Registered Cardiac Sonographer (RCS)

Requires:  Passing the one-part Non-Invasive/Echocardiography Registry Examination.

Who should apply:  Professionals working in the area of Non-Invasive Echocardiography

Specialty Examination Fee: $350

 

Click here for information on ordering the Self Assessment Examination

RCS Navigation

All applicants must meet the following criteria:

1. Have a high school diploma or general education diploma at the time of application.

2. Fulfill one (1) of the qualifications of the exam for which you are applying. See qualifications listed in the tables below.

3. Provide typed documentation to support the qualification under which you are applying. Required documentation for each qualification is listed below. CCI reserves the right to request additional information.

 

Qualification Prerequisite Supporting Documentation
RCS1-2013
Two years of full-time or full-time equivalent experience in cardiac ultrasound. The applicant must have participated in a minimum of 600** cardiac ultrasound studies at the time of application.

 

In the verification letter, the medical director(s) must confirm the number of studies performed during the applicant’s employment.

RCS1-2013
Employment Verification Letter
(must confirm the number of studies performed during the applicant’s
employment).

 

RCS235-2013

 

A graduate of a diploma, associate, or baccalaureate  academic program in health science (including, but not limited to, cardiovascular technology, ultrasound, radiologic technology, respiratory therapy, or nursing)
 

AND

 

One year full-time work experience in cardiac 
ultrasound (echocardiography) 
 

AND

 

Performance of a minimum of 600** cardiac ultrasound studies in their career, which is defined as work experience and/or clinical experience gained during a formal educational program.
 
In the verification letter(s) the medical director(s) and/or program director(s) must confirm the number of studies performed during the applicant’s employment and/or during the academic program.

RCS235-2013
Completion certificate and/or
educational transcript
AND
Employment Verification Letter
AND
Clinical Experience Letter (only required for applicants submitting verification of the number of studies completed during a formal
educational program)

RCS5

A graduate of a NON-programmatically accredited program in cardiac ultrasound (echocardiography) which has a minimum of one year of specialty training and includes a minimum of 800 clinical hours in the specialty in which the examination is being requested.

RCS5
Completion certificate and/or 
educational transcript
AND
Student Verification Letter
AND
Clinical Verification Letter
RCS4
Applicant must be a graduate of a programmatically accredited program in cardiac ultrasound (echocardiography).

RCS4
Completion certificate and/or educational transcript
AND
Student Verification Letter

 

Students applying to take examination prior to graduation will be required to submit this documentation.

 

IMPORTANT: If an individual’s studies were completed after graduation or if the hours are not a requirement for their educational program, then those hours WOULD NOT count toward the 800-hour minimum under qualification RCS5.
** If an individual’s clinical hours were obtained during a formal educational program, then those procedures completed WOULD count toward the minimum of 600 cardiac ultrasound procedures under qualification RCS235-2013.
*** An accredited program is accredited by an agency recognized by the Council for Higher Education Accreditation (CHEA), United States Department of Education (USDOE), or Canadian Medical Association (CMA) that specifically conducts programmatic accreditation for cardiovascular technology, diagnostic cardiac sonography, or vascular technology.

 

Click here for sample Employment Verification Letter, Student Verification Letter and Clinical Verification Letter (Graduates of Non-accredited Programs in Cardiac Medical Sonography (Echocardiography)).

CCI requires the Employment Verification Letter contain the following:

1) Employer’s original, official letterhead or stationery.
2) Indicate the date the letter was signed by employer/supervisor.
3) Indicate the name of the applicant.
4) Indicate full- or part-time employment.
5) Indicate the time period of employment.
6) Indicate the primary duties of applicant, related to the field of cardiovascular technology.

7) Indicate the number of studies performed during the applicant’s employment.

8) Original signature of direct supervisor, who must be a MD or DO or hold an active RCCS, RCES, RCIS, RCS, RDCS, RDMS, RPhS, RVS or RVT credential.

CCI requires the Student Verification Letter contain the following:

1) Educational program’s original, official letterhead or stationery.
2) Indicate the date the letter was signed by educational director.
3) Indicate the name of the applicant.
4) Indicate full- or part-time student.
5) Indicate the date or expected date of graduation.
6) Indicate the specialty of the educational program.
7) For Non-programmatically accredited educational programs, indicate the program length, program specialty (Echo),the number and specialty of clinical hours accrued.
8) Original signature of the educational director.

CCI requires the Clinical Verification Letter (Graduates of Non-accredited Programs in Cardiac Medical Sonography (Echocardiography)) contain the following:

1) Clinical Site’s original, official letterhead or stationery.
2) Indicate the date the letter was signed by the clinical supervisor.
3) Indicate the name of the applicant.
4) Indicate the number of clinical hours.

5) Indicate the number of studies performed during the applicant’s clinical training (required if applying on or after July 1, 2013).

6) Indicate the time period during which the clinical hours were performed.

7) Original signature of the clinical supervisor.
IMPORTANT: If an individual’s clinical hours were obtained after graduation or if the hours are not a requirement for their educational program, then those hours WOULD NOT count toward the 800 minimum under qualification RCS5.

Exam Overview Friday, November 06th 2009 9:46 AM

This examination matrix is provided to illustrate the general distribution of questions and the relative weight or emphasis given to a skill or content area on the examination.

 

 
  Content Category Approximate Percentage of Examination
  General Policies, Procedures and Standards 7%
  Perform echocardiographic examinations 38%
  Perform specialized echocardiographic techniques 13%
  Pathophysiology of Cardiovascular Diseases/Therapeutic Measures 42%
  Total 100%
     

Knowledge List

The list below describes general areas of knowledge that are needed in order to perform the tasks identified.  This knowledge will apply across multiple tasks.

Basic Life Support (BLS)
Basic math skills (formulas, exponents, decimals, scientific notation)
Basic pharmacology
Cardiac abnormalities
Cardiac embryology
Cardiovascular anatomy
Electrophysiology
General anatomy
Hemodynamics
HIPAA (Health Insurance Portability and Accountability Act)
History & physical
Medical ethics
Medical terminology
Pathophysiology
Physiologic maneuvers
Physiology  
QA procedures
Recognize basic cardiac anatomy obtained using other imaging modalities
Safety practices for patients and staff
Ultrasound instrumentation
Ultrasound physics
Ultrasound modalities:
  *3-D  
  *Doppler (Spectral, Tissue and Color)
  *Contrast  
  *M-mode  
  *Stress testing (pharmacological and physiologic)
  *TEE  
Universal Precautions/infection control
     


Task List

The task list below describes the activities which an Registered Cardiac Sonographer is expected to perform on the job.  All examination questions are linked to these tasks.

     
  Duties and Tasks % of Exam
A General Policies, Procedures and Standards 7%
  Ensure Universal Precautions and sterile techniques  
  Respond to emergency situations  
  Maintain competency and Quality Assurance  
  Pre-procedure Activities  
  Manage Workflow  
  Prepare the ultrasound room and equipment for the examination  
  Determine the indication for the examination  
  Perform limited history and physical (e.g., height, weight, physiologic monitoring)  
  Prepare the patient for examination  
  Informed consent  
  Basic ECG, rhythm identification  
  Post-Procedure Activities  
  Manage data flow and images  
  Document findings  
  Communicate with the health care team  
  Maintain equipment, supplies and patient areas  
B Perform echocardiographic examinations 38%
  Understand ultrasound physics and instrumentation  
  Physical properties of ultrasound  
  Acoustical properties of tissue  
  Doppler instrumentation  
  2D instrumentation  
  Transducers  
  Artifacts  
  Resolution (e.g., axial, lateral, temporal, spatial)  
  Understand imaging views (transducer position, planes, anatomy)  
  Left Parasternal  
  Apical  
  Subcostal  
  Suprasternal  
  Right Parasternal  
  Nonstandard  
  Define normal anatomy, physiology and hemodynamics  
  2-D, M mode, anatomy and physiology  
  Doppler (Spectral, Color Flow, Tissue)  
  Measurements and calculations  
  Utilize physiologic maneuvers  
  Valsalva, gripping, squatting  
  Respiration control  
  Practice proper ergonomics  
C Perform specialized echocardiographic techniques 13%
  Assist with TEE  
  Recognize structures on TEE  
  Maintain TEE probe  
  Perform stress echocardiography  
  Exercise stress echo  
  Pharmacologic stress echo  
  Perform contrast echocardiography  
  Contrast agents  
  Start, maintain and/or remove IV's  
  Image optimization and artifacts  
  Indications, warnings and contraindications  
  Identify current and emerging technologies  
  Intracardiac echo (ICE)  
  3D TEE  
  3D TTE  
  Color tissue Doppler imaging (includes strain & strain rate)  
  Speckle imaging  
  Interventional procedures (e.g., valvuloplasty, biopsies)  
  Other imaging modalities (e.g., MRI, CT, Nuclear)  
D Pathophysiology of Cardiovascular Diseases/Therapeutic Measures 42%
  Evaluate pathophysiology in images and modify examination to answer the clinical question  
  Heart failure  
  Valvular heart disease  
  Ischemic heart disease  
  Cardiomyopathies  
  Pericardial diseases  
  Cardiac masses  
  Diseases of the aorta  
  Systemic and pulmonary hypertension  
  Compensatory mechanisms  
  Therapeutic measures and interventions for acquired diseases.  
  Recognize common congenital abnormalities  
  2D  and Doppler (segmental approach)  
  Embryology  
  Interventions for congenital abnormalities  
  Total 100%

 

1.  While performing two-dimensional echocardiography, you discover what appears to be a large thrombus in the left ventricle. The patient states that she just can’t wait to speak with her doctor and that any information you could supply would be a big relief to her. You should inform the patient that
a. Her nurse is the only person qualified to discuss the results of her test.
b. There is a large thrombus in the main pumping chamber of her heart and surgery is definitely necessary.
c. You do see a small abnormality in her echocardiogram, but it is not something she should concern herself with.
d. You cannot interpret her echocardiogram, but assure her that her doctor will be reviewing it as soon as possible.

 

2.  A 90-year-old man is scheduled for a transesophageal echocardiogram. As a preoperative measure, his doctor has given him 25mg of Demoral. Upon entry to the laboratory, his breathing is shallow, and he is unresponsive. After notifying the physician, which of the following medications would be MOST useful for counteracting the effects of the narcotic given?
a. Versed
b. Narcan
c. Oxygen
d. Valium

3. During the holding phase of the Valsalva maneuver, which of the following occurs?

a. Increased cardiac output
b. Decreased intrathoracic pressure
c. Increased venous return to the heart
d. Decreased venous return to the heart

4. A patient comes to the non-invasive laboratory for an exercise stress test. While you are preparing him for the examination, he complains of chest pain that radiates down his left arm. Before the physician can be notified, the patient converts to ventricular tachycardia, lapses to an unconscious state, and has no palpable pulse. According to ACLS guidelines, the sonographer should
a. Begin CPR
b. Administer intracardiac epinephrine
c. Defibrillate the patient at 360 watts/second
d. Prepare an external pacemaker for immediate use

Answers
1. d 2. b 3. d 4. a

 

The textbooks listed below are intended as recommended resources when preparing for examination. You may have previous or later editions of these or other references available that also present acceptable coverage of the subject matter. Any general text in cardiovascular techniques and evaluation, and cardiac patient care and management may be used. It is not necessary to use all of the texts identified. They are provided as suggestions only. CCI does not endorse or recommend any third-party review course or material.

 

1. Any general text on nursing management and care of the cardiac patient.
2. Publications and Reports of the American Society of Echocardiography (ASE), Raleigh, NC. All new ASE Guidelines published on www.asecho.org/Guidelines.
3. Armstrong, William F., Thomas Ryan, and Harvey Feigenbaum. Feigenbaum’s echocardiography. 7th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2010.
4. Braunwald, Eugene, Douglas P. Zipes, and Peter Libby. Heart disease: a textbook of cardiovascular medicine. 9th ed. Philadelphia: Saunders, 2011.
5. Edelman, Sidney K.. Understanding ultrasound physics. 3rd ed. Woodlands, Tex.: ESP, 2005.
6. Kremkau, Frederick W., and Flemming Forsberg. Sonography principles and instruments. 8th ed. St. Louis, Mo.: Elsevier/Saunders, 2011.
7. Miele, Frank R.. Ultrasound physics & instrumentation. 4th ed. Forney, TX: Miele Enterprises, 2006.
8. Oh, Jae K., J. B. Seward, and A. Jamil Tajik. The echo manual. 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2006.
9. Otto, Catherine M.. The practice of clinical echocardiography. 3rd ed. Philadelphia, PA: Saunders/Elsevier, 2007.
10. Otto, Catherine M.. Textbook of clinical echocardiography. 4th ed. Philadelphia, PA: Saunders/Elsevier, 2009. Print.
11. Reynolds, Terry, and Pamela Kidd. The echocardiographer’s pocket reference. 2nd ed. Phoenix, Ariz: School of Cardiac Ultrasound, 2000.
12. Reynolds, Terry, Yan Peng, and Patricia Dubovec. The pediatric echocardiographer’s pocket reference. 3rd ed. Phoenix, Ariz.: School of Cardiac Ultrasound, Arizona Heart Institute, 2002.

 

"Loyal to the Profession of Cardiovascular Technology"Copyright © 1968-2015 Cardiovascular Credentialing International