The incumbent functions independently as a Diagnostic Cardiac Sonographer (Echocardiographer) in the Cardiology Section of Medical Service at the Cincinnati VA Medical Center. The cardiac sonographer is responsible for the performance of a full range of Transthoracic echocardiograms (TTE) and Transesophageal echocardiograms (TEE) utilizing the cardiac ultrasound equipment. The cardiac sonographer uses the cardiac ultrasound machine to produce real-time ultrasound images of heart structures.

Duties

The major duties of the Medical Instrument Technician (Echocardiography) position include: 1. Knowledge of anatomy and physiology of the complete cardiovascular system. a. Knowledge of the complete cardiovascular system, normal variants and deviations produced by a wide variety of cardiovascular disease processes and the skill to instantaneously recognize those variations; i.e. Cardiomyopathies, valvular disease and congenital abnormalities. b. Knowledge to recognize cardiac cross-sectional anatomy and pathophysiology, particularly pertaining to intracardiac structures viewed from numerous angles and planes, to recognize anatomic features, motion characteristics and pathology in order to optimally image the heart for diagnostic results. c. Advanced knowledge of more complex examinations, non-standard treatment procedures and techniques. 2. Knowledge of cardiac arrhythmias and their relationship to hemodynamic conditions of the cardiac cycle. a. Normal and abnormal Electrocardiograms (ECG such as: bundle branch block, Wolff-Parkinson-white syndrome, ventricular ectopy, atrial fibrillation and atrial flutter). 3. Knowledge of ultrasound physics and the acoustic mechanisms by which high quality cardiac images are obtained. a. Ability to produce diagnostic quality images and Doppler frequency shift recordings. Utilizing 2D imaging modes, M-mode, Pulse wave Doppler, Continuous wave Doppler, Color flow Doppler, tissue Doppler imaging (TDI), x-Plane imaging and 3D imaging modes. b. Knowledge of physics, signal processing, digital image processing and all other technology behind echocardiogram instrumentation, including: variables involved in real-time sector scanning, signal processing, echocardiogram imaging controls, factors influencing resolution, potential artifacts (such as: side lobes, reverberations, shadowing and near field clutter), principles of Doppler echocardiography, Doppler display, physiologic information obtained with Doppler echocardiography, Doppler controls, technical limitations of Doppler imaging, transthoracic transducers, transesophageal transducers, intravascular transducers, contrast echocardiography, digital echocardiography, computer manipulation of echocardiogram data, tissue identification using ultrasound, three dimensional echocardiography, and the biological effects of ultrasound to understand cardiac hemodynamics and blood flow velocities in order to determine proper equipment settings. 4. Ability to set up and adjust the ultrasound equipment to meet the conditions of each specific examination and each individual patient to obtain diagnostic quality images. a. Ability to adapt the transducer positioning, instrument controls and examination techniques to the individual patient being scanned and the problem being evaluated. Including recognizing pertinent abnormalities and documenting abnormal findings. b. Ability to adjust the position of the patient's body and adjusting the patient's respiratory state. 5. Ability to communicate effectively and professionally with patients explaining procedures and with employees at varying professional levels. The patient population treated is at high risk for cardiopulmonary arrest and the sonographer must be competent to assist with the rescue during these events. a. Examinations require constant interaction between the patient, sonographer and the ultrasound equipment. 6. Skills and ability to set up, clean up and scan complete Transthoracic echocardiograms (TTE) and Transesophageal echocardiogram (TEE) in all acoustic windows with 2D real-time imaging, M-mode, Color flow Doppler, Pulse wave Doppler, Continuous wave Doppler , Tissue Doppler imaging (TDI) and Left ventricular opacification(LVO). Skills and ability to use 3D imaging modes for transthoracic echocardiograms. a. Ability to perform complex procedures such as cardiac ultrasound studies of the four chambers of the heart and valves using sector scanning techniques to detect cardiac disease such as stenosis and/or incompetent valves, chamber enlargement and pericardial effusion. Cardiac ultrasound studies deriving velocities and pressure gradients across all cardiac valves to assess for degree of obstruction or regurgitation. b. Ability to recognize life threatening echocardiogram findings, i.e. cardiac tamponade. c. Ability to adapt each echocardiogram accordingly with non-standard acoustic window availability providing non-standard images in order to thoroughly evaluate and answer the clinical question. .d. Transthoracic echocardiogram (TTE) and Transesophageal echocardiogram (TEE) probes are Reusable medical equipment (RME), proper cleaning of the machine, probes and ECG. Work Schedule: Monday through Friday, 8:00am to 4:30pm Telework: Not available. Virtual: This is not a virtual position. Functional Statement #: 91460-A Relocation/Recruitment Incentives: Authorized Permanent Change of Station (PCS): Not authorized. Financial Disclosure Report: Not required

Requirements

Qualifications

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements: United States Citizenship. Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Licensure or Certification. Licensure or Certification is not required for this occupation; however, it is strongly desirable at GS-6 or above as evidence of possession of the essential knowledge, skills, and abilities. For certain functional areas at the higher levels or supervisory assignments, specific certifications appropriate to the specialty are indicated in this standard under "Titles and Certification/Registrations". For all specialties identified in this standard, Basic and Advanced Cardiac Life Support certifications are desirable. Training which does not result in official certification does not meet this definition. English Language Proficiency. Medical Instrument Technicians must be proficient in spoken and written English in accordance with chapter 2, section D, paragraph 5a, this part. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grade Determinations: GS-9 Medical Instrument Technician (Echocardiography) Experience. At least 1 year experience comparable to the next lower grade level, GS-8, which is directly related to the duties of the position to be filled, and must fully meet the KSAs at that level. This would be experience which demonstrates possession of the knowledge required in order to provide all aspects of echocardiography services. In addition, the candidate must demonstrate the following technical KSAs and the potential to acquire the assignment specific KSAs designated by an asterisk (*): Demonstrated Knowledge, Skills, and Abilities. KSAs 1, 2, and 3 are appropriate for all positions at this level. KSAs 4 and 5 are to be used in accordance with their appropriateness for the specific assignment. Knowledge of the more complex examination and treatment procedures and techniques in order to provide training and supervision in these procedures, to evaluate and initiate performance improvement projects, and to write policies, procedures, and protocols, that pertain to Echocardiography. * Knowledge of JCAHO and other regulatory requirements. * Ability to communicate effectively and professionally with employees at varying grade levels. Certification. Registration by Cardiovascular Credentialing International (CCI) as a Registered Cardiac Sonographer (RCS) or by the American Registry of Diagnostic Medical Sonographers (ARDMS) as a Registered Diagnostic Cardiac Sonographer (RDCS) is highly desirable. Basic Cardiac Life Support (BCLS) and Advanced Cardiac Life Support (ACLS) certifications are also desirable. Please note: Onsite interview and scanning skills assessment will be required. References: VA Handbook 5005/15, Part II, Appendix G27 Physical Requirements: The majority of the work performed is in the Echocardiography laboratory; however bedside echocardiograms are needed in various care units within the VAMC. The cardiac sonographers work may require long periods of scanning while sitting or standing, bending over and pushing the cardiac ultrasound machine to the bedside of inpatients that cannot be transported to the Echocardiogram Lab. The sonographer may be exposed to infectious and contagious diseases and may need to respond appropriately to an acute change in the patient's condition. The sonographer must have the ability to perform in high stress situations including but not limited to medical emergencies.

Contacts

• Address Cincinnati VA Medical Center 3200 Vine Street Cincinnati, OH 45220 US
• Name: Amanda Flores
• Email: [email protected]