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This chapter describes the procedure for setting up the cardiopulmonary bypass (CPB) system and the safety checks that should be undertaken before embarking on a case. Preparing the CPB circuit and machine, attention to the patient's clinical details and the surgical requirements for the procedure all form part of the process of safe provision of CPB. Most operating rooms have an uninterruptible power supply (UPS), essentially a series of batteries linked to the hospital generator that powers the CPB machine, anesthetic machine, intravenous infusion pumps and other vital equipment should there be a mains power failure. The bubble detector is coupled to the CPB machine console so that if air is sensed in the arterial line an alarmed automatic pump cut out facility is activated. The format of the CPB checklist is either written or automated and best signed off by two perfusionists.