Cardiac Ultrasound Technologist

The Cardiac Sonographer has the task of capably and reliably evaluating a complex intricately moving three-dimensional vital organ - the heart - using the two-dimensional modality of ultrasound. It is crucial that the sonographer has a thorough comprehension of cardiac pathology in order to recognize and distinguish abnormal pathologies from normal and a complete understanding and familiarity of the intricate computer-driven sonography system to capture the necessary digital images for the cardiologist to make the proper determination for the patient. As it is the examination and evaluation of a moving dynamic organ, the echocardiogram is very operator-dependent, and a great responsibility is placed on the sonographer to present the physician with a thorough examination in order for the physician to properly treat the patient.

The Cardiac Sonographer is responsible for participating in daily operations of the Echocardiography Laboratory, including patient scheduling, equipment maintenance, and the report of equipment failures and quality assessment (QA).

ESSENTIAL FUNCTIONS

• Performs clinical assessment and diagnostic echocardiography examinations such as M-Mode, two-dimensional, Doppler, and Color Doppler Echocardiography, Exercise Stress Echocardiograms, and Dobutamine Stress Echocardiograms.
• Uses cognitive sonographic skills to identify, record, and adapt procedures as appropriate to anatomical, pathological diagnostic information, and images.
• Understands basic and complex hemodynamics. Possesses an understanding of wall motion abnormalities.
• Uses technical ability to properly position patients, angulate the transducer, and optimally adjust machine controls, gain settings, and frequency of different machine types to provide the best resolution and cardiac ultrasound images possible.
• Performs accurate and thorough measurements and calculations including wall thickness, chamber size, valve orifice, blood velocity measurements, and pressure gradients across valve orifices.
• Obtains an appropriate patient medical history and maintains a clear understanding of the patient’s diagnosis and the goals and limits of each study. A thorough understanding of cardiac pathology is essential to assure that proper and complete data is recorded.
• Provides quality cardiac ultrasound examinations on a varied adult population including elderly patients, critical care units, and patients with complex congenital heart anomalies.
• Uses independent judgment during the cardiac ultrasound to accurately differentiate normal and pathologic findings.
• Explains the procedure to patients to allay anxiety and to elicit cooperation, maintaining a professional and friendly attitude.
• The sonographer’s daily workflow procedure is organized and efficient, reducing waiting time and exam time for the patients while still obtaining a complete and quality echocardiogram.
• Addresses problems of patient care as they arise and makes decisions to appropriately resolve the problems. Handles difficult patients and situations appropriately and competently.
• Assumes responsibility for the safety, mental, and physical comfort of patients while they are in the sonographer's care.
• Coordinates with other staff to assure appropriate patient care is provided.
• Appropriately follows the departmental Echocardiogram Protocol.
• Recognizes when the use of a contrast agent (e.g., Optison, Definity) and Agitated Saline is needed and obtains optimal images.
• Coordinates work schedule with Departmental Director and/or scheduling desk to assure workload coverage.
• Assists with the daily operations of the Echocardiography laboratory.
• Maintains a daily log of patients seen.
• Maintains ultrasound equipment and work area and maintains adequate supplies.
• Evaluates equipment malfunctions and speaks with the appropriate equipment representative. Reports equipment failures to the appropriate supervisor or staff member.
• Participates in the maintenance of laboratory accreditation.
• Establishes and maintains ethical working relationships and good rapport with all interrelating hospitals, referral or commercial agencies.
• Provides in-service ultrasound training for the Cardiology Fellows and junior sonographers.
• Performs all requested cardiac ultrasounds as ordered by the attending physician: Outpatient, Inpatient, Portable, and Urgent ultrasounds.
• Participates in research studies which may include performing cardiac ultrasound on animals, imaging various vascular structures (e.g., brachial artery and carotid artery), in addition to performing any aspect of cardiac ultrasound.
• Possesses an interest and is active in the field of echocardiography and in the studies performed.
• Identifies patient by checking arm bands and/or asking patient to confirm name, DOB, and test to be done.
• Complies with infection control policies/procedures at all times.
• May take precept/charge as needed.
• Performs other work-related duties as assigned.

• Completion of an Associate Degree in Biological Sciences or equivalent to comprehend and apply principles of physiology to cardiac disease.
• Graduate of a formal Diagnostic Medical Sonography Program or Cardiovascular Technology Program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) is preferred.
• Passing of the registry certification by American Registry of Diagnostic Medical Sonographers (ARDMS) in Adult Echocardiography and Physics or Registered Cardiac Sonographer (RCS) is anticipated during the first two years of employment.
• Registered sonographers must maintain an ‘active’ status by the ARDMS in Adult Echocardiography or RCS.
• Current compliance with ARDMS or RCS Continuing Medical Education (CME) requirements for registered sonographers. A minimum of 15 CME’s is required over a three-year period for sonographers who are not registered.
• In the absence of the minimum educational requirement, a sufficient amount of actual cardiac ultrasound work experience is acceptable.

• Ability to integrate diagnostic sonograms, laboratory results, patient history, and medical records, tailoring the echocardiogram as necessary.
• Ability to use independent judgment to acquire the optimum diagnostic sonographic information in each examination performed.
• Ability to communicate effectively with the patient and the healthcare team, recognizing the special nature of cardiac ultrasound examinations and patients' needs.
• Ability to establish and maintain effective working relationships with the public and healthcare team.
• Ability to follow established departmental procedures.
• Ability to work efficiently and cope with emergency situations.
• Ability to obtain optimal images on technically difficult patients.
• Possesses an understanding of basic and complex hemodynamics and wall motion abnormalities.
• Possesses knowledge of the ‘true’ two-dimensional imaging planes as they may change during a stress echocardiogram.
• Possesses the ability to progress to the next skill level.
• A sonographer must possess competency in performing all aspects of echocardiograms to perform Exercise and Dobutamine Stress Echocardiograms, obtaining the proper views. Skilled sonographers are essential due to the inherent risks of the procedure.

The employee must be physically capable of carrying out all assigned duties:

• Emotional and physical health sufficient to meet the demands of the position.
• Strength sufficient to lift some patients, move heavy equipment on wheels (up to approximately 500 lbs.), and to move patients in wheelchairs and stretchers.
• Ability to maintain prolonged arm positions necessary for scanning.

• Category I - Tasks involve exposure to blood, body fluids, or tissues.