This is a prototype of the CO2 flushing process. Refer to the CO2 Flushing document provided by the instructor for more information.

Overview

Phase 1: Set up

• Perform hand hygiene
• Attach bacterial air filter to the perfusion adapter on the CO₂ tank
• Ensure three-way stop cock open to circuit.
• Using aseptic technique, connect the bacterial air filter to the arterial line pressure isolator three-way stop cock
• Ensure three-way stop cock is open to circuit
• Set the CO₂ to 6 LPM

Phase 2: Oxygenator, Pump, and Reservoir Flush

Direct CO₂ retrograde through the Oxygenator

• Clamp AV loop

Isolate flow to oxygenator -> pump -> reservoir only

• Clamp blood cardioplegia 1/4" line
• Clamp all 1/4' recirculation lines
• Close manifold
• Close oxygenator pre-membrane de-airing purge line
• Allow 2 minutes of CO₂ flushing.

Phase 3: AV Loop Flush

Direct CO₂ to AV Loop

• Move clamp distal to where CO2 entry point on arterial line
• Allow 30-45 seconds flushing
• Return the clamp to proximal position on the arterial line

Phase 4: Cardioplegia Circuit Flush

Direct CO₂ to Cardioplegia via Oxygenator

• Remove blood cardioplegia clamp and apply to oxygenator inlet
• Allow 1 minute of CO₂ flushing

Phase 5: Air Purge

• Using aseptic technique, loosen caps on cardioplegia lines to purge air (~ 15 seconds)
• Re-secure caps

Phase 6: Final Flush & Re-establish Circuit

• Open oxygenator pre-membrane de-airing purge line
• Open manifold
• Remove all 1/4" recirculation line clamps
• Remove oxygenator inlet clamp
• Remove arterial line clamp

Phase 7: Completion

• Turn off CO₂, and fully close tank regulator
• Remove and discard bacterial filter
• Aseptically recap three-way stopcock with sterile cap