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Cardiovascular Technologists and Technicians - What They Do

Cardiovascular technologists and technicians assist physicians in diagnosing and treating cardiac (heart) and peripheral vascular (blood vessel) ailments.

Cardiovascular technologists and technicians schedule appointments, review physicians' interpretations and patient files, and monitor patients' heart rates. They also operate and care for testing equipment, explain test procedures, and compare findings to a standard to identify problems. Other day-to-day activities vary significantly between specialties.

Technologists may specialize in different areas of practice: invasive cardiology, non-invasive—which includes echocardiography—or vascular technology. Technicians specialize in electrocardiograms and stress testing.

Invasive cardiology. Cardiovascular technologists specializing in invasive procedures are called cardiology technologists. They assist physicians with cardiac catheterization procedures in which a small tube, or catheter, is threaded through a patient's artery from a spot on the patient's groin to the heart. The procedure can determine whether a blockage exists in the blood vessels that supply the heart muscle or help to diagnose other problems. Some of these procedures may involve balloon angioplasty, which can be used to treat blockages of blood vessels or heart valves without the need for heart surgery. Cardiology technologists assist physicians as they insert a catheter with a balloon on the end to the point of the obstruction. Catheters are also used in electrophysiology tests, which help locate the specific areas of heart tissue that give rise to the abnormal electrical impulses that cause arrhythmias.

Technologists prepare patients for cardiac catheterization by first positioning them on an examining table and then shaving, cleaning, and administering anesthesia to the top of their leg near the groin. During the procedures, they monitor patients' blood pressure and heart rate with EKG equipment and notify the physician if something appears to be wrong. Some cardiology technologists also prepare and monitor patients during open-heart surgery and during the insertion of pacemakers and stents that open up blockages in arteries to the heart and major blood vessels.

Noninvasive technology. Technologists who specialize in echocardiography or vascular technology perform noninvasive tests. Tests are called “noninvasive” if they do not require the insertion of probes or other instruments into the patient's body. For example, procedures such as Doppler ultrasound transmit high-frequency sound waves into areas of the patient's body and then processes reflected echoes of the sound waves to form an image. Technologists view the ultrasound image on a screen and may record the image on videotape or photograph it for interpretation and diagnosis by a physician.

Echocardiographers. Technologists who use ultrasound to examine the heart chambers, valves, and vessels are referred to as cardiac sonographers, or echocardiographers. They use ultrasound instrumentation to create images called echocardiograms. An echocardiogram may be performed while the patient is either resting or physically active. Technologists may administer medication to physically active patients to assess their heart function. Cardiac sonographers also may assist physicians who perform other procedures.

Vascular technologists. Technologists who assist physicians in the diagnosis of disorders affecting the circulation are known as vascular technologists or vascular sonographers. Vascular technologists complete patients' medical history, evaluate pulses and assess blood flow in arteries and veins by listening to the vascular flow sounds for abnormalities, and assure the appropriate vascular test has been ordered. Then they perform a noninvasive procedure using ultrasound instruments to record vascular information such as vascular blood flow, blood pressure, oxygen saturation, cerebral circulation, peripheral circulation, and abdominal circulation. Many of these tests are performed during or immediately after surgery. Vascular technologists then provide a summary of findings to the physician to aid in patient diagnosis and management.

Cardiographic technicians. Technicians who specialize in electrocardiography, or EKG, stress testing, and perform Holter monitor procedures are known as cardiographic or electrocardiograph (or EKG) technicians.

Technicians take EKGs, which trace electrical impulses transmitted by the heart, attach electrodes to the patient's chest, arms, and legs, and then manipulate switches on an EKG machine to obtain a reading. An EKG is printed out for interpretation by the physician. This test is done before most kinds of surgery or as part of a routine physical examination.

EKG technicians with advanced training perform Holter monitor and stress testing. For Holter monitoring, technicians place electrodes on the patient's chest and attach a portable EKG monitor to the patient's belt. Following 24 or more hours of normal activity by the patient, the technician removes a tape from the monitor and places it in a scanner. After checking the quality of the recorded impulses on an electronic screen, the technician usually prints the information from the tape for analysis by a physician. Physicians use the output from the scanner to diagnose heart ailments, such as heart rhythm abnormalities or problems with pacemakers.

For a treadmill stress test, EKG technicians document the patient's medical history, explain the procedure, connect the patient to an EKG monitor, and obtain a baseline reading and resting blood pressure. Next, they monitor the heart's performance while the patient is walking on a treadmill, gradually increasing the treadmill's speed to observe the effect of increased exertion. Like vascular technologists and cardiac sonographers, cardiographic technicians who perform EKGs, Holter monitoring, and stress tests are known as “noninvasive” technicians.

Work Environment
Cardiovascular technologists and technicians spend a lot of time walking and standing. Heavy lifting may be involved to move equipment or transfer patients. Those who work in catheterization laboratories may face stressful working conditions because they are in close contact with patients with serious heart ailments. For example, some patients may encounter complications that have life-or-death implications.

Some cardiovascular technologists and technicians may have the potential for radiation exposure. However, exposure is kept to a minimum by strict adherence to radiation safety guidelines, such as wearing heavy protective aprons while conducting certain procedures. In addition, those who use sonography can be at an increased risk for musculoskeletal disorders such as carpel tunnel syndrome, neck and back strain, and eye strain. However, greater use of ergonomic equipment and an increasing awareness will continue to minimize such risks.

Technologists and technicians generally work a 5-day, 40-hour week that may include weekends. Those in catheterization laboratories tend to work longer hours and may work evenings. They also may be on call during the night and on weekends. About 18 percent worked part-time in 2008.

Education & Training Required
The majority of cardiovascular technologists, vascular technologists, and cardiac sonographers complete a 2-year junior or community college program resulting in an associate degree. However, 4-year programs are increasingly available. The first year is dedicated to core courses and is followed by a year of specialized instruction in either invasive cardiovascular, noninvasive cardiovascular, or noninvasive vascular technology. Those who are qualified in an allied health profession need to complete only the year of specialized instruction.

The Commission on Accreditation of Allied Health Professionals (CAAHEP) accredits cardiovascular technology education programs. In January 2009, there were 34 accredited programs. Similarly, those who want to study echocardiography or vascular sonography may also attend CAAHEP-accredited programs in diagnostic medical sonography. In 2009, there were 168 such accredited programs. Those who attend these accredited programs are eligible to obtain professional certification.

Unlike most other cardiovascular technologists and technicians, most EKG technicians are trained on the job by an EKG supervisor or a cardiologist. On-the-job training for EKG technicians usually takes about 4 to 6 weeks. Most employers prefer to train people already in the healthcare field—nursing aides, for example. Some EKG technicians are students enrolled in 2-year programs to become technologists, working part time to gain experience and make contact with employers. For technicians who perform Holter monitoring on-the-job training may last around 18 to 24 months. One-year certification programs also exist for basic EKGs, Holter monitoring, and stress testing and can be an alternative to on-the-job training.

Certifications Needed (Licensure)
Credentialing is voluntary. However, it is the professional standard and most employers require credentialing. Credentialing for cardiovascular technologists is available from Cardiovascular Credentialing International (CCI) and the American Registry of Diagnostic Medical Sonographers (ARDMS). Most credentials require that technologists complete an accredited education program to qualify to sit for credentialing examination. Continuing education is required in most cases to maintain certification. For specific requirements, contact the credentialing body.

Other Skills Required (Other qualifications)
Cardiovascular technologists and technicians must be reliable, have mechanical aptitude, and be able to follow detailed instructions. A pleasant, relaxed manner for putting patients at ease is an asset. They must be articulate as they must communicate technically with physicians and also explain procedures simply to patients.

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