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I PASS THE CLAMP OFF

Patient Handoff Tool for Perfusionists

I Isolation precautions contact, droplet, airborne

P Patient name/Procedure
surgical approach, cannulation, backup plan,
target flows

A Age/Allergies
medications, adverse reactions, associated
risks

S Stage of the procedure


preoperative, perioperative, postoperative,
surgical status

S Status of temperature
target temperatures, current temperatures,
rewarming rate

T Transfusion blood type, targets, product use, availability

H History
symptoms, risk factors, diagnosis, prior
procedures, preoperative medications

E Equipment condition mechanical concerns or issues

C
oxygenator, tubing size and coating,
Circuit cardioplegia, shunts, hemoconcentrator,
accessories

L Lab values and targets


hematocrit, blood gasses, electrolytes,
enzymes, targets

A Anticoagulation
status, targets, heparin use, alternative
anticoagulants, blood components

M Medications
vasoconstrictors, vasodilators, cardioplegia,
electrolytes, antiarrhythmics, colloids

P Pump settings
FiO2, sweep, blood flow, vacuum, RPMs,
timers, shunts

O Other conditions or concerns


jehovah’s witness, sickle cell anemia,
pregnancy, sepsis, DIC

F Fluid status
I/Os, crystalloid use, ultrafiltrate amount
and rate, urine

F Final thoughts

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