My Working Day: Noel Lynch, a clinical perfusion scientist at the Mater Private, is so keen on his job that 18 years of service have flown by
I work as a clinical perfusion scientist which basically means I'm responsible for managing the heart lung bypass machine, the machine that replaces the heart and lungs during heart surgery. There are four of us here in the Mater Private and only around 25 in the State.
The operating theatre here usually runs from 8am to 8pm but as the Mater Private runs a 24-hour, seven-days-a-week heart surgery programme, it's quite normal to get a call as you're about to head home on a Friday evening, saying there's a sick patient on the way from Cork or Limerick for an operation. There always has to be a perfusionist fully on call.
First thing in the morning I check the operating list and see what operations I'm scheduled to look after. I then select the equipment and set it up, which involves priming it with the cocktail of drugs and fluids needed.
The surgeon attaches the machine to the patient using various tubes in the heart, and once he or she is happy, we start the machine.
The lungs are switched off and the heart is paralysed using a drug pumped from the machine. The machine then completely takes over the job of the heart and lungs for the duration of the operation.
We sit there while the surgeon works and monitor the patient's blood flow and blood pressure and ensure the machine is doing its job.
An average heart operation such as a triple bypass, where someone has three coronary artery bypass grafts done, would typically take about four hours from beginning to end. For about an hour and a half of that, the patient would be connected to the heart and lung bypass machine and I am in the driving seat, so to speak.
For the remainder of the time I would be in the room or at least very close by.
Auto-transfusion is another responsibility of ours, which is recycling patients' blood during operations where there is a lot of blood loss. I've done that on anything from major vascular surgery to operations involving Jehovah's Witnesses who have a religious objection to donor bloods.
We also look after and manage other life support equipment in intensive care such as intra-aortic balloon pumps and ventricular assist devices. These are pieces of equipment that would be attached to a patient with a particularly sick heart.
Part of our brief is to pop over once or twice a day to the patients involved, making sure everything is going according to plan and that the equipment is functioning properly.
One of the surgeons described perfusion accurately a few years ago when he said it was 99 per cent mundane, 1 per cent sheer terror. If your machine breaks down, it's the equivalent of four engines going in a Boeing 747 halfway across the Atlantic.
With the nature of what I do, you have to be able to think on your feet and if you have a problem, you need to be able to install a solution very quickly. I'm here 18 years now and the years have flown by. With perfusion, we're always trying to keep ahead of the field.
(In conversation with Danielle Barron)