and respiratory therapists, but perfusionists were getting more involved with ECMO; he eventually returned to being a full-time perfusionist when the program matured and a full-time ECMO coordinator was hired; Steve Thompson was director of perfusion services at Johns Hopkins and commented on Rivard’s involvement with ELSO and AmSECT and considered him a model perfusionist; he frequently attended regional meetings at his own expense to lecture on ECMO; Rivard also served on the AmSECT Ethics Committee as its chair; he advised other AmSECT committees)

(this included the updated AmSECT Code of Ethics and was followed by a Procedural Document of Ethics Complaints (see next entry below); a new Preamble had been approved by the AmSECT Board; it stated the purpose of the code was to acknowledge the profession’s acceptance of responsibility and trust conferred upon it; it also acknowledged that no code could encompass all ethical responsibilities; “This code of ethics shall be binding on the members of this society.”; there were several long quotations regarding ethics, followed by thoughts on professional versus personal ethics; it was noted the AmSECT ethics reported herein had been updated from those first promulgated 20 years earlier; the committee sought and used ethics statements from other allied health organizations; there were six canons, as follows: 1) members were required to uphold the dignity and honor of the profession, accept its disciplines, and expose without hesitation illegal, unethical, and incompetent conduct; 2) members were expected to respect patients’ rights and dignity and uphold the doctrine of confidentiality; 3) members were obligated to only provide services for which they were qualified and were prohibited from misrepresenting their qualifications and credentials; 4) members were urged to improve their knowledge and skill on a continuing basis; 5) members were to maintain and promote high standards for perfusion practice that could include education, research, and scientific presentations and/or publications; 6) members were obligated to hold the well-being of the patient paramount and were to provide their services without regard to race, color, creed, national origin, sex, age, religion, sexual preference, or physical and/or mental condition)

(this had several sections detailing the process for handling ethics issues and included the following major sections: 1) Initiation and Investigation of Ethics Complaints; 2) Mediation; 3) Formal Procedures; 4) Certification to Executive Committee; 5) Executive Committee Proceeding; it also had some suggested resources)

(the authors wrote that perfusionists did not agree which perfusion school was better than the other; critics of hospital-based programs believed they did not have the educational resources and skilled instructors as academic-based programs; at the time of the article, hospital-based programs accounted for 20 of the 32 accredited programs; all accredited programs had to meet the minimum requirements as detailed in the Essentials and Guidelines established by the JRC-PE and CAHEA, and graduates of both types of programs were eligible to take the ABCP certification examinations; LeRoy Ferries stated he was asked often about both types of programs; he believed perfusion education was a two-way street insofar as the program provided the learning experience but the students were obligated to learn; he noted some hospital-based programs were excellent and some were mediocre and the same was true for university-based programs; he believed the strong scientific didactic base at university programs was their greatest strength; students in hospital-based programs usually already had Bachelor’s degrees in the health sciences; he suggested that students in hospital-based programs tended to be older and more committed; Jeanne Lange stated the university program at SUNY Upstate emphasized a balance of theory and clinical experience; she was the former chair of the PPDC; she stated, “A good student is going to be a good perfusionist no matter what program he goes to. A not-so-good student can be made a good perfusionist by a good program.”; she cited the availability of experts for various courses in a university-based program; Ohio State University (OSU) had the first formal perfusion education program that was established in 1969; Dr. Phil Beckley was the current program director; he believed the success of the program was due to the strong emphasis on theoretical background; applicants to the OSU program had to have two undergraduate years of general study, which included math, science, chemistry, biochemistry, physics, and anatomy; they also were required to have a minimum 2.2 GPA, but most had a 3.2 GPA; he reported courses they took as junior and senior students; graduates earned a Bachelor of Science degree in Circulation Technology; Louis Brownstein was the program director at Cooper Hospital in Camden, NJ; he explained the program was established in the mid-1980s out of necessity because surgeons wanted certified or certification-eligible perfusionists; his program was affiliated with a university medical school so students had access to a library and research laboratory; students at the program were required to produce a research paper; he agreed with Lange that many hospital-based programs would become affiliated with an academic institution; Roberta Myers was the program director for the Episcopal school in Philadelphia; Bill Maldarelli was the program director at Albert Einstein College of Medicine in New York City; he believed hospital-based programs were focused on training while university-based programs had vested interests in teaching; his program, like the one at Cooper Hospital, had access to an academic institution; he cited instructors were specialists who regularly taught at a medical school; applicants to his program were required to have two years of critical care experience, a Bachelor's degree, and a 3.0 or higher GPA; the article closed by stating higher educational standards would produce better educated perfusionists who would also have better job security; “The harder it is to reach a certain level, the more respect those who have reached that level are due.”)

(he was the chairman of the European Board of Cardiovascular Perfusion; he wrote there was concern over the wide variety of standards in perfusion training and levels of competence in Europe; the purpose of the EBCP was to establish a common basic minimum standard of competence for countries that adopted the EBCP Essentials and Guidelines for training programs; the EBCP was established in 1991 in Brussels; American advisors attended the meeting were ABCP President Mary Winkler; AmSECT President Bruce Bartel; AACP representative Mark Kurusz; and Texas Heart Institute representative Trudi Stafford; Braimbridge described the structure and composition of the EBCP; there were 30 members; non-perfusionists representing the European Association of Cardiothoracic Anaesthesiologists, the European Liaison Committee for Cardiovascular and Thoracic Surgery, and the chairman (a surgeon); every country in the European Community (EC) and the European Free Trade Association (EFTA) was represented on the board, and all were nominated by their society or board; the EBCP had applied to be incorporated and was to seek charitable status; the EBCP had produced two documents: the “Essentials and Guidelines” and “A Guide for the Examination Process of the European Board”; the documents were to be circulated for comment and possible editing, after which they were to be distributed; the Essentials document was to be used by institutions seeking accreditation for their education and training programs in perfusion sciences; the document was not to set maximum standards but to set minimum criteria recommended by the EBCP; a list of accredited programs was to be published; the Guide for the Examination Process addressed basic minimum skills that prospective employers could use for perfusionists; a European Certificate in Cardiovascular Perfusion (ECCP) was to be issued; it was available only to clinical perfusionists; after a brief implementation of a grandperson clause, the certificate was to issued only to graduates of EBCP-accredited training programs after they successfully passed the written, oral, and practical examinations; the “Grandperson” Clause was to be issued to practicing clinical perfusionists according to the following criteria: 1) applicant must have performed not less than 100 clinical perfusions in Europe; 2) the applicant must have been practicing clinical perfusion for at least two years; and 3) there was to be a 12-month deadline for applicants following the date of the initial announcement; the article closed by stating the EBCP program was intended to match their American colleagues in the professionalism of education and training; it was intended to raise the professional status of perfusionist who currently were not officially recognized in most European countries)

(Hedlund bemoaned the fact that the book was not widely advertised or known; Romaine-Davis was a nurse consultant for the US Department of Health and Human Services; she spent two years researching the book; Hedlund recounted the chapters that covered Gibbon’s background; early work as a fellow at Massachusetts General Hospital; his marriage to Mary “Maly” Hopkinson; their laboratory work in Boston and Philadelphia, with the latter at the University of Pennsylvania and Jefferson Medical College; the well-known anecdote when the idea for a heart-lung machine occurred to him as he monitored a patient with pulmonary embolism; initial experience with a rotating cylinder-type oxygenator; association with Thomas Edison (sic, it was Thomas Watson at IBM) to develop the stationary screen oxygenator; the book contained many photographs and laboratory notes; a chapter described use of the heart-lung machine in humans and the successful case on 6 May 1953; the chapter on the first successful patient contained information on the patient’s recovery; another chapter detailed refinements to the heart-lung machine made at the Mayo Clinic, which was used for hundreds of successful cases; later chapters detailed the needs for additional research and the impact of its development; the last book chapter summed up Gibbon as “an intellect, teacher, colleague, husband and father”; the book’s author noted Gibbon dabbled in poetry; Hedlund closed by stating, “Buy the book; study the book. It will make you a better historian, a better perfusionist and a better person.”)

(Gibson was to be a speaker at the 1993 AmSECT conference regarding cost containment and quality care; he was an operating room administrator in the Department of Nurse Anesthesia at the South Alabama Medical Center in Mobile, AL; a list of his AmSECT activities included convention planning; chair of the continuing education sessions at three conferences; continuing education committee member; and others; he received a BS in Zoology from Ohio State University (OSU) and a post-Baccalaureate degree in Circulation Technology from OSU in 1981)

(he was to present a lecture on ECCO 2R at the AmSECT convention in 1993; he began his education at Ohio State University (OSU) in pre-medicine in 1968; in his sophomore year he investigated a new allied health program called Circulation Technology; he applied to the program and graduated in 1972; he worked in hemodialysis, perfusion, and cardiology diagnostics at OSU Hospital and the Community MedCenter in Marion, OH; in 1977, he returned to OSU and became an instructor in the Circulation Technology Program; he earned a Master’s Degree in Physiology in 1982 and a Doctorate in Physiology in 1986; he was promoted to Assistant Professor and Director of the Circulation Technology program in 1986; Beckley enjoyed teaching the most; he had been involved with AmSECT programs for several years; his priorities in life were with his faith and commitment to his family)

(the author was a CCP; he reflected on early AmSECT conferences, which he did not attend; he noted perfusionists in the early days “were saving lives with little more than sheer guts and good old American know-how”; perfusion education in many cases back then consisted a two-week apprenticeship in a neighboring hospital that did open-heart procedures; “Safety devices were the eyes, ears, hands and brain of the pump operator.”; blood gas results took four hours using the Van Slyke method; devices were reusable and required cleaning, resterilization, and reassembly; he attended his first AmSECT conference in the late 1980s as a junior perfusion student; he had awesome impressions of the conference and exhibits; he urged perfusionists to get as much product information as possible from the manufacturers; he attended his second conference as a senior student; he noted the presentations and of giving a talk on his research, which was an agonizing experience; he attended his third conference as a new graduate; he took the ABCP written examination; it, too, was a stressful experience; he described taking the test with others; he passed the test; at his fourth conference, he was on the program faculty; at his job he had become the ECMO liaison for the perfusion department; the ABCP oral examination was considered an easier examination than the written examination, but performance anxiety was worse; oral scenarios were flexible in probing the candidate’s knowledge; the emphasis was always on the patient; after the oral examination, he went to a debriefing room and filled out a short questionnaire for feedback; he passed the orals and became a Certified Clinical Perfusionist)

(this report was from the AmSECT Perfusion Quality Committee; it Chairwoman was Beverly Parrault and members included Christine K. Cushen, Susan M. Haubert, Aaron G. Hill, Mark Kurusz, and Eric G. Whitehead; it recounted the draft “Essentials for Perfusion Practice, Clinical Function: Conduct of Extracorporeal Circulation” that was developed and published in 1992; the committee sought input from AmSECT members and received several important comments and suggestions; the committee completed its final recommendations that were to be presented to the AmSECT Board and then to members at the AmSECT conference in late Feb 1993; the report also noted a mail survey was being developed regarding current perfusion practices; results from the survey were to be used as another resource for the committee; Chief Perfusionists at 800 hospitals were to be mailed survey forms in Mar 1993; the report closed by urging perfusionist input so that a consensus document could be developed)

(NOTE: the word, “suggested” was deleted from the title as originally published in Mar 1990 issue; this checklist was reprinted in subsequent issues)

(this was from the AmSECT Perfusion Quality Committee: Chairman Beverly Parrault (from 1988-May 1994), Christine Cushen, Susan Haubert, Aaron Hill, Mark Kurusz, Eric Whitehead; it reported results from the survey; the questionnaire had been mailed to Chief Perfusionists at 940 medical centers; the return rate was 64%; the cumulative reported caseload was 270,000 cases in calendar year 1992; 93.3% of the cases were adults and 6.7% were pediatric; the committee stated the high return rate validated current practices necessary for the development of perfusion practice guidelines; the committee also relied on committee members and historical references in its plans to develop draft guidelines; sections of the survey were as follows with number of questions in parentheses: 1) Demographics (3); 2) Documentation (42); 3) Personnel (6); 4) Conduct of Cardiopulmonary Bypass (10); 7) Equipment (7); 8) Administrative Policy (6); and Quality Management (5))

(Ferries had been the chairman of the Accreditation Committee for Perfusion Education (AC-PE); he had been asked many times why there were so many perfusion schools; he stated it was outside the purview of the committee to limit the number of schools or students, which could be construed as restraint of trade; he noted some graduates were unable to find jobs after graduation; he emphasized the focus of perfusion education programs should be on the quality of graduates and not the quantity of graduates; he noted there had been a time when additional manpower was needed and the educational community responded; he urged programs to do selfassessments and ask why they are training perfusionists; he concluded that if their answer was not to train the best possible perfusion practitioner and advance the perfusion profession, “then they should get out of the business.”)

(this recounted the meaning of the logo, which was previously described in Perfusion Life, vol. 5, no. 6, pg 25, 1988)

(this was identical to the checklist published in Jul 1993)

(Drs. Michael E. DeBakey and Denton A. Cooley were profiled; the article was reprinted from The New York Times; the article contrasted the two surgeons: DeBakey advocated preserving the traditions of American medical research, training, and treatment; he was opposed to practice standards dictated by government bureaucrats or insurers; he criticized people with no medical experience making decisions on whether a patient should be operated on or how long they should stay in the hospital; Cooley insisted American medicine had to change and become more economical; he had adopted fixed price heart operations a decade ago; some called him the Sam Walton of heart surgery, which he took as a compliment; the two surgeons had refused to speak to one another for 25 years since DeBakey accused Cooley of stealing his device to implant an artificial heart; the article described the beginnings of the Texas Medical Center in 1942; Fannin Street was nicknamed “Bedpan Alley”; it had 55,000 workers, which was more than any other Houston employer; 100,000 patients were seen daily; its operating budgets were greater than $4 billion/year; it had 14 hospitals and 27 clinics; Methodist Hospital was the nation’s wealthiest and the largest tax-exempt with 1,500 beds; DeBakey practiced there; St. Luke’s Hospital was where Cooley operated; other major hospitals in the complex were Hermann Hospital, the Veterans Administration Hospital, Texas Children's Hospital, and M.D. Anderson Cancer Center; two medical schools, Baylor and the University of Texas, operated in the center, along with schools of nursing, dentistry, and other professions; Ben Taub was the county’s public hospital; some major equipment was duplicated at hospitals in the complex; some industry employers were becoming cost conscious in choosing hospitals with the highest survival rates; other hospitals had implemented one-price packages of services as first used by Cooley; some staff at underutilized hospitals were being reduced; DeBakey was noted to nearly always be in scrubs; DeBakey was highly critical of reduced payments for medical training and research; he criticized Cooley’s approach as mass marketer of second-rate medicine; Cooley was characterized as a deal maker in favor of free enterprise unconstrained by the government; in 1951, he joined DeBakey at Methodist, but as his own fame grew, he moved his practice to St. Luke’s; the final rupture in their relationship occurred in 1969 when Cooley implanted the first artificial heart; DeBakey accused him of stealing it from his laboratory; by the 1980s, Cooley and his team were performing 5,000 open-heart operations a year; Cooley invested in real estate; Cooley filed for bankruptcy in 1989, listing debts of nearly $100 million; his annual income had decreased to $1.5 million/year from $9 million/year; he offered coronary artery bypass operations for $27,040 when the national average was $43,370; his emphasis during surgery was no wasted movements, no errant emotions, and no extra tools; Cooley remained confident he could adapt to cost controls; the article concluded that both surgeons had a lot to offer—one who realized medicine was a business and the other who treated it like a religion; the article concluded the challenge was to combine the best of both)

(she referenced the article by LeRoy Ferries published in the Jul 1994 issue of Perfusion Life (vol. 11, no. 6, pg 8); she was responding as chair of the Perfusion Program Directors’ Council (PPDC); she noted she had also gotten input from other program directors for this reply; she noted modifications in the number of perfusion students could not take place quickly and would require two years because of lengths of the programs; she argued the profession was young and the number of retirees was not at 15%, which would allow for positions to be filled by new graduates; she stated that five years earlier she was asked why the schools were not graduating more students; she stated at the time that new schools were being established to try to meet the professional demand; however, she was now being asked why the schools were creating a glut of perfusionists; she reported figures on the number of graduates: 132 in 1989; 206 in 1990; and 233 in 1991; these were in response to the perfusion manpower shortages at the time; she noted that since 1992, the number of graduates had been decreasing; she cited an article published by Patrick Plunkett (“Perfusion Education in the United States: A Future Perspective” in Perfusion 1993, vol. 8, pgs 359-370); the Plunkett article cited the Mississippi School of Perfusion that graduated approximately 50 students, but they were already employed as perfusionists; another large university-based program decreased its student enrollment by 33%; three additional programs had become inactive; the goal was to balance the supply and demand for perfusionists; however, she stated the PPDC was not created to control the marketplace; its goal was to improve the educational process for the growth of the profession; she concluded, “proper education of the members of a profession ‘makes or breaks’ the profession as a whole. Indiscriminate closing of schools could be the first step in the demise of the profession as we know it.”)

(the author was an RN and CCP; he was director of perfusion services at the DCH Regional Medical Center in Tuscaloosa, AL; he received his perfusion training at St. Thomas Hospital School of Cardiovascular Perfusion in Nashville, TN; he recounted the Perfusion Quality Committee was established in 1986 as a standards committee; there were six currently practicing perfusionist on the committee (Christine Cushen; Susan Haubert; Aaron Hill; Mark Kurusz; Beverly Parault; and himself as chair); projects undertaken by the committee were intended to be broad-based and inclusive and directed towards benefiting practicing perfusionists; he recounted accomplishments: 1) Pre-Bypass Perfusion Checklist; 2) Perfusion Scope of Practice; and 3) Essentials for Clinical Function: Cardiopulmonary Bypass; for each of these documents, the committee solicited input from clinical perfusionists; prior to finalizing any documents, they were sent out the membership for comments; the most recent undertaking was to finalize “Guidelines for Perfusion Practice, Clinical Function: Cardiopulmonary Bypass”; the committee relied in part on a perfusion practice survey that had a 64% response rate; the committee was also preparing to address the manpower situation with another survey; all documents were intended to be “living documents” that could be revised as needed in response to changing technologies and techniques; the goal was to provide clinical perfusionists with guidelines for evaluating and improving the quality of their practices; he predicted quality issues would become more important as benchmarks to optimize the quality of perfusion services)

(this was a brief biosketch listing 22 details of her background and interests)

(this was a preview of historical contents in this issue; some were reprints; as noted earlier, in 1964, a small group of “pump technicians” from the upper mid-West met in a lounge in Chicago to share information about the emerging field of cardiopulmonary bypass; their desire was to become better perfusionists and to be able to provide better patient care; the pursuit of knowledge guided the pioneers and was noted to remain the primary focus of AmSECT in efforts for better patient care; this edition coincided with the 30th anniversary of AmSECT’s founding; activities such as certification, accreditation of training programs, national conferences, continuing education seminars, and good salaries were the result of the hard work and dedication of those who came before; the articles highlighted people and events; it was suggested that the articles on Charlie Reed, Jim Dearing, Ed Berger, Ace Adams, and Mary Gibbon ought to be required reading for anyone entering the field; Clarence Colby’s article on early equipment was referenced as a “trip down memory lane” for some and for others a reminder of how far the technology had come; it cited LeRoy Ferries and his article entitled, “Perfusion, Past-Present-Future” that discussed the 1960s and 1970s, which were described as AmSECT’s “adolescence and difficult teenage years”; the article closed by stating the aim of the issue was two-fold: first, as a trigger of fond memories for those who worked in the early years, and, second, a way to remind current perfusionists who to thank for laying the groundwork for what had been achieved and what was yet to be achieved)

(he reported on the new accrediting agency, the Commission on Accreditation of Allied Health Education Programs (CAAHEP); the new program had taken over the duties of allied health accreditation from the Committee on Allied Health Education and Accreditation (CAHEA); because some concerns had been raised about CAAHEP, he sought to explain the “how’s and why’s”; he stated accreditation was a process of external peer review in which a private, non-governmental agency or association granted public recognition to an institution or specialized program of study meeting certain established qualifications and educational standards as determined by initial and periodic evaluations; programs so evaluated were required to periodically perform self-evaluation and plans for continued improvement; perfusionists did not accredit its own schools for several reasons such as cost; accrediting organizations had to be recognized by the US Department of Education and the National Non-Governmental Educational Agency; another requirement was the need for an office with staff including an attorney along with liability insurance; the 1994 Higher Education Act also required such accrediting agencies to be separate and independent, administratively and financially, from any related, associated, or affiliated trade association or membership organizations; CAHEA was an accreditation agency sponsored by the US Department of Education and the Council on Postsecondary Accreditation (COPA) and had 20 review committees; in 1975, AmSECT, the American Association for Thoracic Surgery (AATS) and the Society of Thoracic Surgeons (STS) petitioned the American Medical Association (AMA) for recognition of the occupation of perfusion; in Dec 1975, the Committee on Emerging Health Manpower recommended approval, and the AMA Council on Medical Education (CME) officially recognized extracorporeal technology as an allied health profession the same month; in 1977, AmSECT, AATS, STS, and the American Board of Cardiovascular Perfusion (ABCP) sponsored formation of the Joint Review Committee for Perfusion Education (JRC-PE); “Essentials” for training programs were adopted by the JRC-PE in 1980 and accreditation of perfusion education programs began in 1981; in 1989, the JRC-PE added the Society of Cardiovascular Anesthesiologist (SCA) and the Perfusion Program Directors’ Council (PPDC) to the committee; in 1991, the JRC-PE was renamed the Accreditation Committee for Perfusion Education (AC-PE); in May 1994, CAHEA went out of business, and CAAHEP started as the accreditation agency; all sponsors of CAHEA the move to the new agency; as a result of this development, neither the schools nor the community were to see any changes in accreditation; two internal changes were adopted: 1) the AMA was to no longer sponsor accreditation, but it was to have a seat on the commission and one vote just like other members; and 2) every member organization was to pay $3,000 to join CAAHEP; in the past the AMA subsidized allied health education; one advantage of CAAHEP was to offer member organizations a voice in how it was to be run; in the past, perfusion had no such voice in how CAHEA was operated; perfusion had seven votes in the new scheme; a table listed selected allied health education data from 1993 including length of programs, sites, and certificates/degrees awarded; there was also a list of abbreviations of organizations and their roles in accreditation)

(these were excerpts from selected issues of AmSECT News, which was the first means of communication with the membership; Dec 1967: H. Bing Moy was chairman of the Southern Pacific Region; they had 25 members; others were named and included Jan Englajs, Elizabeth Swenson, and Raymond Savage; Jul 1968: LeRoy Ferries was a member from the Central Midwest Region and was also the treasurer and chairman; Fall 1968: it announced the first issue of the Journal of Extra-Corporeal Technology was to be published soon; Aug 1969: on 19 Jul 1969, the first AmSECT Awards Banquet was held; awardees included: Ruth Stetson, Eastern Central Region; Ray Bess, Northern Pacific Region; Calvin Scott, Southern Pacific Region; Jim Fondeux, Northern Midwest Region; Shannon Lucas, Kansas City Chapter of the Central Midwest Region; Jim Burke, Southern Region-West; Kathryn Hargesheimer, Southern RegionEast; Henry Pringle and Kathryn Hargesheimer shared the Journal Award and were Associate Editors; Jim Wade and Dennis Mills were presented special gifts for past services to the society; Jun 1970: President Ed Berger declined to run for reelection; he recommended the society employ someone to operate the national office; he noted the progress made had been primarily due to Kathryn Hargesheimer, Jim Fondeux, and himself who had served without pay and expended thousands of hours; he suggested more could have been accomplished if others had volunteered; he closed by issuing a challenge for all members to participate; “The foundation has been laid, the baby steps have been taken, and the time to run is NOW.”; Apr 1972: certification, which had been a longtime dream of all members, was nearing reality as reported by James Dearing, Vice President for Certification and Education; pilot testing was underway; Jun 1972: the initial certification examination was scheduled for 29 Jul 1972 during the AmSECT conference in New York City; two examinations were to be offered, one for heart-lung bypass and a second for dialysis; all who qualified under the Grandfather Clause were to be allowed to take the examinations; the criteria had been established by the society’s Medical Advisory Board; the criteria were as follows: for Heart-Lung Perfusion: “Candidate must be currently employed as a clinical perfusionist and must have two years clinical experience. A minimum of 100 clinical perfusions must have been completed.”; additionally, the applicant’s qualifications had to be attested to “by his physician-in-charge on the letterhead of the institution with which he is associated and, at the discretion of the certifying board, may be verified.”; the examination fee was $40 “to defray the costs of printing, administering, grading and evaluation.”)

(this listed the names of awardees and years in parentheses, as follows: Perfusionist of the Year Madeline M. Massengale (1974); Calvin R. Scott (1975); Charles C. Reed (1976); Larry W. Cavanaugh (1977); A. Earl Lawrence (1978); Diane Clark (1979); Bob Pfefferkorn (1980); Carl L. Freytag (1981); Nancy Achorn (1982); Michael B. Hurdle (1983); Scutter Newton (1984); LeRoy Ferries (1985); William J. Horgan (1986); Mary Hartley Winkler (1987); Sandra S. Witherington (1988); Susan Haubert (1989); Dennis R. Williams (1990); Rebekah Trittipoe (1991); Dennis Rivard (1992); Debbie Gherlone (1993); Craig R. Vocelka (1994); Award of Excellence Jeri L. Dobbs (1976); Edward C. Berger (1977); Charles C. Reed (1978); James P. Dearing (1979); Emily Taylor (1980); Gary Reeder (1981); Mark Kurusz (1982); Jerry Richmond (1983); Munier Jallad (1984); Nancy Achorn (1985); William J. Horgan (1986); Sandra S. Witherington (1987); Jeanne Lange (1988); Rebekah Trittipoe (1989); LeRoy Ferries (1990); Beverly Parault (1991); Susan Haubert (1992); Aaron Hill (1993); and Phyllis Palmer Stark (1994); John H. Gibbon Award Dr. Clarence H. Dennis (1974); Dr. Charles A. Hufnagel (1975); Dr. Denton A. Cooley (1976); Dr. Clarence Crafoord (1977); Dr. John Osborne (1978); Dr. C. Walton Lillehei (1979); Dr. Pierre M. Galletti (1980); Dr. Arthur C. Beall (1981); Dr. Marian I. Ionescu (1982); Dr. E. Converse Peirce II (1983); Dr. Yukihiko Nosé (1984); Dr. John Kirklin (1985); Dr. Norman Shumway (1986); James P. Dearing (1987); Dr. Henry Swan (1988); Dr. H. Edward Garrett (1989); Dr. Dwight C. McGoon (1990); Dr. R. Gerald Rainer (1991); Dr. Robert H. Bartlett (1992); Dr. Michael E. DeBakey (1993); and LeRoy Ferries (1994); Presidents beginning in 1964 for year of their installation, as follows: Dick Jensen (1964, 1965); James Wade (1966, 1967, 1968); Ed Berger (1969); Kathryn Hargesheimer (1970, 1971, 1972); Charles Reed (1973, 1974); Michael Dunaway (1975); LeRoy Ferries (1976, 1977); Maddie Massengale (1978); Calvin Scott (1979); Larry Cavanaugh (1980); James Dearing (1981); Scutter Newton (1982); Gary Reeder (1983); Frank Hurley (1984); Michael Hurdle (1985); William Pelley (1986); George Galbraith (1987); Doug Baxter (1988); George Galbraith (1989); Pat Courtney (1990); Sandra Witherington (1991); Bruce Bartel (1992); vacant (1993); and George Beshere (1994))

(reprinted from J ExtraCorp Technol vol. 13, no. 4, 1981)

(reprinted from J ExtraCorp Technol vol. 10, no. 4, 1978)

(reprinted from Perfusion Life, Sep 1990 with reminiscences by Ace Adams and Ed Berger)

(this article recapped Dearing’s Gibbon Award lecture from 1987; it was noted that year was the first time the award was presented to a non-physician; the introductory paragraph summarized his background; it also had four goals for AmSECT, which Daring had presented when running for president in 1981: Goal 1, clarification of the role of AmSECT in the health care system and including its objectives and program planning to achieve them; Goal 2, strengthening AmSECT’s professional services such as continuing education programs, publications, and meetings; Goal 3, strengthening accreditation and certification programs by continuing AmSECT’s interfacing with the various agencies responsible for these vital functions; and Goal 4, increased membership involvement; his lecture acknowledged this was the first time a non-physician was given the Gibbon Award, which he thought appropriate for recognition of members of the society for their contributions for development of the technology; he spoke of training programs, early certification efforts; his family was in attendance during the award ceremony, and he introduced them; a slide presentation accompanying his lecture but was not published)

(parts 1 & 2 were reprinted from Perfusion Life, Nov 1985 and Jan 1986)

(this was reprinted from Perfusion Life, Aug 1986; this had the same text as the original publication but different photographs)

(this was reprinted from Perfusion Life, Jul 1984)

(this was an excerpt of the report by Dr. Arthur C. Beall, Jr. for the American Association for Thoracic Surgery dated 11 Aug 1975; the report was published with the permission of Dr. Beall; it recounted early AmSECT history to develop a certification process and examination; the committee chaired by the Vice President for Certification and Education followed the methodology of the National Board of Medical Examiners (Hubbard, JP: Measuring Medical Education; The Tests and Test Procedures of the National Board of Medical Examiners. Lea & Febiger, Philadelphia, 1971); the committee had members from regions in the country who solicited questions from perfusionists considered senior or “grandfathers”; J. Dearing edited the questions and consistently formatted them to eliminate duplications; he also verified the answers from standard reference sources; approximately 450 questions were sent to committee members as an informal exam and for critiques; the questions were also sent to 25 physicians, some of whom were members of AmSECT’s Medical Advisory Board, for their critiques; the result was an examination with 200 multiplechoice questions; in 1971, 1972, and 1973 the examination was taken by 400 to 450 “grandfathers” who were automatically certified; grandfathers were defined as one who was actively engaged in perfusion with a minimum of two years of experience prior to Jul 1971 and who had conducted a minimum of 100 unsupervised perfusions prior to that date; facts on the perfusionists’ backgrounds had to be verified in writing by their employer, which was most often a surgeon or hospital administrator; after results of the first three examinations were collected and analyzed, the examination was modified and given in Jul 1974 for the first time on a pass-fail basis; approximately 30 grandfathers were also allowed to take the examination in 1974; the examination was given again on a pass-fail basis in 1975 at the AmSECT conference held in Portland, OR; the AmSECT Board recognized that as a scientific organization it was not proper to be certifying its own members; an independent board named the American Board of Cardiovascular Perfusion was established in Apr 1975 and incorporated in the state of Illinois; Beall acknowledged he might have trouble passing the examination; however, 70% of those who took the exam passed it using a sliding scale that required 91 correct answers out of the 200 questions; Beall thought some of the questions, while valuable, might not be necessary for a perfusionist; however, he thought if the field was to be upgraded those questions might be useful; the pool of questions was to be edited with additional questions of similar difficulty on the same subjects; 50 questions were in each of the areas of anatomy and pathology, physiology, perfusion technology, and pharmacology; some questions were basic but some required extensive knowledge and analytical reasoning; a program was also adopted requiring recertification every three years; criteria included remaining active in clinical perfusion and undertaking continuing educational activities; a point system was established wherein 150 points were required every three years; an attachment to the report had the recertification process, and a second attachment described Minimum Standards for Cardiovascular Perfusion Training Programs, which was a requirement of the American Medical Association’s Council of Medical Education; however, it was noted there were no approved schools under the system but this goal was an ideal and something to be implemented in the future)

(this was reprinted from JECT vol. 7. no. 4, 1975; this was the President’s Message; Dunaway challenged members to be progressive in adopting new equipment and techniques; he also contrasted perfusion as a job or an ever-changing expanding and developing art; he urged perfusionists to always strive to make perfusion better)

(these tributes were reprinted from Perfusion Life, Jul 1987)

(these were reminiscences by past presidents Kathryn Hargesheimer (1970-1973), Calvin R. Scott (1979-1980), and Michael Hurdle (1985-1986); Hargesheimer reflected gratitude to “so many wonderful people who helped weave that tapestry you call your life”; in 1967, she had requested information on how to become an AmSECT member; she traveled to San Antonio and met AmSECT Secretary Rose Litturi; there was an effort by some in Texas to break away from AmSECT, but they ultimately decided to support AmSECT; she became president in 1970 at the annual conference held in New Orleans; she noted there were no politics in the early years; “It was a happy time, a time of innocence and naiveté.”; she was reelected in 1971 at the annual conference held in St. Paul, MN; it was discovered AmSECT had never had an audit as was required for being incorporated in the state of Minnesota; she engaged an accounting firm, and in 1972 at the annual conference in New York City, she presented the audit; dues back then were $25/year; many members wondered what AmSECT would do for them, but few wondered what they could do for AmSECT; they decided they needed a Medical Advisory Board, and she approached Dr. Edward Hyman, one of the founders of ASAIO; with his help a Medical Advisory Board was founded consisting of Drs. Benjamin Burton, Richard DeWall, Pierre Galletti, Donald Lyman, Adrian Kantrowitz, William Kolff, and E. Converse Peirce II; she expressed thanks for their help; it was decided to hold a lunch meeting for the advisory board in Seattle during the ASAIO meeting that year; Dr. Vincent Gott, who was the ASAIO president, appointed Drs. E. Converse Peirce II and Charles Gutch as liaisons to AmSECT Cardiopulmonary and Hemodialysis, respectively, to advise on generating certification examinations for the two disciplines; Jim Dearing, as Vice President of the Education and Certification Committee, had prepared examinations; it was delivered to Hargesheimer in New Orleans, and she made copies and distributed it to the committee; she praised Ed Romanowski who worked for Dr. Adrian Kantrowitz; Romanowski became the journal editor at the New York conference when a vacancy arose; Dr. DeWall advised AmSECT to notify the two thoracic surgery organizations (the Society of Thoracic Surgery and the American Association for Thoracic Surgery) of AmSECT’s plans for certification; he urged that surgeons be invited to participate, but they did not at the time; the first examination was taken by all committee members and their surgeons, and a final examination was developed and based on input; the dialysis examination was written by Dietz Van Dura, who worked with Drs. Kolff and Gutch; she noted 300 people took the first examination at the Waldorf Astoria (200 in cardiopulmonary and 100 in hemodialysis); she noted how proud J. Dearing was at the time; the examinations were graded by computer and results were sent to each examinee; certificates were printed at the University of Utah where Dura and Gutch worked; Hargesheimer hand-wrote recipients names on the first certificates that were titled, “Certified in the Practice of Clinical Perfusion” or “Certified in the Practice of Renal Dialysis”; both were certified as CCPs; she recounted one other anecdote to recover AmSECT funds that were being illegally held by a local bank; she acknowledged several people who helped in the early days: Emmanuel Bagby; Julie Casimir; Michael Dunaway; Mary Caiazza; Maddie Massengale; and Emily Taylor; she closed by noting her time as president was “tumultuous, exciting, lots of work and some tearful…and a time…with happiness, humility, satisfaction and gratitude to all who made it possible.”; Scott was concerned about redundancy in his recollections since others were sharing their memories of events in the early years; he entered the field in the early 1960s; he attended his first meeting in Montreal in 1967 and presented a paper; at that time, Canadians were part of the Northeast Region of AmSECT; they later resigned and formed CanSECT; he attended the CanSECT meeting in 1968 in Nova Scotia; a certification process was postulated, but despite many ideas being discussed, plans were dropped; he noted he had served on many AmSECT committees and boards during the tenures of Hargesheimer, Reed, Dunaway, and Massengale; “These were trying times, turbulent times and good times.”; he expressed gratitude for being elected president in 1980; he recounted being involved in early certification first by AmSECT and then by the ABCP; he also took pride in writing the code of ethics, which he noted had recently been updated; he recounted that at one oral examination in Philadelphia an examiner was punched by a hotel security guard and was taken to a police precinct; Scott went the police precinct and the examiner was released, and the security guard was reprimanded; he closed, “I would be remiss if I did not state that it was a privilege and an honor to have served the organization and I am eternally grateful for the family who became a part of my life as a result of that service.”; Hurdle’s thoughts were in the form of several aphorisms)

(the first paragraph recounted the history of the EBCP, which was set up in 1991 in Brussels; its founders were perfusionists from many European countries; it was supported by the European Association for Cardio-Thoracic Surgery, the European Society for Cardiovascular Surgery, and the European Association of Cardiothoracic Anesthesiologists; it had six objectives, as follows: 1) establish, monitor, and maintain equality of standards in education and training; 2) set out Essentials and Guidelines by which training programs were to be accredited; 3) establish a common perfusionists’ certification process in Europe; 4) issue a European Certificate in Cardiovascular Perfusion (ECCP) to perfusionists who had graduated from board-accredited training programs; 5) encourage the development of advanced level education and training programs to train the trainers in perfusion; and 6) liaise with the European Commission to legalize the objectives; the criteria for awarding the ECCP certificate was to be issued under a “Grandperson Clause” for one year as of 1 Nov 1994 to those perfusionists who had conducted 100 unsupervised clinical perfusions in Europe and who had been practicing as a clinical perfusionist for at least two years at the time of application; the fee for the ECCP certificate was £50 (ECU 65); a flow chart showed the composition and structure of the EBCP; all delegates were perfusionists elected by their societies; representatives included surgeons and anesthetists elected by their societies; executives were the Chairman, General Secretary, and Treasurer; the academic committee had two subcommittees: Accreditation and Certification)

(this recounted the case of the first child to undergo a Blalock-Taussig shunt operation on 29 Nov 1944 at Johns Hopkins Hospital in Baltimore, MD; the child’s name was Eileen Saxon, and she was 15 months-old; she was diagnosed with pulmonary stenosis by Dr. Helen Taussig; Dr. Alfred Blalock had done animal experimentation for a decade when he was at Vanderbilt Medical School in Nashville, TN; Taussig had been the one who thought creating a shunt would correct the condition; she approached Dr. Robert Gross about the idea, but he rejected it; Gross reportedly stated, “My job is close ducts, not create them.”; the operation consisted of connecting the left subclavian artery to the lung; the child was discharged by Christmas 1944, but died from liver and stomach problems; two other children had successful operations; Blalock was from Georgia and was a distant cousin of Jefferson Davis; in the operating room he was known to have a fierce temper; Taussig, in contrast, was “tender-hearted and treated every patient as her own child”; she was initially denied admittance to the Harvard School of Public Health because she was a woman; she then enrolled in Boston University Medical School and was later accepted at Harvard Medical School as a “special student”; she was segregated from male students and was not allowed to graduate regardless of her grades; she subsequently received her MD degree from Johns Hopkins in 1927; a third member of the Blalock-Taussig team was Vivien Thomas, who was a black man from Nashville; his first job was as an orderly, but was able to enroll as a pre-med student at Tennessee A&I; however, he lost finances during the stock market crash of 1929; he worked as a carpenter and plumber; in 1930, he was hired by Blalock as a laboratory assistant at Vanderbilt; he became skilled during animal surgery; when Blalock moved to Johns Hopkins, Thomas went with him as a surgical technician; they consulted during the animal experiments; Thomas’ job classification at Johns Hopkins was janitor because there was no funding for a laboratory technician; because of his skills he was promoted to supervisor of the research laboratories; in 1971, Thomas was honored at Johns Hopkins when a portrait of him was unveiled; Taussig investigated the drug thalidomide that caused many babies to be born with birth defects; she alerted the Food and Drug Administration, and the drug was removed from the market in the US; Blalock died of liver cancer in 1964; Thomas died of pancreatic cancer in 1985; Taussig died in 1986 after being struck by an automobile; while the first patient did not survive because of other medical problems, she was a participant in the historic operation)

(this was a reprint of the scope published in Perfusion Life in 1991; it was reprinted in subsequent issues)

(this document was approved by AmSECT Board of Directors and was being presented for membership adoption; it contained 12 Essentials with specific practice guidelines; the Essentials without specific guidelines had been previously adopted by the AmSECT membership; subjects of the Essentials were: 1) perfusion record; 2) checklist(s); 3) knowledgeable and competent perfusionist; 4) anticoagulation monitoring by established protocol; 5) gas exchange by established protocol; 6) blood flow by established protocol; 7) blood pressure by established protocol; 8) operating volumes by established protocol; 9) safety devices; 10) monitoring devices; 11) cost containment; and 12) maintenance of equipment)

(the latter was reprinted from Perfusion Life 1990; Richmond was an AmSECT Life Member; Phyllis Palmer Stark paid tribute to him for having influenced many perfusionists; he was a vice president of a perfusion contract company; Larry Cavanaugh paid tribute to him as a “wonderful human being”; Maddie Massengale and Bob Pfefferkorn also paid tribute; many AmSECT leaders attended his funeral)

(this was an announcement from American Board of Cardiovascular Perfusion; on 28 Apr 1995, the board unanimously decided to replace the oral examination; beginning in 1996, the first segment was to be a four-hour criterion-referenced examination measuring knowledge of the basic sciences as related to perfusion; for those candidates passing the first examination, the second segment was another four-hour criterion-referenced examination measuring the skills in the application of knowledge in clinical perfusion (analysis, synthesis, and evaluation of information to arrive at appropriate clinical decisions); to be eligible for the second examination, candidates had to have passed the first examination and had to have satisfied the caseload and time requirements; the second segment was to be implemented in 1997; the ABCP acknowledged the oral examination had served the perfusion community “honorably and well”; however, it had determined the oral examination needed to be replaced with a more generally agreed upon paradigm for examination; measurement experts in test methodology had concluded an oral examination lacked statistical reliability and validity when compared to more objective forms of testing; another trend in allied health was to move away from normreferenced testing to criterion-referenced tests; the article noted nearly all examinations for licensure were criterion-referenced; the ABCP believed the examination for certification would be best served by changing both aspects of the examination (written and oral) “to provide a continuum of measurement, which reflects the scope of a specific knowledge base”; the ABCP also had determined the breadth of information was too great in scope to be assessed in one four-hour test session; therefore, the two segments were chosen with the first to deal with basic science and the second with practice; the ABCP asserted did not make the change lightly or in haste; the path to certification would continue to be a two-step process; “The conferring of the title CCP will continue to require a high level of preparation and the ability to demonstrate a high level of professional knowledge.”; the ABCP acknowledged the change might generate many concerns and questions; they had established an 800 telephone line and provided email addresses for those wishing to get more information; they planned to transcribe comments received for evaluation at their summer board meeting; the article closed by stating the ABCP welcomed comments and questions)

(there were two photographs—one of Maddie Massengale administering the oath of office to new officers (President-Elect Pat H. Courtney, Jr.; Treasurer Ron Richards; Secretary Sharon Marquis; and President Craig Vocelka); the second photograph was the new Board of Directors (Debbie Gherlone, Region 10; Susan Englert, Region 7; Ron Richards, Treasurer; Craig Vocelka, President; Pat Courtney, Jr., President-Elect; Sharon Marquis, Secretary; Ron Matheis, Region 5; Jeff Edwards, Region 11; Jeff Riley, Region 3; Carl Barringer, Region 4; Chris Cushen, Region 9; Matt Roberts, Region 8—resigned; Greg Mork, Region 6; Paul Cappola, Region 2; and Susan Haubert, Region 1))

(this appeared to be a transcript of Mitchell’s speech delivered on 28 Apr 1995 at the 33 rd AmSECT Convention; he gave a biosketch of his life; he was born in Trinidad, West Indies and educated in Trinidad, Liverpool, England, and the United States, obtaining undergraduate and graduate degrees from Fordham University; he served in WWII in the Merchant Marines as a Medical Corpsman and was honorably discharged from the Coast Guard; he studied x-ray and laboratory technology; in 1953, he was employed part-time in the laboratory of Dr. Adrian Kantrowitz at Montefiore Hospital in New York City; the work involved left heart bypass for mitral valve repairs; in 1954, he was employed at Cornell Medical College in the surgical research laboratory with Drs. George Holswade, Frank Redo, and Mary Allen Engle to develop methods for open-heart surgery; they used the “atrial well” technique designed by Dr. Robert Gross to permit closure of atrial septal defects; patients were cooled to moderate hypothermia in an ice bath; he devised a collapsible canvas tub on the operating table to replace the bath tub for cooling the patients; once patients were immersed in the cold water, he monitored their rectal temperature as they were cooled to 30 0C; the benefit of the canvas tub was it could be emptied of water when the operation needed to be started; after the surgery, the tub was refilled with warm water, and a heating blanket was also used to rewarm the patient; in 1955, his team from Cornell visited the laboratories of Dr. C. Walton Lillehei to learn more about controlled cross-circulation methods for open-heart surgery; however, Lillehei had recently changed to using the DeWall helical bubble oxygenator, and the Cornell team implemented that method in late 1955; they operated on pediatric patients with pulmonary stenosis and adults with mitral stenosis; the oxygenator was placed in a water tank heated by a fish-tank heater; in 1956, his team switched to the Kay-Cross rotating disc oxygenator; cool oxygen entering the device caused the development of water droplets, and he was concerned about hemolysis; he placed a heating wire around the glass cylinder, which also served to maintain the blood normothermic; anti-foam A was used on sponges for cardiotomy-suctioned blood; his job duties were to work in the experimental laboratory and then to use techniques learned there in the operating room; during cardiac operations, he operated the heartlung machine; the only blood monitor used was a pH meter; blood samples were collected during perfusion, placed in capped syringes on ice, and later analyzed on a van Slyke Volumetric Manometer to determine the pO2, pCO2, and CO content; after bypass, he performed a Polybrene-Heparin test to determine the protamine dose to reverse the heparin; he also helped blood bank personnel to collect blood from 17 donors; he believed he was the first non-MD allowed to operate the heart-lung machine in the early days; he then spoke about the early days of AmSECT; he first met James Wade, who was the principal animal technician in Dr. Lillehei’s research laboratory; Wade became AmSECT’s second president; in 1957, Mitchell met Wilbur Herring from St. Luke’s Hospital; the chief of surgery at St. Luke’s suggested Mitchell teach Herring to operate the heart-lung machine; in 1959, Mitchell learned others were performing duties with heart-lung machines as he was; he told a sales representative, Norman Bleicher, that he wanted to communicate with the other technicians involved in extracorporeal circulation; Mitchell received a letter dated 23 Nov 1959 from James Arzuoman who worked at the University of California Medical Center in Los Angeles (the letter was reproduced in the article); Mitchell believed the letter expressing an interest for other extracorporeal technicians to meet was the beginnings for the formation of AmSECT; in 1963, and after nine years at Cornell, he went to work at Mt. Sinai Hospital as Chief Perfusionist; the surgeon was Dr. Robert Litwak; Mitchell worked there for the next 24 years; he operated the Mayo-Gibbon heart-lung machine for many years; the oxygenator weighed 80 lbs and required four hours to disassemble, clean, and sterilize before the next case; in 1963, Richard Jensen, Ace Adams, and James Wade proposed a small meeting to be held in the mid-West; Mitchell was invited but was unable to attend due his schedule; the group adopted the name, “The American Association of PumpOxygenator Technicians”; Jensen was elected president, Rose Litturi from the Cleveland Clinic secretary, and Dennis Mills from Minneapolis Treasurer; in 1964, the second meeting was held at the Cleveland Clinic, and 85 heart-lung and dialysis technicians and nurses attended; speakers included Drs. Willem Kolff, Rene Favolaro, and Yukihiko Nosé; James Wade was elected president; Sister Mary Lauraine from the Order of St. Francis was a heart-lung technician and was elected first Vice President; other officers elected included Rose Litturi (Secretary) and Dennis Mills (Treasurer); regional chairmen were also elected; in 1965, the third national meeting was held in Minneapolis, MN, and in 1966, the fourth meeting was held at the Children’s Hospital in Washington, DC; 115 attended; in 1967, the fifth meeting was held in Montreal, Canada during Expo ’67 and was a “huge success”; the sixth national meeting was in San Francisco and was hosted by Bing Moy; at that time in the Atlantic Northeastern Region, members included pump and dialysis technicians, nurses, and some honorary members from industry; there were 90 dues-paying members in the region, which was the largest AmSECT region; in 1964, Mitchell was elected chairman and held the position until 1969; Betty Greenspan was the treasurer; national dues were $10 per year, of which the region kept $3 for its expenses; by 1967, the national membership totaled 204; at an Executive Board meeting in Minneapolis, Pierre Morin designed the AmSECT logo, which was adopted at the Montreal meeting; at the same meeting, Mitchell coined the term “perfusionist”, and it was adopted by the Board; prior to that, perfusionists were addressed as “pump tech”, “heart lung machine operator”, “pump-boy” or “pump-girl”; the group also changed its name to the American Society of Extra-corporeal Technology, which was abbreviated AmSECT; he noted the organization had “growing pains” with factions pulling in different directions; he praised early leaders including Calvin Scott, Shannon Lucas, LeRoy Ferries, Kathryn Hargesheimer, James Burke, and later Charles Reed; he then stated that one individual who he believed was uniquely responsible for the growth of AmSECT was Edward Berger; Berger was the first editor of the AmSECT journal, which was first published on 25 May 1967; Mitchell believed the journal was one reason surgical societies recognized AmSECT; in 1969, Berger became the third AmSECT president; Mitchell then recounted his international travels as a perfusionist and lecturer; he went to Ecuador to help treat patients with Schistosomiasis; he used a Kay-Cross oxygenator with arterial filter to trap and collect the worms; in 1960, he spent six weeks in Havana, Cuba, where he perfused patients for repair of congenital defects; he also did some isolated limb perfusion for cancer chemotherapy, which he had learned at Sloan Kettering Cancer Institute in New York City; in 1962, he worked with the neurosurgical team that included Drs. Russell Patterson and Bronson Ray at Cornell Medical College/New York Hospital; deep hypothermia and circulatory arrest were used for operations for aneurysms of the Circle of Willis; in 1974, he worked with Dr. E. Converse Peirce II in a blinded study of long term support with a membrane oxygenator for ARDS; he also helped develop the Litwak-Koffsky permanently implantable “heart assist device”; the latter technique was presented at the AmSECT convention in 1974; other international travels were to Russia and Armenia (1981); China (1985); and India, Portugal, Africa, Spain, France, Greece, The Netherlands, and several additional countries in North, Central, and South America; he claimed he was the unofficial ambassador (“without portfolio”) for AmSECT in his travels as he promoted the organization of perfusionists; he mentioned friends such as Dick de Jong (Netherlands); José Moles (Spain); and Maria Helena de Souza (Brazil); he recounted numerous awards he received from foreign perfusion societies; in 1990 he received a Lifetime Achievement Award from AmSECT for his 35 years of contributions; he noted he had published many articles in the AmSECT journal; he closed his lecture by citing very early extracorporeal circulation work (LeGallois in 1812 and John Gibbon in 1953); he cited Theodor Billroth’s famous quotation about surgeons suturing the heart losing esteem and another quotation from the British surgeon Sir Stephen Paget; he noted the successful suturing of the heart by Professor Ludwig Rehn; “May AmSECT continue to grow and enhance your lives. Thank you one and all for including me among the array of distinguished past recipients of the Gibbon Award.”)

(T. Johnson paid tribute to Webb, who had a small contract perfusion company named Genesis Surgical Services in southern CA; Kassay received his perfusion training in Houston; in 1981 he worked in Saudi Arabia with the Baylor Heart Team; in 1984, he returned to Saudi Arabia and worked there for 6.5 years, four of which as Chief Perfusionist)

(20 covers chosen for their design and/or topic were reprinted from past issues)

(he was a cardiothoracic surgeon in private practice; he was introduced to perfusion by Brad Winn, CCP, and Bruce Ratcliff, CCP; he attended the Ohio State University perfusion program; he mentioned instructors Joe Manley, CCP (sic Mandl?), and Phil Beckley, PhD, CCP, and Lou Toth, PhD; he became interested in surgery in the dog lab; he did a clinical rotation at Henry Ford Hospital and Scott Sorenen, CCP, was an instructor; he graduated from perfusion school in 1979; his first job was at the University Hospitals; Rich Motley, CCP, taught him about kidney preservation techniques; Max Miller, CCP, was his mentor; Miller had a Master’s degree in physiology; he had strong influences from two cardiac surgeons: Gerald Kakos, MD, and the late John S. Vasko, MD; he then went to medical school and did an internship, residencies, and a fellowship in cardiothoracic surgery; he closed by stating he and his partner J.D. Talbott, DO, had started a new cardiac surgery program at Sparrow Hospital; they performed 156 operations their first year without any mortalities; he cited good communication among the surgeon, anesthesiologist, and perfusionist for their success)

(he was chair of the Perfusion Quality Committee; he reported on a meeting held 9-10 Dec 1995 with committee members Chris Cushen, Susan Haubert, Aaron Hill, and Mark Kurusz; projects underway included: 1) Perfusion Manpower Survey; 925 questionnaires were sent to institutions in Apr 1995; 408 completed survey forms were returned (44% response rate); results were being analyzed, and results were expected to be published in AmSECT Today; 2) Perfusion Practice Guidelines; the committee had developed the “Guidelines for Clinical Function: Cardiopulmonary Bypass”, which had been approved by the AmSECT Board of Directors and ratified by a majority vote of the AmSECT membership; it was noted that this were the first set of guidelines evolved from the AmSECT “Scope of Practice”; practice guidelines were favored by the AmSECT Board and the committee “to provide a framework for perfusionists to assess, develop, and ultimately improve their clinical practice”; additional practice guidelines were being developed by the committee, as follows: extracorporeal membrane oxygenation; ventricular assistance; blood conservation; isolated limb perfusion; and intra-aortic balloon counterpulsation; draft guidelines were to be submitted to the AmSECT Board for approval and then to the membership for a period of review and commentary; the article reiterated development of the “Pre-Bypass Perfusion Safety Checklist”, the “Perfusion Scope of Practice”, the “Essentials for Perfusion Practice”, and the “Guidelines for Clinical Function: Cardiopulmonary Bypass” that had the participation of the AmSECT membership)

(in early 1995, the AmSECT Board of Directors directed the Perfusion Quality Committee to perform a manpower survey; in Apr 1995, 925 five-page survey questionnaires were mailed to all institutions in the US identified as performing openheart surgery; the survey had 25 questions that asked about number of employees, how they were employed, what procedures they performed, levels of call and coverage responsibilities, and opinions regarding future perfusionist job responsibilities; 408 completed surveys were returned (44% response rate); some questions were crosstabulated regarding number of perfusionists and number on call and those able to be scheduled off at any given time; programs with larger staffs often had more than one perfusionist on call, but 57% of the programs had one perfusionist on call; more than three-quarters of the institutions indicated certification by the American Board of Cardiovascular Perfusion was an institutional requirement; most respondents believed data management duties would increase; a majority thought there would be no changes in current job responsibilities, and only 15.9% believed perfusionists would be crosstrained in new clinical activities; caution was urged in interpreting the results; those participants who requested results were to be mailed the summary and statistical data; the number of responses and percentages for questions were provided)

(effective 1 May 1996, the ABCP was to implement two criterion-referenced written examinations: Part 1 was Perfusion Basic Sciences, and Part 2 was Clinical Applications of Perfusion; both were to be offered in fall 1996 over a twoday period; successful completion of Part 1 and completion of Part 2 application requirements would allow candidates to take Part 2; the deadline for applications was 1 May 1996; both parts were to be administered twice yearly after 1996; the application deadline for the fall examinations was 1 Apr and for the spring examinations 1 Oct; qualifications to take Part 1 were specified in the ABCP Booklet of Information (pg 7, 1996); qualifications to take Part 2 were to have successfully completed Part 1 and to have performed 50 independent clinical perfusions since graduation from an accredited program; previous requirements for time and employment criteria between Part 1 and Part 2 of the examination process had been eliminated)

(the AmSECT Government Relations Program surveyed perfusionists’ attitudes and practice demographics as they related to federal and state public policy issues affecting the profession; a survey questionnaire was developed in 1995 by the committee; it was sent to 1,875 clinically practicing perfusionists; 1,104 perfusionists returned survey forms (59% response rate); response rates varied by states; it reported it was unknown how many practicing perfusionists in the US were not members of AmSECT; 1,760 of the 1,875 surveys sent out (94%) represented AmSECT members, and 115 (6%) represented non-members; topics of the survey included: 1) clinical practice concerns; 2) perfusion training and certification; 3) non-perfusion legal credentials held by perfusionists; and 4) perfusion organizations and political participation; a summary of the results was presented, as follows: 1) perfusionists, as unlicensed medical providers, were concerned about the growth of managed care and how it would impact the perfusion scope of practice; they believed licensure would be “an important perfusion preservation tool”; at least 40% of practicing perfusionists currently or in the past had held a professional license in non-perfusion professions; 2) at least 82% of practicing perfusionists were ABCP-certified, and at least 75% received their education and training at accredited perfusion programs; 3) 89% of respondents strongly supported the formation of professional state societies to become actively engaged at the state and federal levels of government in legislative and regulatory lobbying efforts on issues affecting the profession; the report cited the previously published 1995 Perfusion Manpower Survey in the Feb 1996 issue of AmSECT Today (above Feb 1996 issue); it noted there were differences in that survey and the current one; in the current survey, five clinical practice questions were posed with five possible respondent choices ranging from “most important” (rated 1) to “least important” (rated 5); the most important issue was reported as “protecting the perfusion scope of practice” (rated 1.6); “effects of managed care on the profession” (rated 2.6); “professional licensure” (rated 2.7); the two topics rated least important were “cross-training of other unlicensed health care professionals to do perfusion” and “medical malpractice reform” (3.7 each); the authors noted the “need for professional licensure to maintain high quality patient care and the medical services stipulated in the perfusionist’s scope of practice” was believed to be important by a large majority of perfusionists, which was a change from five years earlier; tables with data on training and certification revealed 75% of respondents had been graduates of an accredited training program, and only 22% had been trained onthe-job; 82% were ABCP-certified; data on legal credentials and certifications revealed 40% of respondents held a professional credential in another non-perfusion medical specialty; 17% of these were as a Registered Nurse and 13% as a Respiratory Therapist; regarding independent perfusion organizations and political participation, 89% reported they were supportive of professional state societies, and 86% indicated they were supportive of perfusionists being actively engaged in lobbying efforts on issues affecting the profession at state and federal levels of government)

(this was a reprint of the Preamble and Code as published in Perfusion Life vol. 9, no. 10 in Nov 1992 (above), but had new Interpretive Statements for each canon)

(Page died during minor foot surgery; he graduated from Jacksonville University with a BS in Biology in 1967; he studied perfusion at the University of Maryland Medical School and Hospital and became Chief Perfusionist there in 1969; in 1971, he moved to Johns Hopkins Hospital and became Director of Perfusion Services; he left Johns Hopkins in 1985 and worked for medical companies in marketing, continuing education, and technical support; he was an Active member of AmSECT, served as an Associate Editor for the J ExtraCorp Technol, authored many publications, lectured at national and international meetings, authored AmSECT’s “Pediatric Self Study Module” in 1981, and was an oral examiner for the ABCP; Cappola wrote, “No words can truly help when someone dear departs. Yet there is some solace knowing from a professional standpoint that his accomplishments in extracorporeal technology will live on.”)

(this was a follow-up to the report Perfusion Life in May 1996 (above) and reported additional findings from the survey, as follows: Perfusion Functions with percentages of respondents performing the activities in parentheses included: ECMO (39%); ATS (autotransfusion) (92%); blood gas analysis (68%); blood chemistry analysis (55%); activated clotting time (ACT) (94%); 97% reported administration of drugs and crystalloid IV solutions, 98% blood product administration, and 81% gaseous anesthetic administration; for Delivery of Perfusion Services, 73% reported they had duties outside the operating room, which included Intensive Care Unit (50%), Cardiac Cath Laboratory (48%); less frequently, 12% reported they were involved in perfusion services during transport/mobile setting and 13% in Neonatal/Pediatric Intensive Care Unit; for Malpractice Insurance, 90% reported having coverage, and it was no longer a problem; coverage was provided by the hospital (40%) or perfusion company (46%); only 5% reported they personally paid for malpractice insurance coverage; data by states for the questions were shown in tables)

(this was part 1 of two articles; the authors had been speakers during a symposium at the Cardiothoracic Research and Education Foundation “Pathophysiology” meeting held in San Diego 29 Feb-3 Mar 1996; Horgan worked for Rocky Mountain Perfusionists and was Chairman of the Accreditation CommitteePerfusion Education (AC-PE); he was also an Executive Board member of the Commission on the Accreditation of Allied Health Education Programs (CAAHEP); Horgan’s section was entitled, “Perfusion Program Accreditation”; he recounted the establishment of CAAHEP; it was the successor to the American Medical Association’s (AMA) Committee on Allied Health Education and Accreditation (CAHEA); he defined accreditation as “the process of external peer review in which a private nongovernmental agency grants public recognition to either an institution or specialized program of study that meets certain established qualifications and education standards, as determined through initial and subsequent periodic evaluation”; he stated accrediting agencies had two goals: first, to provide professional judgment of the quality of the education institution or specialized program, and second, to encourage that program or institution to continually improve; accreditation of perfusion programs was considered “programmatic” because the accrediting agency only was accrediting a specific program; the accreditation process under the new CAAHEP was no different than the previous CAHEA accreditation; the major difference was in subsidization: with CAHEA, the AMA had the only vote on how the program would be operated; under CAAHEP, sponsoring organizations had input on how the program operated; he described CAAHEP organizationally: there were seven commissioners, each with a vote; all perfusion educational programs had to submit a self-study, have a site visit, and then be evaluated; one hope for CAAHEP was to minimize paperwork to streamline the process; site visits were also to be streamlined; CAAHEP agreed to an offer from the AMA for office space and personnel to operate CAAHEP for three years; a new Executive Director was being interviewed who was to add staff after the three year period; location of the new offices was being evaluated; Lange’s section was entitled, “Perfusion Education: Which Way is Up?”; she began by posing several questions about perfusionist training; she recounted the history of on-the-job training, development of formal training programs, and establishment of the Perfusion Program Directors’ Council (PPDC) in 1976; the PPDC sponsored seminars in the fall aimed at improving perfusion education; she noted some in the field were critical of the quality of training program graduates compared to earlier perfusionists; she provided a table with average American Board of Cardiovascular Perfusion (ABCP) scores on the certification examination 1984-1995 to refute the complaint about quality of graduates (the scores did not vary significantly over the 12-year period); she recounted that perfusion educational programs responded to the manpower shortage in the late 1980s and early 1990s; a table showed number of graduates 1988-1997; the number of graduates had doubled over a three to four year period; the table showed a gradual decrease in the number of graduates in more recent years, which she stated would bring the supply and demand into balance; in 1995, there were 35 accredited programs, and two programs had become inactive; the number of graduates in the years 1996-1997 was expected to be 135-150, which was a significant decrease from the peak years of 1991-1992; she acknowledged that forecasting manpower needs was difficult to predict and had resulted in an “overshoot in the projected need” currently affecting the field; she noted attrition rates of 8-14% per year were another factor in affecting manpower needs; she criticized some perfusionists who were complaining about low starting wages; she contrasted the figure of $25-30K with that of a newly graduated PhD who could expect the same starting wage as that of a perfusionist; she asked, “Is perfusion just a job or is it a profession?”; she raised the question of whether the field should go back to on-thejob training; she suggested that standardized educational programs was another alternative and a better one than a return to on-the-job training; she asked for positive feedback for perfusion program directors instead of vague complaints; she closed, “It behooves us as professionals to work together to achieve our mutual goals of the best care we can give our patients. This is the way up.”; Utsey was the Chief Perfusionist at Roper Hospital in Charleston, SC, and President of the ABCP; his goal was to address changes in the board examination process; he stated the years 1994-1995 were the most historic in the ABCP’s history because 1) the former norm-referenced written examination was restructured to a criterion-referenced format and 2) the oral examination was being replaced by a criterion-referenced examination; the first examination was to be called the Perfusion Basic Sciences Examination; it was to be administered for the first time the following week in Dallas, TX; the new criterionreferenced examination replacing the oral examination was to be called the Perfusion Clinical Applications Examination and was also to be administered for the first time in Dallas the next week; changes in the number of times a candidate could sit for the examination were implemented to eliminate the so-called death clause whereby a candidate failing the written examination three times was barred from ever taking the examination again; he noted the ABCP had communicated these changes in publications and in the annual ABCP reports, which included rationales for the changes; he closed by noting the ABCP, which was a group of 12 perfusionists from different geographic areas and backgrounds as directors and volunteered their time to serve on the ABCP; their primary goal was to maintain the CCP as the standard in perfusionist certification; all decisions were considered and discussed and then voted on to establish a consensus for what they believed were the best decisions for the process and the profession)

(part 2, with panel discussion, from the “Pathophysiology” meeting held in San Diego as referenced above; Vocelka was Chief of Perfusion Services at the University of Washington in Seattle, WA; he had held several leadership roles at AmSECT including Treasurer 1993-1995; President 1994-1996; and Secretary in 1996; he mentioned a presentation by Jeff Riley at the American Academy of Cardiovascular Perfusion’s meeting in 1995; Riley had noted the “splintering” of perfusionist professional organizations that began in 1979; Vocelka expressed thanks to Dr. Joe Utley for holding the current symposium; he noted in 1989, perfusionists were forced into the legislative arena when titling and licensure bills were introduced in 12 state legislatures; he noted AmSECT was working with the ABCP to ensure its certification process would become the standard for licensure; he praised the AmSECT Government Relations Committee as critical to the overall mission of AmSECT; “Perfusion by perfusionists is not guaranteed unless the profession can speak with one voice when state and federal legislative and public policy decisions are made.”; he also addressed caseloads and highlighted excerpts of results from the manpower survey conducted by the AmSECT Perfusion Quality Committee (see Feb 1996 above); specifically, 63.8% of perfusionists were hospital-employed, and 52.7% were employed by a private contract service; the mean annual CPB caseload was 140.6 +/- 46 cases; the mean number of hours worked per week was 40.86 +/- 8.5; call was covered by one perfusionist 15% of the time, by two perfusionists by 36.1%, and three 6.9%; additionally, 94% of Chief Perfusionists took call; he expressed hope the manpower survey would be repeated every two years; he noted many perfusionists were being asked to do more clinical activities in the same amount of time; he also addressed contract perfusion and managed care; he noted the entrance of a device manufacturer (Baxter/SETA/PSICOR) into the perfusion service arena during the last year, which had caused considerable concern; he reiterated AmSECT’s goal had always been on patient care, and it would not blacklist any manufacturer or perfusion service; the last part of the article was a panel discussion; those in the audience posing questions were usually not identified; the first question was directed to Utsey regarding whether the ABCP was considering a written recertification examination, and Utsey state it was not; the questioner expressed such an examination would provide “political cover”; Utsey asked if such an examination would be a “watered down version of the original?”, and the questioner suggested it would be specific to the field of practice for those who would take it; for example, those who were not pediatric perfusionists would opt out of a pediatric recertification examination; Mary Hartley suggested Utsey restate the current ABCP recertification process that relied on caseloads and the point system; there was no self-assessment; another questioner asked about the new accreditation process, and Horgan answered that the Society of Thoracic Surgeons and the American Association for Thoracic Surgery had representatives on the committee; another questioner asked Utsey about one criticism of criterion-referenced examinations whereby 100% of test takers could pass it, and the examination represented a fixed body of knowledge that training programs could teach, thus raising higher pass rates; Utsey replied that he did not foresee all test takers passing the examination; he reiterated the ABCP was “keepers of the examination aspect only”; the move to the criterion-referenced examination relied on input from the field including program directors; he cited the changes in candidates who in the early 1980s were predominantly on-the-job trained perfusionists, but current candidates were graduates of accredited programs; norm-referencing to the previous five years of candidates was determined to no longer be fair; one other factor was the ABCP was the only allied health field that was giving norm-referenced examinations for certification; he also cited increased efforts at licensure, which factored into the decision to move to criterion-referenced examinations; Lange asked about the 30% cutoff used in norm-referencing, which meant 62% of the questions, and Utsey confirmed the figures; Utsey then explained the process by which the ABCP gathered information from surveys and questionnaires to collect questions; the result was a 60-70 page document, which was then sent out to volunteer perfusionists for their assessment of 1) level of importance in daily use and 2) how difficult the question was; this methodology was called the Ebel technique to determine an index matrix on each question regarding relevance and difficulty; the directors chose from a pool of questions they deemed important to include on the examination; he emphasized the methodology resulted in a cut-off of near the 67th percentile, but it was not arbitrarily changed year-to-year by the directors; another questioner asked Utsey about frequency of examinations and whether they would be given regionally; he replied the ABCP was to determine how many times and places the examinations would be administered; he noted that with the change to criterion-referencing of both examinations the ABCP no longer was dependent on a group of CCPs to administer the oral examination as it had in the past; a questioner asked Horgan how many disciplines CAAHEP accredited, and he replied 17; another questioner asked about the three-strike rule of the ABCP; Utsey stated those situations would be handled on a case-by-case basis with input from the ABCP attorney; he noted the number of such candidates was very small; Hartley noted it was less than 100 individuals; another question was raised about licensing and the terms “board eligible” and “board certified”; Utsey noted the ABCP’s position was not to acknowledge those terms; the questioner continued by asking about the status of a graduate from an accredited program; Utsey stated that if the person graduated after 1981, “he will henceforth and forever be eligible to enter our process”; audience member Bill Atkinson asked about caseloads, and Lange replied students had to have completed 75 cases during their training and an additional 50 cases in the time between taking the first examination and the second; Utsey spoke about licensure in Texas whereby a new graduate but unlicensed perfusionist had to work under the supervision of a [licensed] perfusionist; a question was asked about the number of graduates who received a Bachelor degree in perfusion; Horgan noted no students were accepted into accredited perfusion training programs without having a Bachelor degree; the questioner continued by asking about someone having a BS degree in nursing being not qualified to perform perfusion; Horgan noted that the AC-PE process was heading towards the goal of all perfusionist graduates having a degree; when asked the time frame to reach that goal, he noted that there were a number of hospital-based programs that could not issue degrees; Utsey noted the consensus of the ABCP was that this issue was beyond its interests; however, he expressed the importance of the 1981 deadline; Lange noted that the Essentials and Guidelines for an Accredited Educational Program were revised in 1995 to mandate a baccalaureate degree for entry into the profession, either granted within the program of study or for prior entry into the program; she acknowledged that there were not enough graduates graduating with BS degrees in Perfusion presently; another questioner raised the experience of nursing that made programs longer and more expensive; Vocelka was asked to respond to a question as to whether the Joint Commission was to require licensure as a form of credentialling of perfusionists; he replied he was not aware of any such requirement; another question was asked about Masters degrees; Vocelka noted there were already three Master level programs; Lange followed up by reporting the three programs were the University of Arizona, Northeastern University, and the Milwaukee School of Engineering; when asked about the perfusionist shortage, Lange opined there would be another shortage into the 2000s; she urged the profession to conduct a survey to better plan for manpower needs; an unidentified person offered clarification on licensure in Texas insofar as supervision of a new graduate but uncertified perfusionist could be from a licensed perfusionist or a board-certified cardiac surgeon; Vocelka noted a licensed perfusionist could supervise without having to be physically present; Hartley then asked the panelists to predict for the year 2000; Horgan suggested there would be more university-based programs; Lange noted the number of graduates from university-based programs was far greater than those coming from hospital-based programs; she mentioned three programs in Ohio (Cleveland Clinic, Christ Hospital, and Ohio State) that had a consortium plan whereby students received their didactic education at Ohio State University but then had clinical rotations at their base institutions, which made more fiscal sense; she noted hospitals were not necessarily in the business of education; she emphasized the importance of a university for the didactic teaching and then a variety of clinical experiences for students to produce a strong program; Vocelka opined minimally invasive coronary artery bypass would have a major impact on perfusionists’ jobs; he predicted consolidation of heart programs; he admitted his response was unclear—either there would be a need for many more perfusionists or there would not be; he mentioned additional technologies that perfusionists might become involved in without being specific; he expressed a perfusionist shortage was imminent; he also mentioned cross-training so more clinical duties could be done with fewer people; he cited perfusionists coming from other allied health occupations because of higher salaries and professional prestige; he predicted managed care would suppress the profession “in terms of image and professional esteem”; another comment apparently was made by a surgeon in the audience regarding managed care and the contraction in cardiac surgery; this speaker mentioned the need for perfusionists to become involved with heart assist devices; Horgan mentioned that a junior college in Florida was being asked to train Patient Care Assistants so one RN per floor supported by the assistants would be responsible for patients; Lange expressed managed care would have a negative effect on the health care system; she cited use of safety devices and some hospital administrators not considering them important because of costs; Hartley asked how many in the audience had had to have made cuts in their standard of perfusion because of managed care; many apparently raised their hands; Lange closed with a comment about encouraging people to enter the field)

(Purpora was chair of the AmSECT Continuing Education Committee; she graduated from Hofstra University in 1981 with a degree in Biology; she then obtained a BS degree in Cardio-Respiratory Science from the State University of New York at Stony Brook; in 1984, her first perfusion job was at Yale University Hospital; in Jul 1991, after working at Columbia Presbyterian and other New York area hospitals, she took a job at Johns Hopkins Hospital as a clinical perfusionist and didactic and clinical instructor at the Hopkins’ School of Perfusion Science; she had been a member of AmSECT since 1983; in 1993 she volunteered to help Rebekah Trittipoe on the Continuing Education Committee; Trittipoe stepped down as committee chair shortly thereafter, and Purpora became cochair with committee member Dennis Rivard, who also worked at Johns Hopkins; in 1995, Purpora became sole chair of the committee; she coordinated many continuing education programs for AmSECT; in 1996, national CE sessions were combined with regional meetings, which she believed was beneficial; she also produced the monthly CE quiz that appeared in Perfusion Life; she learned to delegate responsibilities; she had a 3.5 year-old daughter and 2 year-old son; Judy Luther noted Purpora and Trittipoe were “extraordinary individuals”; in 1996, Purpora received the President’s Award from Craig Vocelka; she expressed no concerns over the future of the field)

(the author stated AmSECT had taken a position the profession should be legally credentialed (see Jun 1995 Perfusion Life); he reported there were four levels of professional recognition and regulatory designations: 1) Registration; 2) Titling; 3) Certification; and 4) Licensure; AmSECT had developed a “Guide for State Licensure Legislation for Perfusionists”, which was available from any AmSECT State Liaison, from a member of the Government Relations Committee, or from the AmSECT National Office; the rest of the article posed frequently asked questions and answers, as follows: 1) why perfusionist licensure now?; several reasons were given such as first, the growth of managed care insurance and its emphasis on credentialing of medical providers as a benchmark for clinical competency; second, national attention on the high cost of medical care procedures; third, health care systems’ efforts to reduce personnel and labor unit costs in an effort to improve bottom line financial operations while maintaining or improving patient medical outcomes; and fourth, the “crosstraining” of unlicensed medical service providers to improve “flexibility” of the health care provider workforce; he stated none of the preceding initiatives would disappear in the future; he then explained that professional licensing defined responsibilities and procedures that a perfusion licensee could perform, the perfusion scope of practice, and making it illegal for unlicensed persons who did not meet minimum standards of education, training, and clinical practice experience to provide, offer to provide, or claim they were qualified to provide perfusion services; he argued that licensure would allow the profession to set standards for qualifications through a state regulatory mechanism to ensure competency and good medical care; he further argued that having an unlicensed status for perfusion could be “tantamount to giving control of the future…to hospitals or managed care administrators or other health professionals in the form of ‘cross-training’”; he expressed that no group other than perfusionists ought to be able to decide what perfusionists could and could not do; licensure was a means to help control the impact of outside developments and allow the profession to play a role in shaping the health care system; a second question asked how would professional licensing protect a perfusionist’s Scope of Practice?; he noted AmSECT had developed a Perfusion Scope of Practice that specifically described the medical duties of perfusionists; licensure mandated academic, examination, and continuing education standards and requirements; licensure would prevent unlicensed personnel from performing the services defined by law; licensing would codify by state law the medical duties and responsibilities for perfusionists developed by AmSECT; the third question asked would professional licensing of perfusionists enhance the quality of patient care in the state?; he stated licensing would give the public and the profession protection against incompetent clinical practice; while it would not guarantee patient care would be enhanced, the licensing process and peer professional review would be viewed as enhancing the quality of patient care because a peer review board with authority to determine if a perfusionist had performed services in a manner to meet accepted standards of care; the fourth question was what benefits would licensing have compared to professional Titling or Certification by the State?; licensing would prevent those without a license to perform the scope of services incorporated into the law unless the academic, examination, and continuing education standards and requirements mandated by the licensing law were met and maintained; he reiterated that without a license it would be illegal to perform any of the scope of practice services designated in the state law; he stated professional licensing allowed for the maximum in patient care protection; certification and titling would not prevent non-titled or noncertified personnel from performing medical services; with Titling, no person could use the protected title unless that person met the minimum level of academic, examination, and continuing education criteria established by law; similarly, with Certification, persons not using the title would not be restricted in performing medical services; there was a note addressing perfusionist titling in California; it limited administration of IV drugs and blood products to nurses, physician assistants, and perfusionists; furthermore, perfusionists were named as being required on the open heart team; a titling law was “essentially a medical practice act without a state regulatory committee or board governing the profession”; thus, the California law was more stringent than the differences noted above; the fifth question was if perfusionists were licensed would there be greater exposure for being sued for malpractice?; licensure would confer less exposure when compared to not having any form of credentialing; licensure would establish perfusion professional peer review; perfusionists would be judged on whether their actions were performed in accordance with the accepted standards of professional conduct; he argued that a perfusionist could have greater exposure to losing a medical malpractice case if it was found the perfusionist was unlicensed and performing a service for which another medical professional was licensed; while licensing would mean less exposure to medical malpractice than if the perfusionist was unlicensed, it would not protect a perfusionist from being sued for alleged incompetent perfusion practice; the sixth question was if perfusionists were licensed, would they have to answer to a state licensing board?; the answer was Yes, but only if a patient filed a complaint with the licensing authority; the seventh question was if perfusionists were licensed would they have to sit for a “licensing examination” in addition to the ABCP certification examination?; the answer to this question was stated as being unclear and would be dependent if the licensing authority accepted the ABCP examination as the recognized examination for professional competency; he stated most states would not be in favor of administering professional examinations, and most states had accepted voluntary professional certification examinations as proof the person making application had proven he had met the professional requirements in his respective medical field; the eighth question asked what is a “provisional license” and how would it apply to perfusion training program graduates?; unlike most other medical provisional groups, perfusion had a provisional licensee category; it was for graduates of accredited programs who would be able to practice for one year under the supervision of a licensed perfusionist so the caseload requirement could be met for the ABCP certification examination; after passing both ABCP examinations, the perfusionist would be able to apply for and receive a full professional license; if a state had perfusionist licensing and there was a perfusion training program in the state, students in the program would be exempt from any licensing requirements; the ninth question asked how much would it cost to have a professional license?; it was stated there were no uniform fees; numbers of perfusionists in a given state and the structure of the licensing (free-standing v. a committee or board established under an existing professional board) were factors affecting costs; the tenth question asked, how much would it cost to renew a license each year?; the answer was the same as the ninth question above; the eleventh question asked how much would it cost to engage in the legislative process to gain a professional license?; there were four factors to determine costs: 1) type of lobbying firm; 2) level of contracted lobbying services; 3) amount of volunteer time from perfusionists; and 4) the political and legislative atmosphere and strength of individual legislator support; lobbying was conducted in three basic forms: 1) law firm specializing in lobbying (most expensive); 2) public relations firms with lobbyists (less expensive than law firm); and 3) small independent contractor (least expensive); retainers could be hourly or monthly; there were three basic packages of lobbying services: 1) written lobbying strategy (least expensive); 2) written lobbying strategy with limited professional services; and 3) comprehensive package (most expensive); Bechtel recommended perfusionists get bids and to factor in how much volunteer time from perfusionists would be expected; the twelfth question asked, how long would it take to get profession licensing legislation enacted?; there was no set time because many factors influenced the process; the thirteenth question asked, would all perfusionists in a state need to be supportive of licensing for success in enacting legislation?; not all perfusionists had to be supportive but a majority would be needed; the fourteenth question asked, if licensing was enacted in one state would it benefit efforts in another state?; the answer was Yes, and the example of Texas and Oklahoma was cited along with additional states where perfusionist licensure was to be introduced (California, Oregon, Wisconsin); the fifteenth question asked, what kind of support would come from AmSECT to pursue professional licensing?; AmSECT was in favor of licensing and would provide some support, but the primary responsibility rested with perfusionists in the state; AmSECT had Proactive Grant Awards to provide funding if there was an AmSECT State Liaison and a professional state society or organization of perfusionists registered in the state; the article closed by reiterating the “Guide for State Licensure Legislation for Perfusionists” was available)

(he was 64 years old when he died of cancer; he had been born in Hungary but immigrated to Canada in 1951; he received an engineering degree from the University of Toronto; in 1964, he moved to California where he worked in the medical manufacturing industry; he founded Delta Medical in 1972 and American Omni Medical in 1985; he held 17 patents, including one for a blood oxygenator for which he received awards; he authored 11 books and >224 articles; he lectured nationally and internationally; he also had an MBA in Marketing and Management and was a Registered Professional Engineer in California and Canada; for nine years, he was a college instructor at Dale Carnegie; he won several awards for his engineering work; he had other interests that included writing nine novels such as “The Green Team”, which was published in 1995; he composed music and lyrics for a folk opera; he was a noted sports competitor, winning a Canadian championship for kayaking in 1962; he raced radio-controlled model cars and became national champion; he was considered a “renaissance man”)

(Resley was a native of El Paso, TX; he initially pursued a career in classical music; his family had many country/western musicians; he played the cello beginning in the fifth grade; he studied music at the University of Texas El Paso; he was accepted into the New School of Music in Center City, Philadelphia; he worked as an au pair while attending the program and then transferred to the Cleveland Institute of Music; he completed his undergraduate and a Master's degree in music at Cleveland; he performed with the Cleveland Opera and the Cleveland Ballet; he became interested in perfusion after meeting perfusionists at the Cleveland Clinic; he met with David Ogella and observed open-heart surgery; he had to take many basic science courses before he could apply to perfusion school; he played the cello to make a living while attending school part-time; when he was admitted to the training program, he did not have a medical background like other students; he graduated in 1991 and accepted a position at Fairfax Hospital; he continued to play some gigs, including at the wedding of Aaron Hill; he became president of AmSECT’s Region III in 1995; he also was treasurer for the Maryland Perfusion Society; he organized a fall meeting and acknowledged help he received from Bob and Holly Groom and Aaron Hill; the meeting also hosted the board examination; a the time of this article he was planning the next regional meeting to be held in Charleston, SC, with the help of Jeff Riley and Jeff Acsell in setting up a webpage; he expressed the motivation for his involvement with the profession was to bring perfusionists together)

(he was the Gibbon Award recipient at 35th AmSECT Conference; this article had excerpts detailing his career; he was the Medical Officer Chief, Section on Pulmonary and Cardiac Assist Devices, PulmonaryCritical Care at the National Heart, Lung, and Blood Institute (NHLBI), National Institute of Health (NIH), in Bethesda, MD; he was affiliated with the American Society for Artificial Internal Organs; his prior experience was as an intern and resident at Cleveland Metropolitan General Hospital (1958-1962); he was a Senior Surgeon in the Laboratory of Technical Development, at the NHLBI/NIH (1962); his research interest was for research and development of instrumental methods for medical science and artificial organs for clinical medicine; he served on the Editorial Board for Artificial Organs and was Section Editor for the International Journal of Artificial Organs; he was a keynote speaker at the Extracorporeal Life Support Organization meeting in 1996 and received the John H. Gibbon Award from AmSECT in 1997; his education was a BS in physics and mathematics (cum laude) at Heidelberg College (1954) and his MD from Western Reserve University; he held 15 patents (1968-1996) including: Artificial Organ for Membrane Dialysis of Biological Fluids; Polysiloxane Membrane Lung; Blood Cell Separator; and Method and Device for Improved Use of Heart Lung Machine; he had 148 publications)

(this was a Letter to the Editor with input from Richard Jensen, Dick Rog, and Jeff Howe; Wade died 26 Dec 1996 at age 69 years old; he was a co-founder of AmSECT and its second president; he was characterized as “Minnesota Nice”—easy going and affable but always a leader; he competed as a high jumper in high school and set a record despite having a serious foot injury; he attended the University of Minnesota and worked in the laboratory of Dr. C. Walton Lillehei; he trained many perfusionists, including Berger; Wade operated cardiopulmonary bypass for what was likely the first prosthetic aortic valve replacement on 31 Oct 1958; the surgeon was Lillehei; the patient’s heart was arrested with cold blood but the systemic circulation was maintained normothermic, which became known as differential hypothermia; he used the DeWall-Lillehei bubble oxygenator; it had a vertical bubble column, a debubbling chamber, and spiral coil of tubing called the “helix reservoir”; the original debubbler was a two-foot length of one-half-inch tubing coated with silicone-based anti-foaming agent; it was subsequently replaced by stainless steel sponges coated with anti-foam; determining the correct mix and viscosity of anti-foam was developed by Wade; Wade and a resident surgeon, Dr. Cuello, developed a doublejacketed debubbling cannister to act as a heat exchanger for inducing hypothermic perfusion; Wade did not have a background in physiology but was able to perform excellent perfusion “by rote”; oxygen flow was adjusted by observing the bubble column to produce a uniform column of rising bubbles; one technique Wade taught was to sniff the exhaust from the debubbler section; if it smelled like sour milk it was a crude assessment of acidosis, and sodium bicarbonate was administered; he eventually became manager of the surgical research facilities for Dr. John Najarian; he then moved to Human Resources and became Personnel Director; all his trainees learned perfusion on-the-job; one was Richard Jensen, who moved with Dr. Richard DeWall in 1960 to start a new program at Mount Sinai Hospital in Chicago; Jensen and Wade often discussed the need for getting perfusionists together to share information; the first meeting was held in Apr 1964 when 35 technicians met at the Sol Fox Lounge at Chicago’s Mount Sinai Hospital; attendees included LeRoy Ferries and Helen Giacobine; they discussed formation of a society; a second organizational meeting was held later in 1964, and the basic structure of the new society was decided; the first name was the American Society of Extracorporeal Circulation Technicians, but it was changed at the meeting in San Francisco in 1968 to the American Society of Extra-Corporeal Technology; Hebert Bing Moy was the local host of the meeting; Richard Jensen was unanimously named President and Wade the Vice President; another attendee was Rose Litturi from the Cleveland Clinic; she was critical of the casualness of the meeting and wanted more structure; she was chosen to host the third meeting held over Halloween 1964 at the Cleveland Clinic; her meeting became the pattern with many speakers; Jensen left clinical perfusion in 1966 to become a salesperson; Wade was elected AmSECT president at the meeting held at Children’s Hospital in Washington, DC, which was held in 1967; Berger succeeded him in 1969; AmSECT dues were $10/year, and were not always collected; Berger proposed establishing a journal; Wade told him to do it but, “Go ahead, if you can pay for it.”; some funding came from selling advertising in the journal; the pilot issue was published in fall 1967; financially, the journal broke even; the next year it became a quarterly publication with help from Bob Crepeau and Rameley Publishing; Wade was credited with “holding it all together” in the early years of AmSECT; he was soft spoken and allowed for dissenting opinions to be discussed; “… in the end, Jim made certain the common good prevailed.”; while he was not the entire foundation of AmSECT, he was considered its “cornerstone”)

(this was a recap with excerpts from vol. 1, no. 1 issue of the Journal of the American Society of Extracorporeal Circulation Technicians (the issue was undated, but the year was either 1967 or 1968); there were two cartoons reprinted along with text including a message from President James B. Wade, Sr. (he was elected in Oct 1967); he noted the society had more than 100 members, and the membership was expected to triple during 1967 with a goal of 1,000 members because of a membership drive; Wade also wrote about “Thoughts on Participation” in which he urged extracorporeal technicians to “be the best possible”; he reiterated the sole purpose of the society was to produce certified Master Extracorporeal Technicians, “who will build traditions of service and responsibility that will rival age-old traditions of the nursing profession.”; Edward Berger was Publications Chairman and wrote an article entitled, “An Introduction to AmSECT” detailing the purpose of AmSECT, which had been formed in 1964, “to promote intercommunication among heart-lung machine technicians, artificial kidney technicians, regional perfusion technicians, and others who are concerned with the movement and treatment of blood in an extra-corporeal circuit.”; sources for dissemination of information was to come from “the doctors with whom we work, the manufacturers who produce our equipment and supplies, and other technicians.”; Berger also wrote, “A major goal of the Society concerns the development of a system of certification in order to engender a uniformity of experience among technicians.”; there was an article that included a “Sample Examination for Technicians” that had been partially developed at the University of Minnesota; another article detailed a one-year educational plan entitled, “A Cardiovascular Engineering Training Program” with course titles; there were two photographs from the AmSECT national meetings held in 1964 (April at Mt. Sinai Hospital of Chicago; Halloween at Cleveland) and May 1966 (held at Children’s Hospital in Washington, DC); the 1968 meeting was to be held 9-10 Jun 1968 in Montreal, Canada; advertisers were listed from the first issue)

(this reported results of a survey sponsored by AmSECT, the American Board of Cardiovascular Perfusion, the American Academy of Cardiovascular Perfusion, the Accreditation Committee-Perfusion Education, and the Perfusion Program Directors’ Council; there were 1,503 responses (response rate not reported; see Riley’s report below); there were 24 questions primarily about perfusionists’ demographics, work experience, and future career plans; other questions asked about trends such as minimally invasive cardiac procedures, managed care, adjunctive techniques (e.g., IABP, autotransfusion, VADs, and ECMO), and number of completed surveys by state or country)

(he provided an analysis of the survey results reported in the Oct 1997 issue (above); 3,088 survey forms were mailed out, and 1,476 responses were received (49% response rate); Table 1 listed responses by states along with the number of perfusionists in each state; the calculated the response rate from all practicing perfusionists was 45%; there were 27 figures, as follows: Figure 1 listed results by AmSECT Regions; Figure 2 reported 97% of respondents reported they were clinically active, their median age group was 35 to 40 years old, and 29% were female; Figure 3 had two bar graphs—one from respondents reporting the year they became a CCP and a second showing estimated number of graduates by years (1968 to 1996) from the Perfusion Program Directors’ Council; Figure 4 was a bar graph showing the age and gender of respondents with most in the 41 to 50 year-old range and more males than females; Figure 5 reported the highest non-degree degrees earned; Figure 6 and Table 2 showed type of education programs for perfusionists; 41% had earned a certificate in Perfusion Technology; Figure 7 was a bar graph of annual caseloads; Figure 8 showed institutional caseloads, with most respondents working at hospitals performing between 600 and 1,300 cases/year; Figures 9 and 10 reported staffing levels and on-call information; Figure 11 reported use of temporary help at 13%; Figure 12 revealed minimally invasive cardiac surgery and managed care was shown to have little effect on perfusionists; Figures 13-19 addressed adjunctive techniques with 85% reporting “no change” or an “increase” in duties; Figure 20 addressed those who were no longer active but the results from this question were determined to be of limited value for interpretation; Figures 21-26 addressed expected age of retirement by respondents with reasons; Figure 27 reported those who were expected to change their focus in perfusion to areas such as department administration, equipment sales, or teaching; Riley noted the format of the survey might have been created in haste leading to difficulties in interpretation of data; he concluded the jointly developed survey would establish a basis for future surveys; he proposed a new survey be undertaken in Jan 1998 with the results reported at the AmSECT conference in spring 1998)

(the format for AmSECT Today was to be changed beginning Jan 1998, which had been decided by the AmSECT Board of Directors; he briefly recounted the history of AmSECT newsletters and magazines; Perfusion Life began in Jan 1984; the decision was also made to change the title of the publication to AmSECT Today; the name Perfusion Life had been occasionally ridiculed; one factor considered by the Board was expectations for content that were never fully realized; the cost of publication was another factor in the decision to change the format; he closed by suggesting the new format would be more informative, timely, and interesting; he asked for feedback from readers)

(Lange died 7 Oct 1997; she was born 16 Nov 1943; she attended college and received a full scholarship in the St. Joseph Hospital’s nursing program; she earned her nursing degree in 1964 and began work at the Upstate Medical Center in Syracuse, NY; six years later, she trained herself to become a perfusionist using a bucket of water; in 1973, she found her true calling in perfusion education when she started the third perfusion school at SUNY Health Science Center at Syracuse; her teaching style was considered unique insofar as she guided students rather than lecturing them; she often said, “I cannot teach you how to run a cardiopulmonary bypass system twenty years from now. I don’t know what it may look like.”; she pushed students to become independent thinkers and would lead them in informal conversations instead of formal lectures; in the operating room, she would teach by the Aristotelian method by forcing students to analyze and re-analyze their actions in response to real and hypothetical consequences; she was active in the Perfusion Program Directors’ Council (PPDC) and the Accreditation Committee for Perfusion Education (AC-PE); the impetus by her to help form the PPDC was to foster communication among program directors; she was president of the PPDC for 12 years, and her emphasis on didactic and clinical evaluation methodologies to improve the quality of perfusion education nationwide; she provided input for all drafts of the “Standards and Guidelines for Perfusion Education Programs”; she also volunteered for program site visits; she served on 12 AmSECT committees; she maintained ties to former students and was sometimes referred to as the “mother of all perfusion students”; she received awards from AmSECT for her dedication to the field; Searles wrote she was a remarkable person; he closed the tribute by announcing that an endowment fund in her name had been established at the SUNY College of Health Professions)

(Horgan was chair of the Accreditation Committee-Perfusion Education (AC-PE), which administered accreditation of perfusion training programs; the AC-PE had AmSECT representatives on the committee; its fall 1997 meeting was held in conjunction with AmSECT’s Region I meeting in Cambridge, MA; some forms used during accreditation were revised and new members were oriented; specifically, the AC-PE developed a post-site visit evaluation form; Dr. Stanton Nolan presented an update on a consensus curriculum, and the AC-PE decided to develop a similar project for perfusion education; the committee took action on programs, discussed budget items, considered an evening perfusion program for CCPs who had no formal education, provisional accreditation, and changes in program directors and medical directors; AC-PE elections were held with Horgan reelected Chair and Bruce Bartel elected Secretary/Treasurer; the AC-PE was evaluated by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) for compliance to CAAHEP policies for Committees on Accreditation (CoAs); the AC-PE also revised guidelines for recognizing clinical affiliates, as follows: 1) new affiliates were required to describe how the new institution would meet specific goals; 2) a proposed clinical affiliate had to document by site visit that it had been evaluated for adequate resources and staff prior to accepting students; 3) a formal contract had to be established between the program and the clinical affiliate; and 4) the Program Director or Clinical Coordinator had to document the affiliate had adequate and certified staff, which were the same as the requirements for clinical faculty at the sponsoring institution and as noted in the Standards and Guidelines; Section I.B.2.b(2) specified: 1) clinical instructors had to be knowledgeable and effective in teaching subjects assigned; 2) clinical supervisors for students operating extracorporeal circulation equipment had to be certified; 3) ABCP certification or an equivalent agency met the certification requirement; 4) personnel who were actively participating in the educational process had to be confirmed; 5) a statement of clinical faculty responsibilities had to be provided with details on how clinical staff were to be integrated into the educational process; 6) program faculty were required to communicate monthly with affiliates when students were assigned there to ensure clinical faculty were aware of the program goals and responsibilities when supervising students; this also required an evaluation method for affiliate instructors; 7) evaluations of clinical affiliate sites were to include student evaluations of their clinical experience, and evaluations from clinical site instructors and clinical coordinators had to be performed annually; 8) the fee to establish a clinical site was $100 remitted to the AC-PE office; sites making application were to be notified of the AC-PE’s decision within 6-8 weeks; a list of schools that received continuing accreditation were: SUNY Health Science Center at Syracuse, the Cleveland Clinic Foundation, and Walter Reed Army Medical Center; the dates for the next AC-PE and CAAHEP meetings in 1998 were listed)

(25 committees were listed (with names), as follows: Achievement Recognition (Dennis Rivard); Bylaws (Dennis Rivard); Curriculum Planning (Allan Lummis); Convention Planning 1999 (Al Stammers); Ethics (Pat Courtney); Government Relations (Debbie Raymond); Internet (Carl Barringer); Investments (Ron Richards); Management Audit (Executive Committee and Ron Matheis); Membership (Susan Englert); Nominating (Vince Olshove); Perfusion Advisory (Maddie Massengale/Allan Lummis); Perfusion Quality (Susan Haubert); Research (Ed Darling); Business Practices (Joel Davis); Transfusion Practices-AABB (Gary Reeder); ABCP (Phil Crawford); AC-PE (Bill Horgan and Craig Vocelka); CAAHEP (Bruce Bartel); ELSO (John Toomasian); JCAHO (TBA); Pediatrics Liaison (Eric Jenkins); Perfusion Program Directors’ Council (Pat Courtney); AmSECT Today (Joe Deptula); and JECT (Phyllis Palmer Stark))

(Kerry was a long-time member of AmSECT; she graduated in 1983 from the Ohio State University, Circulation Technology Program; she worked at Christ Hospital in Cincinnati, OH for >13 years; she was a CCP and was greatly respected by her colleagues)

(Ferries was praised for his many contributions as one of AmSECT’s pioneers; he worked at Marshfield Clinic in Wisconsin; he served on every important AmSECT committee and liaised to outside organizations; “his involvement was not casual”; he retired on 7 Aug 1997 after 37 years; he began work in perfusion in 1961 to help start the heart program at St. Joseph’s Hospital; he set up the cath lab and dog lab; he went to the University of Minnesota to study under Jim Wade and Dr. C. Walton Lillehei; he also traveled to the University of Oklahoma to work with Dr. Zuhdi using the Zuhdi coil and DeWall bubble oxygenator; the first cardiopulmonary bypass case in St. Joseph’s Hospital was performed in 1962; he designed a reusable bubble oxygenator with a built-in heat exchanger in 1963; he noted no FDA approval was required in those days; in 1982, he and a cardiologist developed a cardiac database that was eventually used by every service department at the Marshfield Clinic; in 1985, he was named AmSECT’s Perfusionist of the Year, and in 1994 he received the Gibbon Award; during retirement, he and his wife Julianne were going to spend more time hunting and fishing and visiting with family; his future plans also included continuing to attend AmSECT meetings)

(this article profiled August Krogh (1874-1949), who was a noted Danish scientist and physiologist; among his accomplishments was to develop methods for measuring gas tensions in fluids; he was the first to prove that gas exchange in the lungs occurred by diffusion; he also reported on the function of capillaries, which was termed the Oxygen Pressure Field Theory; he worked with Banting and Best to develop a practical method to mass produce insulin; he was awarded the Nobel Prize in Physiology or Medicine in 1920; he also worked with his wife, who was a physician, to treat diabetic patients)

(PresidentElect Craig Vocelka reported three conclusions from a survey of AmSECT members; first, many were not aware of the services AmSECT provided; second, membership dues were believed to be too high by most respondents; the third finding was the belief that AmSECT was controlled by a clique “who enjoyed various perks”; he noted it was often difficult to get perfusionists to run for office or volunteer for committee work)

(the survey was conducted in Jul 1999; 3,170 questionnaires were mailed; by Sep 1999, 504 surveys were returned (16.3% response rate); perfusionists were polled about their demographics, familiarity with AmSECT’s mission statement, and support for the regions and state societies; other questions asked about meeting formats, dues, AmSECT publications (AmSECT Today and J ExtraCorp Technol), importance of other perfusionrelated meetings with reasons, dates of annual AmSECT conference, and term limits for AmSECT leaders; the questionnaire also asked about perfusionist job availability in the future and scope of practice; raw results for all questions were reported)

(Shaffer died 21 Jul 1999; he was the Chief Perfusionist at Yale University; he began his work in perfusion in 1958; he was a founding member of AmSECT; he taught many perfusionists and helped establish the perfusion education program at Quinnipiac College; a student achievement award at Quinnipiac was established in his memory)

(Cate recounted the story of Dr. Gibbon’s quest to develop a heart-lung machine after witnessing a patient die from a pulmonary embolus in 1930; Cate attributed Mary Gibbon as the “First Perfusionist”; he then recounted the founding of AmSECT and previewed the contents of this issue of AmSECT Today)

(Lummis cited a survey entitled, “Recertification Survey” from the American Board of Cardiovascular Perfusion (ABCP); CCPs were asked their opinions on the clinical activity requirement (40 cases/yr), increasing the Continuing Education requirement, and a “recertification examination” in lieu of or in addition to a clinical activity requirement; Lummis noted there had been discussions and confusion over how ABCP recertification requirements compared to six other medical professions; he posed several questions on the topic; he cited the increased number of “off pump” coronary artery bypass (OPCAB) operations that was making it difficult for some CCPs to perform 40 clinical cases/yr; he cited projections that OPCAB procedures were expected to be 125,000 cases/yr by 2002, which was a doubling from the current 12% of coronary artery bypass cases; he also cited perfusionists’ increasing clinical and managerial duties beyond operation of the heart-lung machine; he cited a 1996 AmSECT Government Relations State Survey wherein 73% of perfusionist respondents reported they performed services outside operating rooms; a question was posed suggesting there was no peer-reviewed scientific basis to confirm professional competence with patient outcomes; he urged AmSECT members to respond to the ABCP “Recertification Survey”; he then presented some facts comparing ABCP recertification to seven other professionals who had working relationships with perfusionists; cardiovascular or thoracic surgeons (Diplomats of the American Board of Thoracic Surgery) had a specific clinical activity requirement for recertification; however, the process for surgeons differed from that required by the ABCP for certification; other related professions did not have a clinical activity requirement for recertification; for thoracic surgeons, those certified after 1976 had to recertify after 10 years by submitting evidence of 70 hours of continuing education prior to taking the examination; they also had to submit 100 patient cases with one year of patient medical outcomes collected over a nine-year period; approval by a professional review committee then allowed candidates to take the criterion-referenced certification examination; Certified Registered Nurse Anesthetists (CRNA) had to recertify for twoyears by maintaining their state nursing license; they also had to document active practice as a CRNA, continuing education, and verification of absence of mental, physical or other problems that could interfere with their practice of anesthesia; there were additional details for CRNAs; Operating Room Nurses (CNOR or CRNFA) were certified by the Certification Board for Perioperative Nursing from either organization; they were required to recertify every five years by documenting continuing education using a point system or by taking a 200-question multiple-choice examination; Respiratory Therapists (RRT) had to be recredentialed every five years by taking a 100-question multiple-choice examination and computer simulations; they also were required to document at least part-time employment; Physician Assistants (NCCPA) recertification required continuing education and passing a test every six years that could be taken online; the examination consisted of 300 multiple-choice questions; Medical Technologist (CLS Certificate) covered laboratory personnel; they could obtain recertification by documenting 36 hours of continuing education or by taking a recertification examination; the credential was valid for three years; the article contained a chart for six of the disciplines with each recognized certification board, length of certification, recertification requirements, continuing education requirements, and whether specific clinical activity was required; only thoracic surgeons and clinical perfusionists had required clinical activities, and there were important differences between the two for clinical activities; whereas surgeons had peer-reviewed patient care, clinical perfusionists did not; the article closed by urging clinical perfusionists to take the ABCP survey)

(this was a reprint from the Journal of ExtraCorporeal Technology, vol. 10, no. 2 in 1978)

(this article had reproductions of early letters related to the development of AmSECT; the first letter was to Ace Adams from Richard Jensen dated 18 Nov 1963; the second was a reply to Jensen from Adams dated 3 Dec 1963; the article noted there were no perfusion schools in the early years; “Hell, we were the school!”; a photograph showed attendees at an early AmSECT meeting)

(this included photographs of past AmSECT presidents with their dates of service, as follows: Richard Jensen (1965-1967); James B. Wade (1967-1969); Edward C. Berger (1969-1970); Kathryn Hargesheimer (1970-1973); Charles C. Reed (1973-1975); Michael W. Dunaway (1975); LeRoy Ferries (1976-1977); Madeline Massengale (1978); Calvin Scott (1979); Larry Cavanaugh (1980); James Dearing (1981); Samuel “Scutter” Newton (1982); Gary Reeder (1983); Frank Hurley (1984); Michael Hurdle (1985); William Pelley (1986); George Galbraith (1987 & 1989); L. Douglas Baxter (1988); Pat Courtney, Jr. (1990-1991; 1996-1998); Sandra Witherington (1991-1992); Bruce Bartel (1992-1993); George Beshere (1994); Craig Vocelka (1994-1996); Allan Lummis (1998-2000))

(this had photographs and years for the Gibbon Award recipients, as follows: Dr. Clarence Dennis (1974); Dr. Charles A. Hufnagel (1975); Dr. Denton A. Cooley (1976); Dr. Clarence Crafoord (1977); Dr. C. Walton Lillehei (1979); Dr. Pierre Galletti (1980); Dr. Arthur C. Beall (1981); Dr. E. Converse Peirce, II (1983); Dr. Yukihiko Nosé (1984); Dr. John Kirklin (1985); Dr. Norman Shumway (1986); Mr. James P. Dearing (1987); Dr. Henry Swan (1988); Dr. H. Edward Garrett (1989); Dr. W. Gerald Rainer (1991); Dr. Robert H. Bartlett (1992); Dr. Michael E. DeBakey (1993); Mr. LeRoy H. Ferries (1994); Mr. Bennett Mitchell (1995); Dr. Richard A. DeWall (1996); Dr. Thedor Kolobow (1997); Ms. Jeanne Lange (1998); Dr. Edward Verrier (1999); photographs were unavailable for Dr. John Osborne (1978); Dr. Marian I. Ionescu (1982); Dr. Dwight C. McGoon (1990))

(this was reprinted from the J ExtraCorp Technol, vol. 13, no. 4, Dec 1981)

(recipients and years were listed, as follows: Award of Excellence Jeri L. Dobbs (1976); Edward C. Berger (1977); Charles C. Reed (1978); James P. Dearing (1979); Emily Taylor (1980); Gary Reeder (1981); Mark Kurusz (1982); Jerry Richmond (1983); Munier Jallad (1984); Nancy Achorn (1985); William J. Horgan (1986); Sandra S. Witherington (1987); Jeanne Lange (1988); Rebekah Trittipoe (1989); LeRoy H. Ferries (1990); Beverly Parrault (1991); Susan Haubert (1992); Aaron Hill (1993); Phyllis Palmer Stark (1994); Alfred H. Stammers (1995); Jeff Riley (1996); Dennis Rivard (1997); Robert D. Longenecker (1998); Ian R. Shearer (1999); Perfusionist of the Year Madeline M. Massengale (1974); Calvin R. Scott (1975); Charles C. Reed (1976); Larry W. Cavanaugh (1977); A. Earl Lawrence (1978); Diane Clark (1979); Bob Pfefferkorn (1980); Carl L. Freytag (1981); Nancy Achorn (1982); Michael B. Hurdle (1983); Scutter Newton (1984); LeRoy H. Ferries (1985); William J. Horgan (1986); Mary Hartley Winkler (1987); Sandra S. Witherington (1988); Susan Haubert (1989); Dennis R. Williams (1990); Rebekah Trittipoe (1991); Dennis Rivard (1992); Debbie Gherlone (1993); Craig R. Vocelka (1994); Beverly Parrault (1995); James Langwell (1996); Richard Burns (1997); Carl Barringer (1998); Sherry C. Faulkner (1999))

(this recounted the idea for the concept of AmSECT, which occurred at a meeting in the Sol Fox Lounge in Chicago on 14 Dec 1963; over the years, there had been many management organizations contracted with for administrative duties for AmSECT; AmSECT evolved to become more like a modern corporation; volunteers were noted to be the heart of the organization; there were 10 photographs of people involved with AmSECT over the years)

(this was a short section with three photographs of extracorporeal technology)

(there were many photographs of attendees at past meetings)

(this reported the results of a 30-question survey detailing perfusionists’ job characteristics; a Likert scale was used ranging from “Strongly Agree” to “Strongly Disagree”; the demographics of respondents were 68% male and 32% female; there was additional information on years working as a perfusionist, employment, and length of employment)

(this was a reprint from the 1972 issue of the AmSECT Newsletter with three photographs of an early meeting to discuss certification plans)

(this report was a reprint from the fall issue of AC-PE Pulse; Horgan recounted how formal perfusion education evolved from on-the-job training in the 1960s to accreditation within 10 years; he recounted the affiliate organizations that supported perfusion accreditation; the Joint Review Committee for Perfusion Education (JRC-PE) was established in 1977; in 1980, the first Essentials and Guidelines were adopted; in 1984, the name of the JRC-PE was changed to the Accreditation Committee for Perfusion Education (AC-PE); in 1994, the American Medical Association stopped accreditation activities, and the Commission on Accreditation of Allied Health Education Programs (CAAHEP) was established; the organization was preparing a handbook to define accreditation standards)

(VonDemmel was a pioneer in perfusion; he was the first perfusionist in Tennessee and worked at Vanderbilt University during their first open-heart procedure in 1957; in 1960, he moved with Dr. Jesse Adams to Chattanooga, TN, to start a new heart program at Erlanger Medical Center; he trained and mentored many perfusionists; the article detailed the demands of early perfusion equipment and job duties of the perfusionist; he was noted to be somewhat reluctant to recount his early experiences but occasionally did tell stories of the early years)

(Guitreau died 6 Jun 2000 in a boating accident; he graduated from the Texas Heart Institute School of Perfusion Technology in 1981; Trudi Stafford recounted how Guitreau would show up just before he was assigned to do a clinical case; because parking was difficult to find in the medical center, he would often park in front of the hospital, for which he received many parking tickets; Steve Thompson also reminisced about Guitreau when he was an instructor; David Lawson also reminisced about fishing with Guitreau; S. Kern noted he loved outdoor sports and cooking; a plaque was installed on the wall in the operating room at Baton Rouge General Medical Center in his memory)

(he recapped Cooley’s career that was delivered during the 2000 AmSECT Pediatric Perfusion Conference; specifically, in 1955 Cooley began work to perfect the heart-lung machine, and in the 1960s he introduced “bloodless” heart surgery; in 1968, he performed the first successful heart transplant in the US; in 1969, he implanted the first total artificial heart in a human; by the end of the year 2000, Cooley and his associates were expected to perform 100,000 open-heart operations; in 1998, he was the recipient of the National Medal of Technology, which was presented by President Clinton; earlier, in 1984, he was presented the National Medal of Freedom by President Reagan; the same year he received the René Leriche Prize from the International Surgical Society; in 1976, AmSECT named him as the Gibbon Award recipient; he authored or co-authored >1,200 scientific articles and several books; as a resident, he assisted Dr. Alfred Blalock on the first “blue baby” operation at Johns Hopkins School of Medicine; AmSECT President Craig Vocelka presented Cooley with an engraved vase in recognition for his long support of AmSECT)

(Vincent Olshove authored a note in the article announcing that the pediatric guidelines were being circulated to get feedback prior to the AmSECT Pediatric meeting that was to be held in Baltimore in Sep 2000; the guidelines were generated by the AmSECT Pediatric Committee and followed the format of the earlier adult Essentials and Guidelines (see Perfusion Life, Mar 1995, vol. 12, no. 3, pgs 20-22 above); there were 12 Essential statements with specific practice guideline details in support of each Essential; some asterisked items were noted to be changes from the adult guidelines)

(there was a note from the editor of AmSECT Today announcing that Mitchell had died; he was 79 years old; “forward looking” excerpts were reprinted from his Gibbon Award Lecture delivered in 1995 at the 33 rd AmSECT conference in Dallas)

(Craig Vocelka was conference chairman, and he announced the keynote speaker was to be Richard Jensen, who was AmSECT’s first president 1965-1967; the same year that Dr. John Gibbon, Jr. performed the first successful open-heart procedure in Philadelphia, Jensen had been a pre-med student from Nebraska; he had aspirations to become a surgeon but became interested in medical instrumentation while working with Dr. C. Walton Lillehei; Lillehei urged Jensen to become a perfusionist and to work with Jim Wade; they also worked with Dr. Richard DeWall; Jensen and Wade decided other perfusionists needed to gather and exchange ideas on the technology; Jensen wrote Ace Adams, who was a perfusionist at Marquette University School of Medicine in Milwaukee, WS; a meeting in Chicago was proposed; the primary goal was to increase communication among those operating extracorporeal circulation equipment; in 1964, AmSECT was created, and Jensen became its first president; Wade followed him as president two years later; perfusionists were in favor of the organization, but surgeons were “unhappy” because they thought AmSECT would be a precursor to a union; they also believed salaries would be driven up and licensure could limit the number of perfusionists; Jensen credited Dr. DeWall at the University of Minnesota for supporting perfusionists; Jensen stated, “I know Mary Gibbon is considered the first perfusionist, but in my heart Dr. DeWall will always be the first. He knew every aspect of the machine and the procedures, and he taught Jim Wade and me most of what we needed to be able to pump cases.”; when DeWall moved to Mt. Sinai Hospital in Chicago, Jensen followed him; a decade later, Jensen became a sales representative for companies marketing products to perfusionists; Jensen was interviewed as part of the article; he recounted before AmSECT was founded, perfusionists would attend cardiac surgical meetings; surgeons were tenacious in fighting to save patients’ lives; he noted Dr. Lillehei never screamed in the operating room; Jensen noted other individuals he admired; he also spoke of the future of perfusion and stated he agreed with the move to expand the perfusionists’ scope of practice; he considered the loss of dialysis technicians from AmSECT a mistake; he believed that AmSECT was doing what its founders had hoped it would do; he praised the J ExtraCorp Technol and the continuing education programs sponsored by AmSECT] NOTE: AmSECT Today began publishing online only in Sep 2003)

(the authors’ purpose was to urge perfusionists to embrace perioperative blood management; they also stated AmSECT could offer educational opportunities since creating a new membership category for Autotransfusionists; there was a Transfusion Practices Committee that was to develop a plan; they acknowledged perfusionists were newcomers to the field; the American Board of Clinical Autotransfusion (ABCA) administered a certification process for those performing autotransfusion; the authors recommended a book entitled, “Blood, An Epic History of Medicine and Commerce” written by Douglas Starr; a PBS show called “Red Gold” was based on the book; the first autotransfusion devices were the Bentley Autotransfusion System (FDA-approved in the 1960s) and the Haemonetics CellSaver I (approved in 1974); in later decades, many additional blood component separation techniques and devices appeared; autologous blood component separation and therapy techniques had been used in the blood banking industry before devices for use in the operating room became popularized; another name given to blood processing was “cellular therapies”; in 1995, the ABCA was established by interested parties from blood banking, perfusion, nursing, and surgical technologists; the ABCA process was developed after President Larry Cavanaugh of the American Board of Cardiovascular Perfusion (ABCP) had proposed to develop a separate examination and certification process for non-perfusion autotransfusionists; the ABCA was criticized because no society or educational programs existed for autotransfusionists; it was noted that manufacturers provided inservice training for autotransfusion equipment; the American Association of Blood Banks (AABB), under pressure from the FDA, had been directed to make the nation’s supply of blood safer; standards were implemented to this end by interested parties; one result was development of a comprehensive set of Perioperative Autologous Blood Standards; the standards were written to conform to ISO 9000 Standards; the AABB standards were written in a non-prescriptive manner whereby each institution would have latitude in developing goals for their standards; the AABB’s “Perioperative Standards and Guidance” document addressed goals that were expected to be set and met; there was also an accreditation process for hospital blood banks, but it was not mandatory; a section of the article described the past history of involvement of perfusionists in autotransfusion in the 1970s and 1980s; autotransfusion equipment was often in the operating room when cardiopulmonary bypass (CPB) was being used; it was used to process residual blood from the CPB circuit after CPB; some perfusionists recognized a possible need for autotransfusion during aortic surgery; during the 1980s with the threat of HIV transmission, the interest in autotransfusion increased; it was estimated that 50% of all blood transfusions during surgery could be from autologous blood; the only modality that became popular was preoperative autologous donor blood (PADB); however, concerns over bacterial contamination along with logistical issues became major deterrents to the practice; beginning in the 1980s, the demand for perioperative autotransfusion for non-cardiac surgical procedures became apparent; because of their primary duties for CPB, perfusionists were unable to meet the need, and less qualified individuals began to perform autotransfusion; it was noted that the types of personnel operating autotransfusion equipment ranged from orderlies to MDs; the authors asserted that few perfusionists took the technology seriously; many did not appreciate the benefits of autotransfusion could offer for patients, hospitals, surgeons, and the community blood supply; the present was described as occurring in the 1990s when interest in perioperative blood management arose; many physician societies issued consensus statements on blood conservation in efforts to educate their members of the risks associated with blood and platelet transfusions; in 1999, the College of American Pathologists (CAP) conducted a survey related to intraoperative blood salvage; the survey was sent to 3,815 hospitals, and the response rate was 53% (2,008 returned questionnaires); hospital blood bank personnel were clinically responsible in a small percentage of programs (1.2%); other hospital departments such as nursing, anesthesiology, orthopedics, and cardiovascular surgery managed autotransfusion in 54% of the programs; 45% of the hospitals contracted the work to independent allied health groups or non-allied health companies; 53% of the hospitals reported they were unaware of whether those programs performed quality controls; AmSECT began promoting perioperative blood management as a perfusionist revenue opportunity in light of declining cardiac procedures; the authors emphasized the need for perfusionists to become better educated in transfusion strategies to broaden their base knowledge, skills, and value; the future was described as a new frontier with the inclusion of an Autotransfusionist membership category in AmSECT; they urged perfusionists to see the opportunity in perioperative blood management and the potential for growth; it was noted that autotransfusion was taught in perfusion schools, and perfusionist graduates were the only allied health professionals with such formal education for perioperative autologous blood collection and administration; the last section of the article emphasized the need for AmSECT to lead the way with the technology of autologous blood management; the AmSECT Transfusion Practices Committee was committed to promoting such education and to meet AABB standards; the article concluded by advocating perfusionists to become involved and committed to embracing the opportunity)

(the author was a member of the Perfusion Quality Committee; this brief article noted the reactivation of the committee; it was directed to address practice guidelines for staffing for off-pump coronary artery bypass (OPCAB) cases and cardiopulmonary bypass standby procedures; Jim Bowman was the committee chair; the committee was also to update the AmSECT Perfusion Pre-Bypass Checklist that had first been published in 1990; the committee had submitted two new Essentials and a revised checklist to the AmSECT Board in Jun 2003; they had been posted on the AmSECT website for membership review and input but had received little input; the article asked for members to offer input; the period of review had been extended until 15 Jan 2004; after that date the documents would be published; members of the committee were: Jim Bowman, Chair; Tim Dickinson; Aaron Hill; Mark Kurusz; Lynn Pfaender; and Dirck Rilla)

(the author was chair of the Perfusion Quality Committee; he addressed the perfusion Scope of Practice and the importance of perfusionists’ jobs for the well-being of patients; he recounted accomplishments of the committee, which included drafting two new Essentials (or Practice Guidelines) and updating the Pre-Bypass Checklist; the committee was reviewing members’ input; another goal of the committee was to develop a Perfusion Resource Manual to be available electronically to AmSECT members; the intention was to provide a guideline so institution-specific manuals could be generated; the manual was to consist of two parts: first, a Safety Policy, checklists, and templates for creating institution-specific policies and procedures for local practice; second, a Perfusion Manager template for department management guidelines; he closed by writing the focus of patient care was “simple trust”)

(the author was a JD, CCP, LCP, and Chair of the AmSECT Government Relations Committee (GRC); the CRC committee was monitoring all states for legislation that could impact perfusion practice; some legislation would limit the Scope of Practice for perfusionists if perfusion credentialling was not in place; he cited two examples— one in Michigan and one in Florida; if credentialling was in place, exemptions would allow perfusionists to continue to perform activities within their Scope of Practice; if no credentialling existed, perfusionists were at risk of having restrictions imposed on them by legislation covering other health care providers; “Respiratory care services” was the area that most often presented the risk to perfusionists; the article then described in detail the Michigan House Bill No. 4236; A bill to amend 1978 PA 368, entitled “Public health code,” with underlined language in the bill that would affect perfusionists; similarly, it described in detail, also with underlined language, the Florida Senate Bill sb0476c1, CS for SB 476; Beckman noted that both proposed legislations could bar perfusionists from performing many traditional tasks that were part of their responsibilities; he stated that without legal recognition in the form of licensure, “perfusionists are increasingly placed in the position of defending themselves in reaction to bills that would limit their scope of practice.”; he advocated perfusionists engage at the state level to represent their interests; he noted that through dues and volunteer efforts, perfusionists would be able to maintain effective mechanisms to address concerns at the state and national levels; he closed by urging perfusionist nonmembers of to join AmSECT)

(the authors recounted the establishment of the Extracorporeal Life Support Organization in 1989; its primary mission was to maintain a registry of the use of extracorporeal membrane oxygenation (ECMO) in member centers; ELSO conducted many conferences and had many publications such as the second edition of the book entitled, “ECMO: Extracorporeal Cardiopulmonary Support in Critical Care” edited by Drs. Joseph B. Zwischenberger, Robin H. Steinhorn, and Robert H. Bartlett; another book was the second edition of “ECMO Specialist Training Manual” edited by Dr. Krista Van Meurs; the authors cited some perfusionists who had a strong historic connection to ECMO (e.g., John Toomasian, Mark Kurusz, Sherry Faulkner, Dennis Rivard, and William Harris); however, the authors noted there had been minimal perfusionist involvement with respiratory ECMO; they cited a survey from 1990 that showed 28% perfusionist involvement in setting up and initiating ECMO in surveyed centers; the low figures were corroborated in 2002 in another survey that showed perfusionists were responsible setup, priming, and initiation in 22% of the programs; the authors found this “perplexing” given the similarities between cardiopulmonary bypass and the specialized application of the heart-lung machine for ECMO; they attributed the emergence and rapid expansion of neonatal respiratory ECMO programs during the 1980s coincided with the exponential growth of interventional cardiology and open-heart surgery programs; this led to a perfusionist shortage, and they were unable to participate in neonatal ECMO; Nursing and Respiratory Care personnel assumed ECMO responsibilities; they served as ECMO specialists and coordinators; the authors praised their work in filling the void; they noted the technical aspects of ECMO had remained much the same for two decades with incremental improvements such as better cannulas, stronger raceway tubing, and pressure servo-regulation; the authors argued that perfusionists had a second opportunity to become involved in ECMO by using newer technologies such as hollow fiber oxygenators and centrifugal pumps; involvement of perfusionists to implement circuit changes was viewed as beneficial; they acknowledged that perfusionists did not need to sit bedside for ECMO management but could perform setup, priming, initiating, and troubleshooting; they concluded that while perfusionists were not ECMO authorities, they did have the knowledge base in cardiopulmonary support and were experts in dealing with blood pumps and extracorporeal circuitry; the authors noted there was to be a joint meeting in Ann Arbor of AmSECT pediatric perfusionists and ELSO in Sep 2004; they advocated perfusionists could become “an integral part of any institution’s ECMO team”)

(the author briefly recounted early history of extracorporeal circulation beginning with the LeGallois publication in 1811; he then referred to Denman who began working as a perfusionist 45 years prior to this tribute; he recounted Denman’s background in Oklahoma and as service in the US Marine Corps; he moved to Dallas, TX, in 1959 where he worked for Drs. Hugh Wilson and Richard Ernst, who had developed a cardiac surgical program at Children's Medical Center; the first pediatric case at Baylor University Medical Center was performed in Aug 1958; Sutton briefly described the first successful open-heart surgical case performed by Dr. John Gibbon, Jr. in May 1953; Denman had used the Mayo Gibbon heart-lung machine and later an Olsen heart-lung machine; he noted that in 1960, less than 10,000 open-heart procedures had been performed worldwide; the first adult cardiac case using cardiopulmonary bypass in Dallas was performed in 1964 at St. Paul Hospital; for pediatric cases, the mortality rate was high (one survivor out of seven cases was cited); Denman had reunited with that one survivor 43 years later; the patient had undergone closure of ventricular septal defects; Denman was featured in a local newspaper that showed him operating a PEMCO pump and the DeWall-Lillehei helical coil bubble oxygenator; in 1963, Denman was recruited by Dr. Ernst to help start an open-heart program at Harris Hospital and John Peter Smith Hospital; Denman married Nancy Szatynski in 1964; they had two children; Denman worked in the Dallas area with two surgeons, Drs. Ben Mitchel and Maurice Adam until 1984; Sutton met Denman in Aug 1974; Denman introduced Sutton to Charlie Reed and Diane Clark; Sutton then attended the Texas Heart Institute School of Perfusion Technology; he also mentioned other perfusionists in the Dallas area such as Guy Prater, Stan Fennig, and Tom Rawles; Denman worked for Psicor for four years and then established his own perfusion contract company, Texas Life Support, Inc.; Denman had been a member of AmSECT since its inception in 1964 and served on the Board of Directors; Sutton praised Denman as an “exemplary example of professionalism” and for his humor and wit; five photographs of Denman and extracorporeal equipment accompanied the article)

(Muziani recounted the early days when “pump techs” worked long hours, were not paid for being on call, and circuits had to be hand-assembled; he recounted lessons he had learned from Narvaez; he praised him for being a caring person who never complained and always remained compassionate; Chan praised him for his humor and for being humble, mature, and gracious; Narvaez also had outside activities such as windsurfing and scuba diving; there was a photograph of Narvaez)

(Leadon was considered a pioneer Canadian perfusionist; he first worked in perfusion in Birmingham, UK, when he was 22 years old in 1958; he and a Canadian cardiac surgeon subsequently moved to Halifax, Nova Scotia in 1970; Leadon became Chief Perfusionist at the Victoria General Hospital and the Izaak Walton Children’s Hospital; he had retired in 2001 after 31 years; he traveled internationally to work with disadvantaged patients during cardiac surgery; he also worked with Dr. David Alton Murphy, who was a Halifax-based cardiac surgeon; Leadon was awarded by the IWK Children's Hospital for his clinical excellence; his outside interests included photography, gardening, and being a soccer coach; he also served on a local school board; MacDonald met Leadon during his training in the animal research laboratory; they used the LandeEdwards membrane oxygenator for pediatric cases; Leadon was honored in 2003 during a meeting celebrating the 50th anniversary of the first cardiopulmonary bypass case in Canada; there was a photograph of Leadon)

(the author recounted seeing a pediatric cardiac surgery patient in Oct 1960 that led to his becoming a perfusionist; his early work consisted of cleaning discs for the Kay-Cross oxygenator; the pump was a “finger” type that used latex tubing; many believed this pump was less hemolytic than a roller type; those who used a roller pump used large-bore latex or silicone rubber in the pump head and not PVC tubing; he recounted how the disc oxygenator required four pints of blood for priming to reduce hemodilution in pediatric patients; ACTs were unavailable; he also used early membrane oxygenators and an early version of counterpulsation that moved blood in and out of the femoral arteries for cardiac assistance; in 1969 with the advent of coronary artery bypass operations, his team began using disposable oxygenators; he described use of CO2 to lessen the risk of air embolism; plastic bands were not available so they used stainless steel wire to secure tubing to metal connectors; custom tubing packs were unavailable, and he described hand-cutting tubing and autoclaving it for sterilization since ETO sterilization was unavailable; the pediatric patient he described was, in fact, his daughter, and she did not survive her cardiac surgery; at the time of her death, Fennig was a pre-law student, but the experience led him to a career as a perfusionist; there was a photograph of Fennig with two students from the mid-1980s)

(the article recounted the history of the first successful cardiac surgery case using cardiopulmonary bypass on 6 May 1953; one of the members of the team was Dr. Bernard J. Miller, who had done extensive laboratory work using an early version of the Gibbon heart-lung machine; biographical information on Dr. Miller was described: he was born in Philadelphia in 1918 and worked in a pathology laboratory after graduating from high school; his first publication was when he was 20 years old; he graduated from Villanova University as first in his class; he attended medical school at Jefferson Medical College and graduated in 1943; after three years of military service, he returned to Jefferson in 1947 to finish his surgical residency; he spent time in Gibbon’s research laboratory and worked with IBM engineers to improve the heart-lung machine; there was a photograph of Miller and others in the animal laboratory; he also developed a negative pressure respirator that increased survival of animals after experimental surgery; the newer Gibbon-IBM heartlung machine had many safety devices in its design such as high-pressure shut-offs for the roller pumps, servo-regulated pumps depending on venous drainage, low-level sensors, a screen mesh arterial filter, integral heat exchanger and temperature probes, battery backup, and a pH sensor to regulate gas delivery; function of the stationary screen oxygenator was described; events during the case on 6 May 1953 were recounted that required Miller to intervene to maintain operation of the heart-lung machine when blood clotting and automatic pump shut-down occurred; in early 1954, Miller left Jefferson after a falling out with Dr. Gibbon; he pursued general, thoracic, vascular, and oncologic surgery; he developed other forms of perfusion equipment such as a hyperbaric film oxygenator used for chemotherapy; in 1981, he was awarded the Samuel D. Gross Award from the Department of Surgery at Jefferson; in 1996, the American Society of Mechanical Engineers awarded him the Holley Medal for his innovations on the heart-lung machine; the tribute closed with praise for Dr. Miller for his integrity, intelligence, and the focus he brought to the early development of the heart-lung machine in the early 1950s; Miller died in Dec 2007)

(the author remembered three early perfusionists—Joe Guzman, JB Denman, and Stan Fennig as having made an impact in the perfusion community; Guzman had trained Denman; Denman was offered the perfusion director’s position at Texas Heart Institute before Charlie Reed but turned it down because he wanted to stay in the Dallas area; Fennig trained many perfusionists on-the-job; the first open-heart operation in Dallas was in 1958 but the first successful case was not until summer 1960, which “took a lot of soul-searching and persistence”; Molina closed by praising the three pioneers as role models; there were photographs of the three early perfusionists)

(Hawkins was born 9 Aug 1937 in Spring Hope, NC; he served in the Navy for four years starting in the mid-1950s; he began working at Massachusetts General Hospital in 1963, performing general maintenance; he was helped to get a job as an operating room technician by Dr. Judah Folkman; he eventually moved to the cardiac surgery operating room where he assisted the perfusionist; he worked with a person named Miss Libby, and the equipment was a disc oxygenator; he spent 11 years scrubbing in on cardiac cases; in 1974, Hawkins was offered an opportunity to become a perfusionist by Drs. W. Gerald Austen and Mortimer Buckley; at the time of this article, he was still working as a perfusionist with 48 years of experience; Hawkins recounted the early cases and how residents stayed with patients postoperatively; the article closed with Hawkins expressing gratitude to those who helped him in his career; there was a photograph of him)

(the author recounted his on-the-job training as a “pump tech” in the early 1970s and the challenges with use of early extracorporeal equipment; he spent time in the dog lab learning perfusion; there were no reliable heat exchangers in disposable oxygenators in the early years; other equipment currently available was non-existent such as inline temperature probes; few perfusion teams were using membrane oxygenators or screen arterial filters; low level sensors were unreliable, the choice of cannulas was limited, and adult equipment had to be adopted for use on pediatric cases; there was no air bubble detector, activated clotting time devices, or cardioplegia; certification and accreditation did not exist; the two major textbooks were Galletti and Brecher’s “Heart Lung Bypass” published in 1962 and Stofer’s “A Technic for Extracorporeal Circulation” published in 1968; Kurusz reflected on early publications from AmSECT that were published erratically; perfusion in the early days was more art than science; safety concerns were an impetus for professional activities in the ensuing years; early standards for perfusion practice evolved to standards based on evidence-based publications; he noted early databases in other countries and by the Society of Thoracic Surgeons and the Extracorporeal Life Support Organization; he concluded safety was ultimately a judgment of acceptability of risk)

(Martin was considered the first perfusionist for Baylor College of Medicine at St. Luke’s Episcopal Hospital in Houston, TX; she was referred to as a “heart-lung machine operator” or “pump technician” early in her career; she worked for surgeons Denton A. Cooley and Michael E. DeBakey from 1957 to 1969; in 1969, she relocated to Methodist Hospital with the Department of Surgery at Baylor where she worked for Dr. DeBakey until her retirement in 1981; the first blood pump she used was a Sigmamotor finger pump; she also used the DeWall-Lillehei helical bubble oxygenator and Dr. Cooley’s “Coffee Pot” bubble oxygenator that was made from parts from Commercial Kitchens in Houston, TX; Martin worked with machinists at Baylor to fabricate new devices needed by perfusionists; she accompanied Drs. Cooley and DeBakey in their world travels as they performed open-heart surgery; she taught many perfusionists on-thejob; she spoke at the Michael E. DeBakey International Surgical Society meeting in Houston on 3 May 2008; there were two photographs of Martin)

(he briefly recounted the contributions of Dr. John H. Gibbon and the first successful use of a heart-lung machine on 6 May 1953; he considered Mary Gibbon to be the first perfusionist)

(the author reiterated the answer to the question posed in the title of his article was, “Through education and technical help from colleagues”; he cited AmSECT publications, working with other organizations, and talking to colleagues at meetings as ways to promote the best patient outcomes; in 1972, he moved to Denver, CO, and met Maddie Massengale; she urged him to become involved in AmSECT activities; one of his first tasks was to assign recertification points for meetings; he recounted leadership roles he had held, including work on accreditation of perfusion educational programs)

(Lawrence noted there were two early perspectives about the future of the profession: one group was part of an organization, who were primarily dialysis technicians and were aligned with cardiac surgeons who believed the surgeons should have control; in contrast, Charlie Reed believed perfusionists should be independent to develop national certification and education programs; the ABCP was established, but many cardiac surgeons feared losing control and were skeptical of formal perfusion schools; there was much acrimony and passion on both sides; political pressure led to Reed resigning the presidency from the ABCP under threat of loss of his job; Lawrence replaced him as ABCP President; accreditation of schools had been established by the ABCP, but surgeons believed they should control the accreditation process; the ABCP was committed to independence; the two challenges Lawrence faced were 1) strengthening the certification process and 2) relying on accredited perfusion schools as the source of new perfusionists to replace on-the-job training; Jerry Richmond, an ABCP director told Lawrence about his brother who was a college professor with expertise in education; Lawrence expressed the field was grateful to Mark Richmond and his wife, Beth, for their help in strengthening the certification and accreditation processes; because of the educators’ credentials, opposition from the other side was minimized; he closed by asserting that without their help, the perfusion profession might not have survived; Horgan also noted the Richmond’s help in changing the profession; they confirmed the ABCP written examination as reliable and valid; other accomplishments included publication of a test manual and work to strengthen the oral examination; in 1982, many believed there was a perfusionist shortage, so the so-called alternative process for admittance to the certification process was decided by the board; in 1983, Richmond published results of a manpower survey showing there was no shortage of perfusionists; the Richmond’s also showed that without formal education, a perfusionist could not pass the ABCP examination; this led to the two thoracic surgery organizations to support only graduates from an accredited perfusion program; the ABCP recognized a separate accreditation organization would be needed, and the AMA-CAHEA accreditation process was started in 1984; in 1985, there were enough questions for the written examination that they were chosen randomly by a computer; the Richmond’s were instrumental in teaching board members how to write valid questions, and the bank of questions grew; he closed by stating the ABCP certification process was the gold standard, not only for perfusion, but for all allied health professions; Cavanaugh praised Mark and Beth Richmond as the ABCP’s best assets; he considered his tenure ABCP President as occurring during the adolescence period of the board; he recounted the annual test development meetings that were hard work but fostered team building; every test question was analyzed for inclusion or removal from the examination; one issue that was discussed was the difference between norm-referencing and criterion-referencing; the ABCP adopted criterion-referencing; while Mark Richmond focused on the test process, Beth focused the national office operations; both ensured the ABCP remained financially solvent; both offered counsel and guidance to the officers and directors; Hartley noted in the early years the ABCP was being pressured to relax its standards by surgeons, program directors, professional organizations, and employers; Mark and Beth Richmond counseled standing firm; their educational backgrounds served the board well during the challenging and trying times; she closed by expressing the profession owed them for their contributions; Utsey acknowledged early in his career he knew little of the ABCP’s work but became aware of the directors’ commitments of service above self that was aided by the Richmond’s contributions to the certification process; they helped the board in making the correct decisions by avoiding those that would have been contrary to its mission; “They were non-perfusionists who cared as much about our profession as we did.”; Mark Richmond was described as a “psychometric and statistical genius” who had a talent in test structure and data analysis; the ABCP used computers to enhance the process; Mark often said, “Make a great exam and let the exam do its work.”; he challenged the directors to be professionals for the profession; Beth was described as “the epitome of a southern lady” who was gentle and gracious but no pushover; she was praised for her keen memory; if Mark and Beth disagreed on some issue, the board would always listen to Beth; he closed by reflecting his board experience was the most rewarding professional experience of his career; he expressed gratitude and appreciation for what the Richmond’s accomplished for the profession; O’Connor cited what his grandmother told him, which was education was the pathway to a better life; he characterized the Richmond’s as unwavering in their commitment to the certification process; he remembered the transition from the norm-referenced and oral examination to criterion-referencing; many hours were spent by the directors learning “the ways of psychometric testing”; while the directors sometimes had disparate views on how best to achieve goals, the Richmond’s “steered that ship into a safe harbor”; he closed by ruminating why two college professors would spend so much time and with little understanding of what perfusionists did every day; they were “tireless” in their work on behalf of the profession; Bishop likened the Richmond’s to a watermark on a page—while not being responsible for the content of the page, they made the page better by their presence; their contributions benefited the perfusion profession immensely; they educated a series of dedicated clinicians who were directors to become knowledgeable test developers; the transition to criterion-referencing was made easier by the Richmond’s teaching the meanings of reliability and validity and the importance of Ebels and taxonomy ratings each year during test development meetings; they provided the ABCP with continuity and stability; he closed by quoting a popular commercial that “while we don’t make the products we make them better”; Mongero noted the ABCP was once a certification committee of AmSECT; the Richmond’s had a 30-year record with the ABCP at the time of the article; perfusionists owed them a debt of gratitude for their guidance; she closed by expressing thanks to the early perfusionists who developed the certification process and for perfusionists for their support; a memorial scholarship had been established in honor of Jerry and Mark Richmond and was to be administered by AmSECT)

(Adams was the oldest living perfusion pioneer at the time of his death; he became a perfusionist from his military and operating room skills; he was a medical technician during World War II; after the service, he worked in two Veterans Administration (VA) hospitals in Wisconsin; he began in the dog lab and then worked under Dr. C. Walton Lillehei for a two-week work-study program to learn to operate the heart-lung machine; he was Chief Perfusionist at St. Luke’s Hospital in Milwaukee (19531978) and concurrently at the VA Hospital in Wood, WS (1953-1976); he typically performed 250-300 cases per year; he also collected data and statistics for the surgeons; he also directed the animal research laboratory at the Medical College of Wisconsin; he mentored and trained 21 perfusionists; when asked what characteristic he sought in potential perfusionists, he said he looked for “picture straighteners” who had attention to detail; in 1964, he attended the formulative meeting that was to become AmSECT in Chicago at Mt. Sinai Hospital where fellow technicians discussed how to improve the profession; after retirement, Adams attended many AmSECT meetings; he was a dedicated family man; he also was an accomplished musician)

(the author wrote about a film from 1940 entitled, “Experiments in the Revival of Organisms”; it featured the work of Dr. Sergei Bryukhonenko, who worked at the Institute of Experimental Physiology and Therapy in Moscow; in 1925, he invented an “autojector” that, in fact, was a type of heart-lung machine that predated Dr. John Gibbon’s work; the autojector was used so surgeons could develop techniques for repairing heart valves and other cardiac defects; he proposed using the device on the battlefield to revive soldiers who had been killed; Bryukhonenko and Gibbon apparently never communicated on their research activities; Grist contrasted the design and operation of the two machines; Gibbon used roller pumps, but Bryukhonenko used two bi-valved ventricular pumps powered by one motor; Bryukhonenko accessed the circulation via the carotid artery and internal jugular vein, which was how contemporary ECMO cannulation was performed 50 years later; the “autojector” was a small device, whereas the Gibbon machine was much larger; on 22 Nov 1943, a film of Bryukhonenko’s device was shown to 1,000 scientists in New York at the Congress of American-Soviet Friendship; Grist provided a link where the film could be viewed; there were some critics of what was claimed in the film; one experiment showed perfusion of a severed dog’s head, and the dog responded to various stimuli; Grist also referred to the “Frankenstein” movie; Bryukhonenko was considered ahead of his time and was greatly respected in Russia; he was posthumously awarded the Lenin Prize in 1965, which was the highest award for Soviet citizens; Grist closed by recommending all perfusionists view the film)

(the author began his perfusion work in 1972; he had been trained by Yarrow and worked with Sir Brian Barratt-Boyes and Drs. Eve Seelye and Marie Simpson at Green Lane Hospital in Auckland, NZ; Yarrow was recruited to Green Lane Hospital in 1954 by a cardiologist to work in the catheterization lab; his background was in electronics; he worked with Drs. Barratt-Boyes and David Cole to perfect cardiopulmonary bypass techniques in the laboratory; he used the DeWall bubble oxygenator, but for the first clinical case, he used a Melrose heart-lung machine obtained from the UK; it had no instructions for use, and Yarrow had to get it functioning before use; in 1972, most components of the circuit were reusable; 50 years later, when Yarrow was 85 years old, he visited the operating room and described his early work; in the early years Barratt-Boyes directed Yarrow to develop a pacemaker for heart block when VSDs were closed; early cases required six to eight pints of blood to prime the heart-lung machine; Yarrow helped establish the Australasian Society of Cardiovascular Perfusionists (renamed the Australia and New Zealand College of Perfusionists); Yarrow’s funeral was attended by many in the medical field; an award was created in his name for the best presentation at their annual scientific meeting)

(the author reflected on AmSECT’s original mission statement, which was “to foster improved patient care and safety by providing for the continuing education and professional needs of the extracorporeal circulation technology community”; she cited early publications stating the purpose of AmSECT; goals were 1) to unite into one national organization; 2) provide information and technical service to members; and 3) foster leadership to promote the art of the technology, maximum standards of practice, acceptance by medical and public communities… “to the best interests of patients and the art of medicine”; to achieve these goals AmSECT was to promote intercommunications to those concerned with the “the movement and treatment of blood in an extracorporeal circuit”; it also was to disseminate information from multiple sources to insure “data is available to all”; it also had a goal to develop certification “to engender a uniformity of experience”, a journal, and research; certification was accomplished in 1974; in 1976, dialysis technicians left AmSECT due to limited membership; until 1971, all perfusionists were on-the-job trained; they had a variety of backgrounds and “rich personalities”; a disadvantage of on-the-job training was employers had no way to determine the competence of practitioners; formal educational programs were established; she expressed the current scope of perfusion practice far exceeded what the founders might have envisioned; she closed by urging perfusionists to become involved to influence the future of the profession)

(Groom was encouraged to run for an AmSECT office in the early 1990s; he wished to become involved in planning regional meetings; he served as Region III President and Vice President; he was also on the editorial board of the J ExtraCorp Technol starting in 2005; he was elected AmSECT Treasurer in 2010; when asked about role models, he cited Aaron Hill, Ian Shearer, Ed Darling, Joe Sistino, and Jeff Riley; he also mentioned Al Stammers, who was editor of the journal; Groom succeeded Stammers as Editor and learned the process for producing the journal; similarly, he learned about the Treasurer’s role from Craig Vocelka, who had been in that role; serving in a leadership position had broadened Groom’s perspective; he valued the relationships from his volunteer work; he cited visionary past leaders such as Maddie Massengale-Beall, Charlie Reed, Earl Lawrence, Jerry Richmond, Mark Richmond, Jeri Dobbs, Mark Kurusz, Bill Horgan, Diane Clark and “many, many others”; he noted CEU and clinical activity requirements established in 1975 were instrumental in development of the profession; he stated the public was safer because of certification; he praised the AmSECT “Guidelines and Essentials for Clinical Practice” were a benchmark for clinicians; he also mentioned the International Consortium for Evidence-Based Perfusion, which became an AmSECT committee under President Al Stammers; he also mentioned the International Board of Blood Management for establishing standards for autotransfusion; he recommended volunteering as a career opportunity; he named some open positions in AmSECT)

(Smith died 22 Jun 2011 in Italy while on a motorcycle trip; he trained as a perfusionist in 1975 and worked in Salt Lake City, UT; he presented and published papers on perfusion; he was the perfusionist during the artificial heart implant on patient Barney Clark in 1982; he took great pride in his family; he shared his knowledge with many in the field)

(the author reflected on the early years of AmSECT; it was started by the first perfusionists to share knowledge about the new field; many worked in research laboratories and in the operating room; early equipment was reusable and had to be hand-cleaned, defoamed, and sterilized before cases; early perfusionists had to be “creative, inventive and hardworking”; this period of time was before computers and email; perfusionists often traveled to other centers to observe open-heart surgery; a group from the University of Minnesota (Jim Wade and Dick Jensen) and also LeRoy Ferries and Ed Berger joined in the early meetings; Dobbs attended his first AmSECT meeting in 1966; there was much discussion on perfusion schools versus on-the-job training, recognition by the AMA, surgeons, hospitals, and salaries; he mentioned Kathryn Hargesheimer, Mike Dunaway, and Calvin Scott as pioneers; he acknowledged the manufacturers and their support of the new profession; he mentioned Tom Wharton, who gave time and money to AmSECT; he cited early books such the one by Galletti and Brecher (“Heart-Lung Bypass”); Raymond Stofer’s, “A Technic for Extracorporeal Circulation”; “Cardiopulmonary Perfusion” by Charles Reed and Diane Clark; and “The Physiology of Adequate Perfusion” by Edward Berger; he considered them to be pioneers; he mentioned Emily Taylor and Mark Kurusz as editors of early AmSECT journals; he mentioned formal training programs such as the one at the Cleveland Clinic with John Meserko as the director; the program at Ohio State University started in 1968 with Joe Mandl as its director; in 1971, the training program at Texas Heart Institute was started by Charles Reed; Reed also was an AmSECT President and helped establish the American Board of Cardiovascular Perfusion; in 1974, Dobbs started a perfusion training program at the University of Oregon Medical School that also trained Physician Assistants; early program directors were pioneers; he acknowledged Ben Mitchell was credited with the name Perfusionist to replace “Pump Tech”; he noted recognition of the profession by the American Medical Association as an allied health occupation in 1977; two individuals who were the driving forces in that accomplishment were Maddie Massengale and LeRoy Ferries; he also mentioned other pioneers such as Jim Dearing, Jerry Richmond, Richard Berryessa, Richard Chan, Aaron Hill, Jeff Riley, Bill Horgan, and David Ogella; he closed by stating, “I would hope that we never forget the names and recognize the hard work of the early pioneers of our society.”)

(this recounted the meaning of the logo, which was previously described in Perfusion Life, vol. 5, no. 6, pg 25, 1988)

(Lummis died 30 Apr 2014; he served in the US Navy as a Corpsman specializing in respiratory therapy; he was part of the team for one of the first cardiac transplants at St. Albans Naval Hospital on Long Island, NY; he trained as a perfusionist at the Shadyside Hospital in Pittsburgh, PA; he worked in Fresno, CA, where he owned a perfusion contract company; he was AmSECT President 1998-2000; he also made several cardiac surgery mission trips to Poland; on one trip he was thanked by then President Lech Walesa and the Cardinal of Krakow, Karol Wojtyla, who became Pope John Paul II; Lummis earned a BA degree in Psychology)

(Reeder died 4 Feb 2014; he had aspirations to become a doctor and started working as an orderly and medical aide at Whittier Presbyterian Hospital in CA; he worked for NASA and studied the effects of space flight in Rhesus monkeys; he founded a perfusion contract company called Cardio Sciences, where he developed many perfusion techniques; he received the AmSECT Award of Excellence in 1981; he collaborated with the University of Pittsburgh and authored several books on hematology; he eventually moved to Denver, CO, and worked for Electromedics as head of research and development; he was named on 14 patents; he owned a ranch in Beulah, CO; he wrote more books; in 2009, he sold his ranch and moved to OK and developed a computer keyboard with a Cherokee alphabet; Rivera worked with Reeder 1988-1995 at Electromedics; they coinvented a platelet-rich plasma sequestration process for autotransfusion equipment; Reeder’s company was the first to offer perfusion and autotransfusion services; he organized many autotransfusion training sessions while at Electromedics and trained thousands of clinicians; he played the guitar and banjo and had a Black Belt in karate; he was fluent in Japanese; he was a gourmet cook; he worked with Keith Samolyk to commercialize the HemoBag; he was considered a “Renaissance Man”)

(Massengale had a background in nursing; she received her nurse training at Johns Hopkins University; she moved to CA and was learned perfusion at the University of California San Francisco; she then moved to Denver, CO; she was a former AmSECT President and the first representative to the Joint Review Committee for Perfusion Education (JRC-PE); she received the AmSECT Gibbon Award and was the unofficial AmSECT historian; she was “absolutely and totally committed to AmSECT”; a tribute to her was to appear in the J ExtraCorp Technol; Music remembered her as a teacher, mentor, and friend for nearly 40 years)

(Ross died at age 92 years old; he was a military veteran who served during WWII; he attended Howard University and was a member of the prestigious 2515 Army Service Unit known as the Prometheans; after WWII, he returned to Howard University and obtained a Bachelor of Science degree; he was AmSECT President and worked in the Los Angeles, CA, area for 38 years; he retired to San Antonio, TX, which was near his childhood home in Houston)

(the author noted emergency cases were unusual in the late 1960s; most cardiac centers performed one to three cases per week; the coronary artery bypass operation was not performed, and most cases were for valve replacements, repairs, and septal defect closures; most circuits used non-disposable glass and stainless steel disc oxygenators, heat exchangers, venous reservoirs, cardiotomy reservoirs, and arterial filters; after cases, the equipment had to be disassembled and cleaned and prepared for resterilization; tubing had to be cut by hand; six to eight units of blood were required for priming the circuit; cardiac cases stressed the blood banks; in the late 1960s, disposable bubble oxygenators were commonly used; membrane oxygenators began to be used in the early 1970s, but many teams did not make the transition to them until the mid-1980s; ECMO was used for long-term respiratory support in some centers; early perfusionists came from diverse backgrounds and had varying levels of medical education; AmSECT provided a forum for exchange of ideas with its journal and at conferences)

(Dobbs was known as a researcher and teacher; he spent his entire career at the University of Oregon Medical School; early research work was on the Starr-Edwards heart valve, Landé Edwards membrane oxygenator, pacemakers, and intra-aortic balloon pumps; he was one of the original directors of the American Board of Cardiovascular Perfusion and its first Secretary-Treasurer; he was credited for being able to bring outspoken leaders in the field together to arrive at consensus positions)

(the author was an orderly in 1968 when he applied for a new job as a technician at a hospital; he met Jerry Swett in the dialysis unit; Swett was an extracorporeal technologist who operated dialysis and cardiopulmonary bypass equipment; Swett trained him on-the-job; other duties included performing electrocardiograms, electroencephalograms, operating the hyperbaric chamber, and operating a Swenko organ perfusion system for kidney transplants; Swett had been a Marine during the Korean War; he taught martial art classes; he referred to the heart-lung machine as the “pump-oxygenator” as did Dr. John Gibbon, Jr.; Grist had to clean, re-assemble, and steam sterilize the non-disposable parts (disc oxygenator, venous/cardiotomy reservoir, heat exchanger, and arterial filter); he described the process for re-assembly; Swett stood up to the cardiac surgeons who sometimes demeaned perfusionists; Grist eventually lost contact with Swett; Swett died at age 52 years old)

(the subject of this article was the brief history of blood transfusion and minimization of blood loss during ECMO by use of peripheral cannulation; she also cited some clinical practices that minimized or eliminated systemic anticoagulation; she reviewed several relevant articles on the subject that correlated blood transfusion with patient morbidity and mortality)

(Buckberg died 20 Sep 2018; his career was spent “researching and remedying heart disease”; he received major awards from thoracic surgery societies and the Gibbon Award from AmSECT in 2008; he published his autobiography entitled, “Solving the Mysteries of Heart Disease” (subtitled, “Life-Saving Answers Ignored by the Medical Establishment”) in 2018)

(Goodwin had been a Respiratory Therapist in Florida after serving in the US Army; one of his duties was to operate the intra-aortic balloon pump in the ICU; after he observed a cardiopulmonary bypass procedure, he went to the Texas Heart Institute School of Perfusion; he mentioned the program director, Charlie Reed, who he characterized as demanding but fair; in 1983, Goodwin moved to Tyler, TX, with a heart surgeon to start a new cardiac surgery program; he described the equipment he used (Sarns model 7000 pump and Shiley bubble oxygenator and no arterial filter); in 1986, he started a perfusion contract company, which operated for 28 years; in Nov 2010, the contract business ended, and he became a hospital employee; this allowed him more family time; he described his leisure activities that include raising honey bees)

(the author recounted how he became involved with AmSECT; he contacted Jim Reagor and participated in some medical missions and the Perfusion Without Borders committee; he succeeded Reagor as Chair of the committee; he also was elected to the AmSECT Board of Directors from Zone 3; he also was AmSECT Treasurer for two terms; he worked at Duke Heart Center in Durham, NC; he praised volunteers for development of the profession; he closed by urging members to volunteer for AmSECT activities)

(the article referred to the Galletti and Brecher book, “Heart-Lung Bypass; Principles and Techniques of Extracorporeal Circulation”, which was published in 1962; Pierre M. Galletti, MD, PhD, was a biomedical engineer and Gerhard A. Brecher, MD, PhD, was an expert in venous physiology; the book was a compendium of all that was known about extracorporeal circuits in the 1950s and early 1960s; there was much written about bubbles and how to remove them from the extracorporeal circuit; methods of venous return, either active with a pump or vacuum, or passive with syphon drainage were described; one illustration showed 17 types of blood pumps; all types of oxygenators that had been used were described including heterologous and homologous lungs; most equipment was non-disposable; the book described early physiological circuits, including the “autojector” used by Brukhenenko to keep severed dogs’ heads alive; the book also described the physiology of perfusion; hypothermia was not well understood at the time of the book’ publication; methods to arrest the heart so surgery could be performed were discussed; crystalloid hemodilution was not used at the time; Grist considered the book a “reflection of its time” but not ahead of its time; Muziani knew Galletti personally and characterized him as a “magnificent person with a singular vision”; the book was considered the “gold standard” at the time; Galletti was a scientist and not a perfusionist, and the book was written as such; he did not recommend any particular equipment but instead presented what was known so readers could decide how to conduct perfusion; it was suggested Galletti considered the book a guide; he was considered a Renaissance man and a “Man for all Seasons”; he was credited for establishing the emerging field of biomedical engineering; he worked at Brown University and had earlier been at Morehouse School of Medicine in Atlanta, GA; in 1994, Galletti was Chairman of the Board for Sorin Biomedical in Irvine, CA; he was considered a visionary person)

(the author described the Gibbon-IBM heart-lung machine that had been used during the first successful cardiopulmonary bypass (CPB) case in 1953; he recounted Dr. John Gibbon’s background at Massachusetts General Hospital to develop the apparatus for pulmonary embolectomy cases; this followed additional animal experiments at the University of Pennsylvania and Jefferson Medical College; there were three models developed with IBM engineers, but all relied on a thin film of blood for gas exchange; the Model II heartlung machine was enclosed in one large cabinet; it had four roller pumps: one for each cava to remove venous blood, a recirculation pump to maintain a film of blood on several stationary screens, and an arterial pump to return blood to the patient's systemic circulation; there were many safety devices on the console such as high pressure cut-offs, inline temperature probes, an arterial screen filter, a blood level sensor to servo-regulate the arterial pump, battery backup, and a pH sensor to regulate gas composition to the oxygenator; other than the tubing, all parts were nondisposable; a venous collecting system was added and used vacuum to remove blood from the operating field; sterilization of the assemble system relied on Zephiran solution that had to be rinsed away before priming; the system was primed with saline followed by whole blood to wet the screens; details were recounted of the historic case on 6 May 1953 that included several complications in the operation of CPB; the Model III machine incorporated improvements such as greater oxygenation capability, larger roller pumps, a cooling system for hypothermia, adjustable vacuum for the venous collection system; IBM produced the Model III machine in 16 weeks, and it cost $79,650 ($770,529 in current dollars); failures with early cardiac surgery cases were not due to the function of the heart-lung machine but were the result of mistaken diagnoses, blood clotting, or cardiac arrest prior to starting CPB; the Gibbon-IBM pump was modified by Dr. James Kirklin and was called the Mayo-Gibbon heart-lung machine; the article had a list of relevant citations)

(the history of establishment of the International Board of Blood Management (IBBM) was recounted; it was recognized there was a need for such an organization in 1995 by perfusionists K.C. Roberts, Bill Horgan, and Ron Richards; it was initially called the American Board of Clinical Autotransfusion (ABCA) to offer an examination for those conducting platelet gel, stem cell, bone marrow aspirate, and autotransfusion; the examination was acquired by AmSECT in 2007 and overseen by the Blood Management Task Force; those on the committee were named; the purpose of the board was “to promote education and sound scientific principles to advance the safe and competent practice of perioperative blood management, which will lead to recognition of this specialization through examination and certification”; the IBBM created a website as a source of information on the examination; designation for the Perioperative Blood Management Technologist (PBMT) was established for those performing autotransfusion and platelet/stem cell processing and by passing the certification examination; annual recertification was required by continuing education and reporting 40 clinical cases/yr; a secondary certification for Perioperative Blood Management Specialist (PBMS) was also established for recognition of advanced expertise; in 2014 the IBBM/AmSECT invited two other organizations, the Society for the Advancement of Blood Management (SABM) and the American Association for Blood Banks (AABM) to collaborate in an effort to improve, market, and finalize the development of the PBMS examination; the AABB continued to collaborate; a table describing the PBMS Job Domain was included in the article; in 2019, AmSECT also undertook to develop and validate a certification examination for ECMO Specialists; details on how the examination was developed and administered were described; those certified used the initials CES-A denoted those passing the examination for adult ECMO; more than 250 had taken the examination; recertification was required after two years; the program was supported by the AmSECT Board of Directors; AmSECT University offered review courses to help prepare those taking the examinations)

(the author recounted a case of a pediatric water-to-blood leak that occurred after CPB; the surgeon was informed the circuit could not be used if the patient needed to go back on CPB, but this was not required; the oxygenator was rinsed with a bleach solution and returned to the manufacturer; two months later an FBI agent contacted the hospital’s Human Resources department; the FBI was investigating a case of industrial sabotage, and the author was accused of deliberately damaging the heat exchanger with a caustic chemical; the company would have been required to recall their oxygenators unless they could prove a deliberate act of sabotage; since that experience, the author has not sent any defective equipment back to the manufacturer; he cited examples in the literature of leaking heat exchangers; he proposed a simple test for heater-coolers to confirm safe pressures; he also advocated aspiration of water from the heat exchanger instead of positive pressure flow; this would draw blood into the heater-cooler instead of forcing water into the blood pathway; he also described a blood leak detector sensitive to minute amounts of blood not visible to the naked eye; he also discussed decontamination procedures for heater-coolers; he closed by expressing the hope manufacturers would make such improvements to prevent potential patient injury or legal ramifications for the perfusionist)

(the authors wrote about a gastric cooling device for treatment of ulcers; the Swenko device was developed by Dr. Owen Wangensteen at the University of Minnesota; a local refrigeration appliance manufacturer constructed a device to circulate freezing alcohol to inflate a balloon; there was background on the Swenko company; the medical device was developed in 1962; the company also developed an organ preservation machine that was used with hypobaric oxygenation to prolong the safe storage period for harvested organs; Grist recounted his early experiences on a kidney transplant team and operation of the Swenko device; donors were found from newspaper articles on victims of vehicle accidents; there were no cardiac, lung, or liver transplants done at that time; the Swenko device had a hypobaric section; the system was supplied with oxygen, ice, and intravenous solutions and pumps; he described being on call when donor kidneys were to be harvested; there were no organ banks; eventually, hypobaric oxygenation was abandoned, and the kidneys were transplanted within eight hours after removal from the donor; he recounted an anecdote from Richard Jensen, who also used the Swenko device; there was a photograph and a figure showing the system and some relevant references)

(the author recounted his experience with the portable Emergency Pump Oxygenator (EPO) system for a postoperative patient in the ICU who was bleeding; he described how the system worked using a Travenol bag bubble oxygenator and two modular roller pumps; it was battery-powered; the emergency system was first described by cardiac surgeons Cooley and Beall in 1961; a few cases were reported in the literature in the 1970s and 1980s; the EPO system was a precursor to bedside ECMO; despite the patient’s dire situation in the case described, she survived and was discharged from the hospital; the case was published in the Proceed Am Acad Cardiovasc Perfusion in 1983; there were figures in the article and a list of relevant references)

(this was a tribute to Riley who died 15 Oct 2021; he was praised for his dedication to the profession and for serving in many leadership positions with AmSECT; he had mentored many perfusionists; the AmSECT Board of Directors listed his many activities in the society that included being president and editor)

(the authors profiled Dr. William T. Mustard (1914-1987) who was a Canadian surgeon who did orthopedic surgery and cardiac surgery; he was a colorful character; in the 1950s, he and his colleagues in Toronto developed a heart-lung machine that used isolated monkey lungs as the oxygenator; a backup set of lungs had to be available because the first set typically functioned for only 20 minutes; the circuity used by Mustard was described along with a diagram from one of his early publications; two pumps were used—one for removing venous blood from a reservoir and a second for reinfusion into the patient’s left subclavian artery; the speed of each pump and stroke volumes had to be adjusted during the perfusion; he used hypothermia to 250C that would allow the heart to be stopped for three to five minutes; the circuit had continuous oximetry monitoring; it was unclear from his publications on what fluids were used to prime the machine, but it likely involved normal saline solution followed by fresh whole blood; Mustard and his team did extensive experiments before attempting clinical cases; the first seven patients did not survive; patients who were at highest risk from their cardiac conditions were operated on; Mustard reported on an additional 21 patients who had congenital defects with only three survivors; by the mid-1950s, Mustard recognized the use of monkey lungs was unfeasible; Dr. William G. Williams, a cardiac surgeon from Toronto who knew Mustard well offered some personal information on Mustard; he was a gifted surgeon and “a truly unique and wonderful man”; there were figures and a reference list with the article)

(this included reflections from Debbie Gherlone, who worked with Motley on the AmSECT Government Relations Committee)

(the author was in the field for 45-plus years; he recounted how he was trained as a physician assistant (PA) in 1977 and then attended the perfusion technology program at Texas Heart Institute in 1978; he obtained additional perfusion training at Baylor College of Medicine, Fondren Brown Hospital and Methodist Hospital in Houston; he recounted his participation in cardiac congenital surgery and foreign mission cases; there were many photographs)

(this was the first of four articles from a perfusionist who was a member of an organ harvesting team in the late 1960s; he operated an organ preservation machine called a Swenko; the hospital’s transplant team would check newspaper reports for motor vehicle accidents whose victims may have had severe brain damage; families of brain-dead patients were approached about organ donation; when a donor was located, the perfusionist would follow the harvesting team (better described as procurement team) with the Swenko machine; tissue typing was performed between potential recipients and donor organs; two kidneys would be used for two different patients; the Swenko apparatus used hyperbaric oxygenation; organ donation could not be performed until the EEG was flat; the donor heart remained beating; one case is recounted during which two kidneys were harvested and subsequently transplanted)

(the authors provided biosketches of early manufacturers of cardiopulmonary bypass equipment; the list included Richard “Dick” Sarns; Edward Olson; William Koteles; Donald Bentley; Lowell Edwards; Donald Shiley; David Pall; Roy Swank; the Galen and William Harvey oxygenators were named after historical figures; the Travenol Variflo bubble oxygenator was an early disposable bubble oxygenator; the GE Peirce and Landé membrane oxygenators were named after their inventors; the Hemochron ACT machine was for automatically determining the activated clotting time of whole blood; other equipment and devices were also mentioned)

(Riley was profiled for his major impact on the profession; he was described as a person “full of life, thoughtful and pensive, with a steadfast demeanor” who encouraged many perfusionists to “stand for what was right and what would push our field forward”; he was widely published (139 peer-reviewed manuscripts, 92 of which were in the J ExtraCorp Technol); he joined AmSECT in 1974; he was recognized by AmSECT and received many awards, including the Gibbon Award; he was one of 36 AmSECT Pioneers in Perfusion in 2015; the tribute included words of praise from Dr. Sundt, a cardiac surgeon who had worked with Riley, wrote, “We are all better for having known him and lesser for having lost him.”)

(the author reported two cases; the first was a living donor kidney procurement procedure, but the female patient was found to be pregnant during surgery; the donation was canceled; in this case, the patient should have had a pregnancy test before surgery, but this did not happen; various team members thought others had done such a test, and the OR nurses did not check the patient’s chart to confirm if test results were recorded; the second case was complicated by a winter storm that prevented the author from driving to the donor hospital; he was able to get a ride from a police department officer, but when they got to the hospital the condition of the potential donor had deteriorated, and the kidneys were no longer viable; the author was reprimanded by the hospital for recruiting a ride from the policeman; the surgeon supported him, and he avoided the risk of being fired for exceeding his authority when calling the police for help in getting to the donor hospital)

(the author was a 2021 graduate of the Texas Heart Institute School of Perfusion Technology; she interviewed MacDonald, who had started his career in 1967; he worked at Victoria General Hospital and the Halifax Children’s Hospital; in 1978, he moved to University Hospital in London, Ontario; he taught perfusion students from the Mitchener Institute of Applied Health Sciences in Toronto; he later became Chief Perfusionist at the London Health Sciences Centre; he retired in 2010; in retirement he was an independent consultant and worked with Quest Medical, Inc. in Allen, TX; he was originally an operating room technician who worked in the thoracic and cardiac surgery rooms; he was trained on-the-job in Halifax, Nova Scotia, by Alan Smith; he spent time in the animal research laboratory with the cardiac surgeons; his training period was two years; he took the Canadian perfusion oral examination in 1969 that was administered by two cardiac surgeons, two cardiac anesthesiologists, and two heart-lung technologists; MacDonald witnessed major advancements in perfusion during his career; improved oxygenators were a major change; he trained using the Kay-Cross disc oxygenator, which was time-consuming to prepare between cases; he also used the Travenol sheet bubble oxygenator; disposable equipment made cardiac surgery cases routine; he recommended perfusionists to become involved with their peers; he was a leader in the Canadian Council of Cardiovascular Perfusion (president 1980-1983), the American Academy of Cardiovascular Perfusion (president 1993), and active in AmSECT; he advised that education was an ongoing process)

(the author recounted a case in which a young woman had a massive hemorrhagic stroke; the patient’s husband had agreed to organ donation from his wife; once he left his wife’s bedside, the patient was taken to the OR for kidney harvesting; the author knew what he was doing was not wrong or immoral, but the experience left him with some sense of shame over the situation)

(this article had excerpts regarding the development of the first certification test for perfusionists (technicians) and a call for submitting news to the newsletter; there was a photograph of Ferries and an excerpt of his biosketch from the “Pioneers in Perfusion” booklet published by Shiley in 1982)

(the author recounted his experience in helping to establish an ECMP program; he designed the ECMO configuration and trained ICU nurses to operate it; the perfusion team was unable to cover ECMO cases that would sometimes last weeks; one case involved a small girl had a cardiac arrest in the ICU and was placed on ECMO for possible transfer for a heart transplant; however, it was determined by EEG the girl was brain dead; the parents consented for her to be an organ donor; the ECMO circuit was kept operating to maintain organ viability; harvest teams from other hospitals arrived; the patient was declared dead, and all charting ceased; the patient was transported to the OR but the author was having difficulty maintaining an adequate blood pressure; the patient’s kidneys and lungs were removed, and ECMO was discontinued; typically, when ECMO is discontinued when the patient had no hope for survival, parents would be present at the time extracorporeal blood flow was stopped; in this case, because organs were being harvested in the OR, the parents were not present; after removal of donor organs, the incisions were closed “sloppily”; however, the cannulas from the ECMO circuit were still in place in the child’s neck; no surgeon would remove them, so the body was transferred to the morgue; the author was disappointed at what had transpired; he reiterated the preferred term, procurement, instead of harvesting)

(the author documented the evolution of names for those who operated perfusion equipment and even the name of the society that began in 1964 as the “American Association of Pump Oxygenator Technicians” to the American Society of ExtraCorporeal Technology (AmSECT) in 1968; the change from technician to technologist was an attempt to gain recognition and acceptance from the medical establishment; in 1977, the American Medical Association recognized the extracorporeal technologist as an allied health professional; perfusionist Bennett Mitchell is credited with using the word perfusionist, first in 1967 in an issue of AmSECT News when he was chairman of the Atlantic Northeastern region; the word was also used in the sixth annual meeting of AmSECT held in San Francisco in 1968; it appeared in the Dec 1968 issue of the J ExtraCorp Technol; by the early 1970s, the name perfusionist was widely accepted, and the certification of clinical perfusionists (CCP) by the American Board of Cardiovascular Perfusion further solidified its use)