AI in High-Acuity Surgery and Critical Care
AI in Perfusion, Surgery, and Critical Care is the first clinical governance document for artificial intelligence in high-acuity medicine. Written by a Certified Clinical Perfusionist with 20 years of clinical experience across cardiac surgery, extracorporeal membrane oxygenation, normothermic regional perfusion, and transplant medicine at 24 hospitals.
The governance framework in this book applies to every surgical specialty, every critical care environment, and every hospital deploying AI tools in clinical settings. The clinical examples are drawn from cardiac surgery and ECMO — the highest-acuity, highest-consequence clinical environments in medicine. If the governance framework is sufficient for those environments, it is sufficient for yours.
What's inside — 14 chapters, foreword, and 3 appendices:
Foreword — The fabricated citation that started this book.
Chapter 1 — How AI actually works. What a large language model is, what it is not, and why confidence is not accuracy.
Chapter 2 — What AI is trained on. The knowledge cutoff, the corpus bias, and what your AI tool does not know about the most recent clinical guidelines.
Chapter 3 — The data you are giving away. Combination identification, the secondary data market, and what happens to clinical queries after they leave your device.
Chapter 4 — HIPAA was not written for this. The seven statutory gaps that leave clinical AI data legally unprotected. The six legislative fixes required to close them.
Chapter 5 — AI at the pump and in the OR. The Red/Yellow/Green framework for what AI can and cannot safely do in cardiac surgery, ECMO, and high-acuity clinical environments.
Chapter 6 — Hallucinations, anchoring, and clinical risk. The fabricated citation problem. The five-step citation verification protocol every clinician needs before acting on AI output.
Chapter 7 — Bias in the machine. What demographic underrepresentation in training data means for vulnerable patient populations and high-risk surgical cases.
Chapter 8 — AI and the clinical record. Documentation liability, attestation requirements, and how AI involvement in clinical decisions will be argued in future litigation.
Chapter 9 — Building an institutional AI governance framework. The governance committee, the four-gate tool approval pathway, the acceptable use policy, vendor contract requirements, and ongoing surveillance.
Chapter 10 — What acceptable use looks like. The pre-query checklist, the de-identification standard, the output verification protocol, and when to close the app and call a colleague.
Chapter 11 — The ECMO-specific AI problem. Why the highest-acuity extracorporeal support environment is the highest-risk AI deployment environment in medicine.
Chapter 12 — Where this is going. AI in hemodynamic monitoring, AI-integrated surgical devices, and the clinician's professional role in an AI-enabled environment.
Chapter 13 — A framework for advocacy. Federal standards, legislative asks, society actions, and what individual clinicians can do today.
Chapter 14 — When AI fails. Documented lawsuits, adverse events, cybersecurity breaches, and firsthand accounts of the privacy failures happening in clinical settings right now.
Three appendices — ready to implement:
Appendix A — AI Risk Taxonomy for High-Acuity Medicine. Five risk domains, 16 risk classes, and governance implications for each.
Appendix B — BAA and Vendor Due Diligence Checklist. Four gates with specific evaluation criteria for legal review, IT security, clinical validation, and policy integration.
Appendix C — Institutional AI Governance Policy Template. Complete and ready to adapt. A review by qualified health law counsel is recommended before institutional adoption.
Who this book is for:
Certified Clinical Perfusionists. ECMO specialists and coordinators. Cardiac surgeons, anesthesiologists, and OR teams. ICU physicians and critical care nurses. Hospital CMOs, compliance officers, and risk managers. Legal professionals handling AI-related healthcare litigation. Professional society leaders are developing clinical AI position statements.
If you work in a high-acuity clinical environment and AI tools are available to your team, this book is for you.
$89.99.
Less than one hour of legal consultation. Less than one malpractice deposition. Less than one HIPAA settlement.
You cannot afford to ignore it.
Format: Digital download — Microsoft Word DOCX. Compatible with Word, Google Docs, and Pages.
Institutional licensing available for hospitals, perfusion staffing organizations, surgical programs, and professional societies. Contact centralcoastperfusion@gmail.com for institutional pricing.
© 2026 Central Coast Perfusion LLC — centralcoastperfusion.com
For educational purposes only. Not legal advice. Verify all regulatory citations against current primary sources before institutional application.