1 a “radiologic technologist” (or radiographer) medical professional –in a challenging field...

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A “Radiologic Technologist” (or Radiographer)

• Medical Professional

– In a challenging field

• Safely uses x-rays to image anatomy – Positions– Using sophisticated technology– Practices radiation protection

• Provides quality-diagnostic images– Assists DR – Communicates with patient– Practices patient privacy

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Registered Technologist

R.T.• Dawn Charman, M.Ed., RT (R)(M), CRT(R)(F)• Kelly Clark, M.S.R.T. RT (R)(CT), CRT(R)(F)• Mina Colunga, B.S.R.T. RT (R), CRT(R)(F)

ARRT – R.T.State of California– C.R.T.

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Radiologic Technologist

• ECC program is for an entry level into the profession

• Radiation Therapy and Nuclear Medicine would require additional education

Certification/licenses• ARRT- American Registry of Radiologic

Technologies– Provides national certification

• CRT-- California Registered Technologist– After completing ARRT exam you pay a fee and get your

California license to practice– A separate test is taken for fluoroscopy

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Certification vs. License• ARRT

– National certification• R.T.

– Must take an exam• Pass with 75%

– Can take this after completing program

• CRT– State Licensing– Must pass ARRT

exam to get this– Pay fee to get

radiography license (R)

– Take fluoroscopy exam and pay a fee for (F) license

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All types of EXAMS & PEOPLE

• Infants• Elderly• All classes• All ethnicity• All backgrounds

• Head to toes• Trauma• Special procedures• Critical patients• Walk ins• Surgery

6FIG. 4–2 Radiologic science professionals must use advanced critical thinking skills when handling all patient care situations.

Elsevier items and derived items © 2007, 2003 by Saunders, an imprint of Elsevier Inc.

Radiologic Technologist

•Must be able to communicate effectively with:

•Patients, staff, & peers

•Must use:

•good judgment

•Critical thinking skills

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Critical Thinking

• Involves sound, professional judgment

• Applied with high ethical standard

• And integrity

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Critical Thinking

• Analysis

• Synthesis

• Evaluation

• Critique

• Achieved through– Role Playing– Lab experiments– Case Studies

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Patient Communication

• Interacting with the patient

• Interacting with family and friends

• Methods of Effective Communication

• Age as a factor in Patient Interactions

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Communication & Adaptingto Special Condition Patients

• Traumatized Patients

• Visually Impaired Patients

• Speech and Hearing Impaired Patients

• Non-English Speaking Patients

• Mentally Impaired Patients

• Substance Abusers

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Education in the Radiologic Sciences at ECC

• Didactic Curriculum (lecture)– Specifically describes the objectives – What the students will learn– How they will learn (instructional activities)

• Clinical– Hospital training– Apply didactic principals to clinical setting

12FIG. 5–1 The articulation of didactic, laboratory, and clinical instruction.

(From Ford C, ed: Clinical education for the allied health professions, St Louis, 1978, Mosby.)

RT ProgramsDidactic and Clinical Education

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Types of Diagnostic Exams

• Chest

• Extremities

• Skull/ Facial

• Spine

• Gastrointestinal

• Interventional

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Some studies of spinal trauma have recorded a missed injury rate as high as 33%.

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Comminuted Open

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ELDERLY

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INFANTS & CHILDREN

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SURGERY

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Fluoroscopy

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TECHNOLOGIST

• FLUOROSCOPY

• Dawn Charman RT (R), (F)

• CONTRAST MEDIA (X-RAY DYE)

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ARRT Standards Accrediting Agencies

• JRCNMT

• Committee on Accreditation of Allied Health Education Programs (CAAHEP) – in collaboration with the Joint Review Committee on

Education in Diagnostic Medical Sonography (JRC-DMS)

• Regional Institutional Accrediting Agencies (degree-granting divisions) WSAC

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Accrediting Agencies

• SCHOOLS/PROGRAMS

• JRCERT: Joint Review Committee on Education in Radiologic Technology

• HOSPITAL ACCREDITATION

• JCAHO :Joint Commission on Accreditation of Healthcare (Hospital) Organizations

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5 Primary Exams

1)2)3)4)5)

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Post Primary

• Cardiovascular-Interventional Radiography (CVIT)– Note: No longer available for

new candidates

• Mammography (M)

• Computed Tomography(CT)

• Magnetic Resonance Imaging (MR) or (MRI)– Note: Both a primary and post-

primary track

• Quality Management (QM)

• Sonography (US) or (RDMS)– Note: Both a primary and post-

primary track

• Bone Densitometry (BD)• • Vascular Sonography • Cardiac-Interventional

Radiography (CI)

• Vascular-Interventional Radiography (VI)

• Breast Sonography

• Registered Radiologist Assistant (RA)

Beyond Diagnostic Radiography

Advanced Modalities

MAMMOGRAPHY

Dawn Charman, RT (M)

RADIOGRAPHIC IMAGING OF THE

BREAST Diagnostic for breast cancer

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Bone Densitometry

“low dose

Radiation”

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BONE DENSITOMETRY

• JOE RUIZ, RT (R) (BD)

• POST PRIMARY EXAM BEGAN IN JANUARY 2001

• ??? May also have certification w/o RT ????

• MEASURING MINERAL CONTENT AND DENSITY OF BONES

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CT SCAN & MRI

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Computed Tomography

• Jennifer Smith, RT (R) (CT)

• 1995 began post primary exam

35FIG. 1–9 A computed tomographic technologist uses a computerized x-ray system to produce sectional anatomic images of the body.

(Courtesy of Philips Medical Systems.)

CT SCANNER

• Uses – Radiation– Computer

• Rescontructs images– Some in 3-D

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C T SCANNER

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Magnetic Resonance Imaging

• RT (R) (MRI)

• RT (T) (MRI)

• (MRI)

• 1995 ARRT began post primary exams

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MRI SIGNAL PRODUCTION

• Uses– Magnet field– radio waves

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MRI SAFETY

1.Use non magnetic materials

2.Can cause harm to patient or employees

3.1 reported death from oxygen tank1. 6 years old

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RADIOGRAPHY VS MRI

Which one is MRI? CT?

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Look for the signs….

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What are the differences between MRI and CT?

CT

• Uses ionizing radiation

• Can be used on any patient

• Fast

MRI

• Uses magnets and radiowaves

• Cannot be used on patients who have metal in their body

• Slow47

Which is better?

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What are the similarities between CT and MRI?

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Angiography

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ANGIOGRAPHY is a specialized radiographic examination where the images of the blood

vessels of the body are demonstrated by injection

of contrast media

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INTERVENTIONALRADIOGRAPHY

1) CI:________________________

2) CVI:_______________________

3) VI:________________________

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CARDIAC-INTERVENTIONAL RADIOGRAPHY

• Mike Smith, RT (R) (CI)

• POST PRIMARY EXAM BEGAN IN JANUARY 2003

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Cardiovascular Interventional Radiography

• Jane Smith, RT (R) (CVI)

• Angiography

• 1991 began post primary exam for CVIT Radiographers

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Angiography of Heart vessels

• http://images.google.com/imgres?imgurl=http://http://images.google.com/imgres?imgurl=http://www.nhlbi.nih.gov/health/dci/images/www.nhlbi.nih.gov/health/dci/images/stent_restenosis.gif&imgrefurl=http://stent_restenosis.gif&imgrefurl=http://www.nhlbi.nih.gov/health/dci/Diseases/stents/www.nhlbi.nih.gov/health/dci/Diseases/stents/stents_all.html&usg=__xDlbsaX9JhuYbpVojLcz19stents_all.html&usg=__xDlbsaX9JhuYbpVojLcz19apr-apr-I=&h=513&w=450&sz=59&hl=en&start=20&tbnid=I=&h=513&w=450&sz=59&hl=en&start=20&tbnid=vWwqaG-RNW7M-vWwqaG-RNW7M-M:&tbnh=131&tbnw=115&prev=/images%3FqM:&tbnh=131&tbnw=115&prev=/images%3Fq%3Dabdominal%2Bstents%26gbv%3D2%26hl%3Dabdominal%2Bstents%26gbv%3D2%26hl%3Den%3Den

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VASCULAR-INTERVENTIONAL RADIOGRAPHY

• JOE CAR, RT (R) (VI)

• POST PRIMARY EXAM BEGAN IN JANUARY 2003

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595959

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NUCLEAR

MEDICINE

use radioactive isotopes to make images

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Nuclear Medicine

• RT (NM)

• ARRT or NMTCB

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NM – Images collected afterinjections of a RADIOISOTOPE

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The tracer travels into the blood vessels until it arrives to the

bone

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PET Scan & SPECT Scan

• PET = Positron Emission Tomography

• SPECT= Single Photon Emission Computed Tomography

• X-rays/MRI with Radioisotopes

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• PET Scan showing diffuse spread of prostate cancer to bone. PET has the advantage over traditional bone scanning in its ability to differentiate active from dormant disease.

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Prostate cancer metastasized in bones

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Co-registration:

PET + CT or MRI

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RADIATION THERAPY

R.T.(T)• 2 YRS ADDITIONAL EDUCATION

• CITY OF HOPE

• LLU

• CAL STATE LONG BEACH

• The branch of Radiology that involves the treatment of disease by means of high energy x-rays or radioactive substances

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RADIATION THERAPY

• branch of Radiology that involves the treatment of disease by means of high energy x-rays (GAMMA) or radioactive substances

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Radiation Therapy

• RT (T) = Registered technologist in radiation therapy technology

• Medical dosimetrists are involved in treatment planning and dose calculations

• 1-4 year program

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ULTRASOUND

uses a technique similar to Navy SONAR to produce diagnostic images.

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ULTRASOUNDCypress CollegeOrange Coast

LLU1 – 2 years

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Diagnostic Medical Sonographers

• RT (R) (S) or RT (S) or (RDMS)

• American Registry of Diagnostic Medical Sonographers

• ARRT in 1999 began post primary exam

• ARRT in 2005 began primary exam

84Determines depth

Ultrasound beam is transmitted and reflected – as special crystal at the end of the transducer candetermine the type of tissue

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Uses SOUND WAVES (NOT X-RAYS)

“real time” images

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ULTRASOUND

uses a technique similar to Navy SONAR to produce diagnostic images.

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19 Week fetus

• http://images.google.com/imgres?imgurl=http://embryology.med.unsw.edu.au/movies/usound/19weeklabel2.jpg&imgrefurl=http://embryology.med.unsw.edu.au/movies/usound/Hum19w4D.htm&usg=__EfDiZ2qdLFEQ_ZGPy9YS628QyPI=&h=379&w=358&sz=11&hl=en&start=71&tbnid=QqSTbyckVI-jYM:&tbnh=123&tbnw=116&prev=/images%3Fq%3Dfetal%2Bultrasound%26gbv%3D2%26ndsp%3D20%26hl%3Den%26sa%3DN%26start%3D60

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2D vs. 3D/4D

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U/S & the “real thing”

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Breast Sonography

• Post Primary Exam

• Valuable for Technologists that specialize in Mammography

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VASCULAR ULTRASOUND

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New - RA• Radiology Assistant (Like PA)

• Weber State (On line – Utah)

• LLU

• 3 others in US (2007 – more)

• $$$$ NEW GRADS = 100 K/YEAR (?)

• PART OF RADIOLOGIST GROUP

• As of 2007 – NOT APPROVED BY STATE to Work as RA in California

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Additional Opportunities

• Education

• Administration

• Management (QM)

• Commercial

• Radiologist Assistant = RA

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RADIOLOGY ASSISTANT RA

• LLU • 2 YRS RT• BA DEGREE

• WEBER STATE• 6YR RT

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OTHER PATHWAYS

• SALES

• APPLICATIONS SPECIALIST

• INDUSTRIAL X-RAY

• MANAGEMENT (DEGREE)

• EDUCATON

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TRAVELING TECHNOLOGIST = SEE THE WORLD AND GET $$$

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Other working opportunities…

• Registry (local)

• Registry (out of state)

• X rays taken around the world !!

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Variety of Work Settings• physicians offices,• • clinical outpatient facilities,

• free standing imaging centers,

• mobile imaging centers

• portable services to rehabs

• Mammo’s to under privileged areas

• Urgent care

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SALARY RANGES RT’s

• NEW R.T. = $ 25 -$38 PER HOUR• ON-CALL + O.T. $45,000 – $60,000 YR

• ADVANCE SPECIALTIES• $ 30 - $50 PER HOUR

• A GREAT SHORTAGE IN ALL HEALTH CARE – A GREAT NEED TO AQUIRE NEW TECHNOLOGIST TO THIS AREA

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Professional Organizations

• ASRT – American Society of Radiologic Technologist

• CSRT – California SocietySociety of Radiologic Technologists

• RTEC – Radiologic Technology Educators of California

• International Societies, other state societies, other modalities