<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".07" citation="COMAR 10.32.20.07" title_num="10" subtitle_num="32" chapter_num="20" heading="Scope of Practice.">
  <paragraph num="A.">
    <text>A licensed perfusionist may practice only under the supervision of a licensed physician.</text>
  </paragraph>
  <paragraph num="B.">
    <text>The scope of practice of a licensed perfusionist is performance of the functions necessary for the support, treatment, measurement, or supplementation of the cardiovascular, circulatory, or respiratory systems, or other organs to ensure the safe management of physiologic functions by monitoring and analyzing the parameters of the systems.</text>
  </paragraph>
  <paragraph num="C.">
    <text>The scope of practice of a licensed perfusionist includes the following special procedures, performed on the order of and under the supervision of a licensed physician:</text>
    <paragraph num="(1)">
      <text>Cardiopulmonary bypass for adult, pediatric, and neonatal patients;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Extracorporeal circulatory support for renal, neurological, hepatic, and vascular surgery;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Extracorporeal resuscitation;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Extracorporeal circulation for long-term support of failing respiratory or cardiac function;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Extracorporeal membrane oxygenation;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Extracorporeal carbon dioxide removal;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Myocardial protection;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Perfusion-assisted direct coronary artery bypass;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Hemofiltration and hemodialysis;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Anticoagulation and hemostasis monitoring, analysis, and intervention;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Thermal regulation;</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Blood gas and blood chemistry monitoring, analysis, and intervention;</text>
    </paragraph>
    <paragraph num="(13)">
      <text>Physiological monitoring, analysis, and intervention;</text>
    </paragraph>
    <paragraph num="(14)">
      <text>Administration of blood components and pharmaceuticals;</text>
    </paragraph>
    <paragraph num="(15)">
      <text>Administration of anesthetic agents through a heart lung machine at the direction of an anesthesiologist;</text>
    </paragraph>
    <paragraph num="(16)">
      <text>Ventricular assist device and mechanical circulatory support management;</text>
    </paragraph>
    <paragraph num="(17)">
      <text>Intra-aortic balloon counterpulsation;</text>
    </paragraph>
    <paragraph num="(18)">
      <text>Temporary pacemaker management;</text>
    </paragraph>
    <paragraph num="(19)">
      <text>Periodic flow augmentation therapy;</text>
    </paragraph>
    <paragraph num="(20)">
      <text>Autotransfusion;</text>
    </paragraph>
    <paragraph num="(21)">
      <text>Platelet gel production, autologous hemocyte tissue matrix production;</text>
    </paragraph>
    <paragraph num="(22)">
      <text>Nondifferentiated progenitor cell harvest bone marrow aspirate concentration;</text>
    </paragraph>
    <paragraph num="(23)">
      <text>Acute normovolemic hemodilution;</text>
    </paragraph>
    <paragraph num="(24)">
      <text>Isolated limb or organ delivery of chemotherapeutics, progenitor cells, gene therapy vectors, and other items;</text>
    </paragraph>
    <paragraph num="(25)">
      <text>Organ procurement and preservation;</text>
    </paragraph>
    <paragraph num="(26)">
      <text>Thermogenic lavage;</text>
    </paragraph>
    <paragraph num="(27)">
      <text>Electrophysiological analysis;</text>
    </paragraph>
    <paragraph num="(28)">
      <text>Therapeutic hyperthermia;</text>
    </paragraph>
    <paragraph num="(29)">
      <text>Intravascular membrane oxygenation; and</text>
    </paragraph>
    <paragraph num="(30)">
      <text>Renal perfusion.</text>
    </paragraph>
  </paragraph>
</regulation>