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A Collection of ALL TIME Graphics
This Blog & It’s Stunning Art Maps out the intricacies of Open Heart Surgery, and openly engages the peaks and valleys of surgical, ethical, or moral-successes & failures. It highlights moments where lives are saved by the strength of the character of the team- as well as surgical strategies undone by flaws imbued in the…
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Excerpt: Basketball & Heart Surgery
And that’s my life, that’s my chessboard. An old playground, made up from, and used up by… a lot of souls that have their own shots to make, and their own goals to defend. A metaphor for my life in the future I guess, a lot of unmet challenges with unnamed players and unfamiliar playing…
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Excerpt: A Foward from LVAD 1
It is ironic that Frank calls me a hero, where he and all perfusionists are the real heroes… perhaps we all are heroes, the way a Bull Rider straps to a bull and completes his or her 8 second ride.
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Excerpt: Epiphany
My immediate mission was to go from nursing station to nursing station, on all four hospital floors, pick up their trash, and shove it down an old garbage/linen chute, and later go to the sub-basement and burn it all in a furnace room that looked like the gateway to hell. It probably did have “Dante”…
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We Are Growing !
Not too bad.. 67 Countries and counting. We are establishing a very good sized readership. The book shall be released this Summer 2025- Thankyou for your encouraging words and support- Frank
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Excerpt- “Let’s go on Sucker Bypass!”
A shower of betadine hits the patient’s chest like a like a firemen’s bucket parade- dousing a fire, surgical drapes are thrown down, lines are passed off and divided, chest or femoral incisions are made, patient is heparinized and when that ACT hits 350 seconds? We are going on bypass Baybee!
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PerfusionART: “PluggedIN”
PerfusionART: “ PluggedIN ” Photographer: Frank Aprile, CCP, BBA, LP Equipment: IPhone 15+ Editing: Photoshop, Correll Paintshop Narrative: A Different Perspective on our Tethers Time & Place: 2024- Somewhere South of Hudson Bay About The Artist: CCP Commentary: All About Life Lines… 🙂
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We Call them HEROES: An American Heart Team in Ukraine…
“Pensiveness best describes the scene, as we swirl our glasses watching the foam tumble down the side of the glass and picking at a cold piece of pizza. We all know what is coming but none of us know what to expect.”
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A Day in the Life… [And Then Comes Sunday]
![A Day in the Life… [And Then Comes Sunday]](https://tipsofspears.com/wp-content/uploads/2026/03/cce64-img_9305b-1.jpg?w=1024)
24 Hours… of ECMO Jesse struggles to do a stretch during a therapy session with occupational therapist Megan Taylor on Tuesday, June 12, 2011. (Miranda Grubbs/ Lubbock Avalanche-Journal) Click Image Above to View Video Interview… The End and a new beginning This is the culmination of Jessie’s story. His life is a new chapter now,…
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A Day In The Life… [5]
![A Day In The Life… [5]](https://tipsofspears.com/wp-content/uploads/2026/03/79f7b-img_57521.jpg?w=688)
My bud Ashley just looks at me like I’m some sort of freak, as I have a full bag of Bugles opened next to my coffee, and an undisclosed meal in a McDonald’s bag.
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A Day In The Life… [4]
![A Day In The Life… [4]](https://tipsofspears.com/wp-content/uploads/2026/03/f8c7f-xray1.jpg?w=603)
Every once in awhile comes a seminal moment. That epiphany we are all gifted to encounter once in a while during our clinical lives, that moment of clarity when the clouds part a bit, and you can see blue sky and a distant shore. That was the drama of this morning’s CXR.
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A Day In The Life… [3]
![A Day In The Life… [3]](https://tipsofspears.com/wp-content/uploads/2026/03/79fa5-img_801311.jpg?w=768)
Low flows = the potential for stasis of blood flowing through the circuit, which in turn can lead to greater susceptibility for clot formation in the oxygenator or extracorporeal circuit.
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A Day In The Life… [2]
![A Day In The Life… [2]](https://tipsofspears.com/wp-content/uploads/2026/03/e2591-img_9305b.jpg?w=1024)
We found ourselves in the midst of a campaign to get “negative” (in other words- take off more fluid in total, than the 4 liters the patient had received during the initial stages of the ECMO run). And as of tonight, we were starting to win that particular little battle.
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A Day In The Life… [1]
![A Day In The Life… [1]](https://tipsofspears.com/wp-content/uploads/2026/03/bfb18-jesse.jpg?w=600)
24 hours to the finish line, and all you can do is just hope you don’t trip and fall. That pretty much sums up this ECMO run. Just trust your feet, and don’t lose sight of the goal…
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Salient Quips- From the Surgeon’s Lips
“Taken out of context- and without knowing the people in the discussion- the quotes themselves are intriguingly odd and non-sequitor.” Editor’s Note: Over several Years I have been collecting a few odd catch phrases or comments being tossed around during the course of open-heart surgery. It made me think of all the terms we use…
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To Alma Public Schools: Veteran’s Day, 2023
Presented By: Frank Aprile, HM2, USN Length of Service: 4.7 years / Honorable Discharge Stationed: Navy Medical Regional Center, San Diego CA Camp Pendleton Marine Corps Base, Ocean Side California U.S. Naval Hospital Emergency Room, Subic Bay, Republic of the Phillipines Operating Room Technical School, Navy Regional Medical Center: Bethesda, MD Naval Hospital, Charleston, SC Dedication: SOMETIMES…
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Excerpt: TipsOfSpears: Epiphany
Editor’s Note: A casual preview of the upcoming book: The Tips Of Spears Epiphany As a junior in High School, I needed to find a way to make money, as it wasn’t going to be coming from an allowance or stipend from my mom or dad. Being in a university town, that prospect wasn’t going…
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Perfusion Art: A COMET’s Tale
Perfusion Art: “A COMET’s Tale” Photographer: Frank Aprile, CCP, BBA, LP Equipment: IPhone 13+ Editing: Photoshop, Correll Paintshop Narrative: Hostile Environment V Patient Abandonment Time & Place: 2023- Somewhere West of the Nova Scotia Deluge About The Artist: CCP Commentary: Looks Bleak TBH 🙂 ___________________________________
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Paper Tigers… Or a Legitimate Code of Ethics?
Editor’s Note: This is Not beating a dead horse after all- I think it’s pretty clear that it is certainly pretty inanimate and lifeless at this point- right? So it stands to reason that a dead horse obviously cant feel the frustration being laid upon it. But it still remains right there there in front…
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Reversing Your Code of Conduct: A Dialogue on Pumping With Your Oxygenator in Reverse
Editor’s Note: Perfusion is a dicey proposition when placing a patient on Cardiopulmonary Bypass. A lot of moving parts, a lot of equipment, a lot of potential for failure. Going on bypass is a very critical moment, similar to when an airplane lifts off. A lot of decisions and observations interplay simultaneously to either establish…
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A Locum’s ScrapBOOK: Hospitals 59, 60 & 61
_____________ Editor’s Note: Typically, I don’t combine three clinical sites into one story, but in this case- due to the calamity of the times this journey from the West coast to a pair of separate hospitals on the East coast remains a story inextricably intertwined. Hospital 59 – was in LA and is sort of…
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A Locum’s ScrapBOOK: Changing Faces
First a shout out- to a couple of very special people that helped me when it was clear I was kinda down and out for the count. Bryan and Kristy you know who you are 🙂 Thank YOU! I typically stray away from sharing any aspect of what motivates me- or causes me to totally…
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Perfusion Policies 101: Agatroban
Editor’s Note: Well it was one of those mornings where you are driving into work to do a routine cell saver case when all of a sudden your phone blows up and you are getting calls from the hospital operating room desk as well as several colleagues trying to figure out what is going on…
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88% of Female Respondents Claim a Hostile Work Environment in the CV Surgery Arena! # Perfusion2 Survey Results
Editor’s Note: Over the past few months, putting this survey together and constantly poking and prodding on social media to suggest participation- had certainly made me think whether or not “it was over the top” or “overly sensitive”- or a “grow a pair” (which is in-and-of-itself completely misogynistic) – and it certainly made me question…
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Our O.R. Work Environment is 3.5 x UNHEALTHIER than the American Business Sector!
Editor’s Note: Over the past few months, putting this survey together and constantly poking and prodding on social media to suggest participation- had certainly made me think whether or not “it was over the top” or “overly sensitive”- or a “grow a pair” (which is in-and-of-itself completely misogynistic) – and it certainly made me question…
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Plz Take This Survey: #PerfusionToo!
Editor’s Note: I have been in medicine my entire life. Janitor-Crisis Center Volunteer-EMT-Navy Hospital Corpsman-Surgical Scrub Tech-1st Assistant-Perfusionist. That covers a few decades, 60+ hospitals, and a lot of medical professionals to meet, greet, and work with. Obviously, with that sort of exposure, you see a lot of things, and colleagues share their thoughts, feelings,…
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A Locum’s ScrapBook: Sometimes… The Bear Gets YOU…
Editor’s Note: Just when you get to the comfort zone of thinking “you are pretty good”? You find out you’re pretty NOT! But don’t get knocked down and NOT get back up. Shit happens, and it happens to all of us. To view the entire “Locum’s ScrapBook” series- click here Sometimes… The Bear Gets YOU… As in everything in…
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What Doesn’t Kill You Makes You Stronger…
The take home message on this is that I believe in Miracles– And we could use a few of those- so never give up. That’s a shout out to: Our Staff: Our Patients: Patient Families: Our Families _____________ How did I get Here? So I found myself driving South of the Ohio River once again to head back to Daniel Boone country,…
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What is It that We Do?
Perfusion 101 If you were wondering what a perfusionist is, basically it can be summed up as “we stop your heart to keep you alive”, an almost paradoxical statement for a profession so few realize even exists. As the title on the cover says, this is a book on open heart surgery in America, and…
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Hello World :)
This is a new blog designed to connect our perfusion community as a whole (domestic as well as international) to one another. It has no agenda, other to educate and to share some of the exciting principals, stories, technologies that we as perfusionists all around the globe- utilize and deliver every day. This book is…
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The Tips of Spears... 