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Re: A response to the discussion in the July 2011 Cath Lab Digest regarding the registered cardiovascular invasive specialist (RCIS) credential (available at http://tinyurl.com/WDYT-RCIS).
First of all, congratulations to Kory Briggs for taking and passing the RCIS exam. You are now a member of an organization that recognizes you as a cardiovascular professional fully capable of working in any capacity within the cardiac cath lab. Not only are you recognized by Cardiovascular Credentialing Inc (CCI), but the Society of Invasive Cardiovascular Professionals (SICP) has stated on their website and in their literature that the American College of Cardiology (ACC) and the Society for Cardiovascular Angiography and Interventions (SCAI) also recognize the RCIS as the credential of choice for those working in the cardiac cath lab environment.
As a non-radiological technologist working in the cardiac cath lab for the last 16 years, I too initially felt like you, a “second-class” component of a highly specialized team of professionals, who were trusted to care for individuals with cardiovascular disorders. I am not familiar with your particular background, but I came into the lab with 15 years of experience working as a paramedic and educator, and had a high level of confidence in my skills and ability to care for patients in any setting. My first few years in the cath lab were challenging, not being a registered radiologic technologist (RT[R]). My feeling was there were concerns over a non-radiological technologist being hired in a technologist position and we certainly had to work through that. As my passion to learn was recognized, my utilization within the lab became more substantial and I was able to integrate myself in many ways as a more valuable part of the team. I also took and passed the registered cardiovascular specialist assistant (RCSA), RCIS, and registered cardiac electrophysiology specialist (RCES) exams. With the exception of my initiation in the cath lab, I have not, for one minute, felt that an RT(R) was any more valuable to that team than I. Now, as far as Brandon McDonnell, RT(R)(CV)’s comments, he is correct in that most states currently require a radiologic technologist or an exempt health care professional to deliver radiation to a patient. Kory, as you have done by taking the RCIS exam, so should other radiologic technologists working in the cardiac cath lab to determine their level of competency to function as a cardiovascular technologist. From the standpoint of radiological services, utilization of the radiological technologist in today’s cath lab environments has been diminished in terms of being able to deliver fluoroscopy by stepping on “the pedal.” Most imaging systems now have predetermined and or automatic settings that no longer require making individual changes to the delivery process, and we no longer process our own film. Many states have amended their regulations or laws, allowing for other health care providers to position the patient and pan the table, but not to deliver fluoroscopy. It is my understanding that SICP and CCI are both sponsors on the CARE Bill and there will be provisions for the RCIS if that bill is passed. That being said, it would be a federal law and not state law, so we will have to see how that plays out, if the bill is passed. I encourage you and other RCIS activists to read the September 2011 Cath Lab Digest article “Birth of a Cath Lab Law” (available online at www.cathlabdigest.com). The state of Washington just unanimously passed an amendment to the “Radiation Technologist Law” in their state that adds the Cardiovascular Invasive Specialist (CIS) as a new category in that law. Thanks to the incredible work of House Representative Dawn Morrell, RN, and many others, the RCIS is now an equal in the cardiac cath labs of the state of Washington. It is my hope that all states will follow suit and amend their regulations or laws recognizing the RCIS certification. So in conclusion, Kory, keep doing what you are doing, find the right support, utilize your resources, and follow in the footsteps of House Representative Morrell and the state of Washington. The RCIS credential and working as a team member in the cardiac cath lab is something you should take pride in, knowing that what you do each day positively affects those afflicted with cardiovascular disease.
James H. Combs RCSA, RCIS, RCES, EMTP, Rockford Memorial Hospital
We are trying to collect data from cath labs about requirements for the circulator and whether cath labs require the circulator to wear a mask during regular angiographic/interventional procedures, including pacemaker implants. Any help would be greatly appreciated.
Roger Sadberry, Director Cath Lab/Day Patient/GI Lab, Bakersfield Heart Hospital, Bakersfield, CA
We have instituted the same standard for infection control as our main operating room. We have lined the doors with red tape inside the control rooms and on the outside perimeter (where patients enter the rooms). All case participants, including transport, are required to wear a cap and mask inside all labs. Caps and masks are required when instruments, supplies, procedure tables are opened. Parents accompanying minors also need to wear jumpsuit and mask.
Hope this helps!
Liza Vitturi, RN, MA, Administrative RN II, UCLA Interventional Cardiology & Electrophysiology Lab
Re: Tech-Only Cath Labs
Do any hospitals in the southeastern U.S. have cath labs with only cath techs doing cases and no RNs?