You might find the lady above familiar.

In celebration of SingHealth’s Allied Health Professionals (AHP) Day in March, she was featured on the lift stickers at the patient and visitor lift doors at NHCS as well as on collaterals seen all over SGH Campus.

Meet Me Me Hnin Khine, a Perfusionist.

The coolest thing about her job? Me Me counts the Operating Theatre (OT) as her office, and the heart-lung machine, her workstation.

Up until 2015 when she was in her final year at the National University of Singapore where she was majoring in Life Sciences, Me Me has never heard of the Perfusion profession, much less considered it a career choice.

Currently into her third year at NHCS, Me Me is one of just 50 specialists in the niche community of Perfusionists in Singapore. The young and affable lady tells us more.

How did you become a Perfusionist? You mentioned you have never heard of this field.
I have always liked sciences and imagined myself working in a hospital, but where, I don’t know! One day, I came across a job advertisement by NHCS, googled ‘Perfusionist’, thought to myself ‘how interesting!’ and applied for the position.

I still remember on the very same day of my interview, the Perfusionist who interviewed me, brought me to the OT to show me where I would be working if I were to join them. I guess they were trying to be very realistic about the job expectations and environment!

That must have given you a reality check. Anyway, your job sounds cool. Do tell us what a Perfusionist does exactly?
During cardiovascular surgeries, the surgeon has to stop the patient’s heart and lungs from functioning in order to perform the procedure. The patient is kept alive by a cardiopulmonary (heart- lung) bypass machine which delivers oxygenated blood throughout the patient’s body. Perfusionists are the group of Allied Health Professionals who operate this machine.

NHCS Perfusionists with heart-lung machine
(L-R) Senior Perfusionist, Maggie, guiding Me Me on the cardioplegia (a drug used to temporarily stop cardiac activity) delivery dosage to the patient.

We also handle the balloon pump, mainly used to provide support to patients with poor heart function pre- and/or post-operation. If a patient needs extra support, we will then come in with the extracorporeal membrane oxygenation (ECMO) machine. The ECMO is like a smaller heart-lung machine that provides respiratory and cardiac support to critically ill patients.

During a surgery, if there is heavy blood lost, Perfusionists can also help to salvage, clean and transfuse the blood back to the patient using a machine known as a cell saver.

We understand that there is no formal education in Perfusion studies. Where do you acquire your knowledge then?
Upon joining NHCS, I was paired with my mentor, Maggie Cheah, a Senior Perfusionist, to undergo on-the-job training for the next two years. It was an extremely steep learning curve, particularly in the first few months.

Thankfully, my mentor has been very patient. She guided and imparted to me, all the necessary skills and knowledge needed to become competent in my job. During the period, Maggie was always beside me for most operations that I was involved in. Since January 2018, I have completed my two-year training and have been doing cases independently.
NHCS Perfusionists
It is essential for Perfusionists to keep themselves up-to-date on Perfusion practices and literature.

What has been the most challenging aspect of the job so far?
On average, the duration of an elective operation is about six hours. While handling the heart-lung machine, Perfusionists have to constantly observe the patient’s haemodynamics and be on our toes for any changes. I had encountered a complex case which took almost 24 hours to complete! So yes it can get physically and mentally draining.

In addition, the heart-lung machine is also pretty heavy. On days when we have multiple surgeries, pushing the machine in and out of the OT can be rather taxing.

Besides adult patients, we are also involved in paediatric cases at KKH. Working with young children can be very challenging – not only are they smaller in body size, the machines and tubings are comparatively way smaller as well. Our work must be very precise and no mistakes are allowed. Due to the complexity of these surgeries and the low volume we are exposed to, I will still be attached to a senior for paediatric cases. It would be a dream come true if I can run my own case one day.

What’s next for you?
Once we accumulate enough experience, typically around the five-year mark, we will undergo certification by the Australian and New Zealand College of Perfusionists (ANZCP), the peak regulatory body representing accredited Perfusionists. The certification comprises a series of modules and continuous assessments, and takes about two years to complete.

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When asked what gives her the most satisfaction in her work, Me Me shared that she has had patients whom she thought could not pull through but when she saw how they were cared for by their family throughout the recovery journey and eventually recovered well, it warmed her heart. She added that it is the smiles and caring gestures of the family that put a smile on her face (beneath her mask that is!) and make her feel that her efforts put in are all worthwhile.