2590-2596

BUSINESS AND PROFESSIONS CODE
SECTION 2590-2596




2590.  (a) For purposes of this section, "perfusion" means those
functions necessary for the support, treatment, measurement, or
supplementation of the cardiovascular system, circulatory system with
or without the oxygenation circuit, or any combination of those
activities, and to ensure the safe management of physiologic
functions by monitoring the necessary parameters of those systems
pursuant to an order and under the supervision of a licensed
physician and surgeon.
   (b) Perfusion services include, but are not limited to, all of the
following:
   (1) The use of extracorporeal circulation, cardiopulmonary support
techniques, and other ancillary therapeutic and diagnostic
technologies. "Extracorporeal circulation," as used in this section,
means the diversion of a patient's blood through a heart-lung machine
or a similar device that assumes the functions of the patient's
heart, lungs, or both.
   (2) Counterpulsation, ventricular assistance, autotransfusion,
including blood conservation techniques, myocardial and organ
preservation, extracorporeal life support, and isolated limb
perfusion.
   (3) The use of techniques involving blood management, advanced
life support, and other related functions.
   (c) Perfusion services also include, but only during the
performance of functions described in subdivision (b), the following:
   (1) The administration of pharmacological and therapeutic agents,
blood products, or anesthetic agents through the extracorporeal
circuit or through an intravenous line as ordered by a physician and
surgeon.
   (2) The performance and use of anticoagulation analysis,
physiologic monitoring, blood gas and chemistry analysis, hematocrit
analysis, hypothermia, hyperthermia, hemoconcentration, and
hemodilution. Nothing in this paragraph shall exempt perfusionists
from the requirements of Chapter 3 (commencing with Section 1200),
including, but not limited to, quality assurance and equipment
maintenance requirements.
   (3) The observation of signs and symptoms related to perfusion
services.
   (4) Making a determination whether the signs and symptoms related
to perfusion services exhibit abnormal characteristics.
   (5) Implementation, based on observed abnormalities, of
appropriate reporting, or perfusion protocols, or changes in
treatment regimen, pursuant to an order by a physician and surgeon,
or the initiation of emergency procedures. "Perfusion protocols" as
used in this section means perfusion-related policies and protocols
developed or approved by a licensed health facility or a physician
and surgeon through collaboration with administrators and health
professionals, including perfusionists.
   (d) Commencing January 1, 1993, no person shall hold himself or
herself out as a perfusionist, unless at the time of doing so the
person meets the educational and examination requirements specified
in subdivisions (e) and (f).
   (e) Except as provided in subdivision (f), persons holding
themselves out as perfusionists shall be graduates of a training
program described in Section 2592 and produce satisfactory evidence
of successful completion of the entire examination of the American
Board of Cardiovascular Perfusion, or its successor agency, or the
equivalent thereof if an equivalent is determined to be necessary by
the Division of Licensing of the Medical Board of California.
   (f) Any person may be deemed to have completed the equivalent of
the examination and education requirements if that person is
currently certified by the American Board of Cardiovascular
Perfusion, or if, as of January 1, 1993, the person has practiced as
a perfusionist and has annually performed a minimum of 40 cases of
cardiopulmonary bypass during cardiac surgery in a licensed health
facility and has done so for at least five years since January 1,
1987. For the purposes of this subdivision, "licensed health facility"
means a health facility licensed in any jurisdiction within the
United States.
   (g) In order to continue to use the title of "perfusionist," the
person shall complete the continuing education requirements of, or
maintain active certification by, the American Board of
Cardiovascular Perfusion, or its successor agency, or the equivalent
if an equivalent is determined to be necessary by the Division of
Licensing of the Medical Board of California.
   (h) Any person who violates this section is guilty of a
misdemeanor.



2591.  (a) After completion of an approved perfusion training
program, as defined in Section 2592, and until notification of
passage of the entire examination of the American Board of
Cardiovascular Perfusion, or its successor agency, that person shall
identify himself or herself only as a "graduate perfusionist."
   (b) The use of the title "graduate perfusionist" is valid for no
more than three years from the date of completion of an approved
perfusion training program.


2592.  (a) Except as otherwise provided in Section 2590, all persons
calling themselves perfusionists shall be graduates of an approved
perfusion training program.
   (b) For purposes of this article, an "approved perfusion training
program" means a training program in perfusion reviewed by the
Accreditation Committee on Perfusion Education and approved by the
Commission on Accreditation of Allied Health Education Programs or
its successor or the equivalent training program if an equivalent is
determined to be necessary by the Division of Licensing of the
Medical Board of California.



2593.  (a) During the period of any clinical training provided by an
approved perfusion training program, perfusion may be performed by a
student enrolled in the approved perfusion training program when
those services are part of his or her course of study.
   (b) A person enrolled as a student in an approved perfusion
training program shall be identified as a "student perfusionist" or
as a "perfusion intern."
   (c) During the period of any clinical training, a student
perfusionist or perfusion intern shall be under the direct
supervision of a perfusionist who has met all the requirements of
this chapter. For purposes of this section, "direct supervision"
means assigned to a perfusionist who is on duty and immediately
available in the assigned patient care area.



2595.  Nothing in this chapter shall limit, preclude, or otherwise
interfere with the practices of other persons licensed or otherwise
authorized to practice under this division in performing perfusion
services consistent with the laws governing their respective scopes
of practice. None of the activities described in subdivisions (b) and
(c) of Section 2590, including, but not limited to, extracorporeal
life support, shall be construed to be exclusively perfusion
services, but may be performed by other licensed persons when
consistent with their respective scopes of practice.



2596.  It is the intent of the Legislature that authority be
reserved to the Division of Licensing of the Medical Board of
California to adopt examination, continuing education, and training
standards for perfusionists, with appropriate consultation, in the
event that existing standards of the American Board of Cardiovascular
Perfusion or the Accreditation Committee on Perfusion Education of
the Committee on Allied Health Education and Accreditation of the
American Medical Association prove inadequate after an appropriate
trial period of at least three years.