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CAREERS IN RADIOLOGIC TECHNOLOGY (FINAL) • RADIOLOGIC TECHNOLOGIST – RADIOGRAPHER – X-RAY TECHNOLOGIST • “ TECHNICIAN” – Limited License • RADIOLOGIST – Medical doctor 1 What does a Radiologic Technologist do? 2 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 3 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. 4 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 5 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 6 EXAMS • • • • • • All types of & PEOPLE Head to toes Trauma Special procedures Critical patients Walk ins Surgery • • • • • Infants Elderly All classes All ethnicity All backgrounds 7 Radiologic Technologist •Must be able to communicate effectively with: •Patients, staff, & peers •Must use: •good judgment •Critical thinking skills FIG. 4–2 Radiologic science professionals must use advanced critical thinking skills when handling all patient care situations. 8 Elsevier items and derived items © 2007, 2003 by Saunders, an imprint of Elsevier Inc. Critical Thinking • Involves sound, professional judgment • Applied with high ethical standard • And integrity 9 Critical Thinking • • • • Analysis Synthesis Evaluation Critique • Achieved through – Role Playing – Lab experiments – Case Studies 10 Patient Communication • Interacting with the patient • Interacting with family and friends • Methods of Effective Communication • Age as a factor in Patient Interactions 11 Communication & Adapting to Special Condition Patients • • • • • • Traumatized Patients Visually Impaired Patients Speech and Hearing Impaired Patients Non-English Speaking Patients Mentally Impaired Patients Substance Abusers 12 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 13 RT Programs Didactic and Clinical Education FIG. 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.) 14 Types of Diagnostic Exams • • • • • • Chest Extremities Skull/ Facial Spine Gastrointestinal Interventional 15 LEARNING • COGNITIVE – – thought / knowledge • PSYCHOMOTOR – – physical actions • AFFECTIVE – – guided by feelings 16 Some studies of spinal trauma have recorded a missed injury rate as high as 33%. 17 Comminuted Open 18 ELDERLY 19 INFANTS & CHILDREN 20 SURGERY 21 Fluoroscopy 22 TECHNOLOGIST • FLUOROSCOPY • Dawn Charman RT (R), (F) • CONTRAST MEDIA (X-RAY DYE) 23 24 25 ARRT Standards Accrediting Agencies • Joint Review Committee on Educational Programs in Nuclear Medicine Technology (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 • Conjoint Accreditation Services of the Canadian Medical Association • Australian Institute of Radiography 26 Accrediting Agencies • SCHOOLS/PROGRAMS • JRCERT: Joint Review Committee on Education in Radiologic Technology • HOSPITAL ACCREDITATION • JCAHO :Joint Commission on Accreditation of Healthcare (Hospital) Organizations 27 “Alphabet Soup” NATIONAL & STATE LICENSES ARRT = (R.T.) American Registry of Radiologic Technology R.T. – Certification in Radiologic Technology CRT – Certified Radiologic Technology State of California, Dept of Health - Radiation Health Branch – Licensing to practice in California C.R.T. (R) (F) (M) Radiography, Fluoroscopy, Mammography 28 5 Primary Exams • Radiography (R) • Nuclear Medicine Technology (NM) • Radiation Therapy (T) • Sonography (US) (RDMS) • Magnetic Resonance Imaging (MR) 29 Post Primary • CardiovascularInterventional 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 postprimary track • Quality Management (QM) • Sonography (US) or (RDMS) – Note: Both a primary and postprimary track • Bone Densitometry (BD) • Vascular Sonography • • Cardiac-Interventional Radiography (CI) • Vascular-Interventional Radiography (VI) • Breast Sonography • Registered Radiologist Assistant (RA) 30 “Alphabet Soup” KNOW THESE! J.R.C.E.R.T Joint Review Committee on Education in Radiologic Technology J.C.A.H.O – Joint Commission of Accreditation of Healthcare Organizations A.R.R.TAmerican Registry of Radiologic Technologists 31 Beyond Diagnostic Radiography Advanced Modalities ADVANCED SKILL LEVELS • • • • • • • • CAT SCAN (CT) MRI (MR) ANGIOGRAPHY (CIT) (CV) RADIATION THERAPY (T) MAMMOGRAPHY (M) Bone Densitometry (BD) ULTRASOUND (RDMS) NUCLEAR MEDICINE(NM) – PET – SPECT • MANAGEMENT (BS) • EDUCATION (BS,MEd, PhD EDD) 33 MAMMOGRAPHY Dawn Charman, RT (M) RADIOGRAPHIC IMAGING OF THE BREAST Diagnostic for breast cancer 35 Bone Densitometry “low dose Radiation” 36 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 37 FIG. 1–7 A nuclear medicine technologist performs procedures requiring the use of radioactive substances. (Courtesy of Philips Medical Systems.) 38 CAT SCAN & MRI 39 Computed Tomography • Kelly Clark, RT (R) (CT) • 1995 began post primary exam 40 CT SCANNER • USES • RADIATION – AND A COMPUTER • TO RECONSTRUCT • IMAGES • 3-D FIG. 1–9 A computed tomographic technologist uses a computerized x-ray system to produce sectional anatomic images of 41 the body. (Courtesy of Philips Medical Systems.) C T SCANNER 42 43 Electron Beam Tomography EBT WHOLE BODY SCANNER Risk factor • HIGH DOSES ? • WHAT YOU DON’T • KNOW ……. • ‘FALSE POSITIVE’S” • NOW THAT YOU KNOW – WHAT ARE YOU GOING TO DO ABOUT IT? = 45 Radiation Dose • EBT scans expose the patient to about 1/5th the radiation of a multi-slice CT scanner. • OR so they tell you.. • $$$$$$$$ 46 Magnetic Resonance Imaging • RT (R) (MRI) or • RT (T) (MRI) or (N) (MRI) • 1995 ARRT began post primary exams 47 MRI SIGNAL PRODUCTION • Images are crated by interaction of Magnet field, radio waves with tissue • Atoms – Nucleus – Electrons 48 49 MRI SAFETY USE NON MAGNETIC MATERIALS CAN CAUSE HARM TO PATIENT & PERSONELL 1 REPORTED DEATH FROM O2 TANK & 6YO PATIENT 50 MRI • NOT IONIZING RADIATION • USES MAGENTIC RESONANCE • (RADIO WAVES) • Jane Schultz, R.T. (MR) 51 52 53 54 RADIOGRAPHY VS MRI BONE vs. Soft Tissue 55 PET Scan & SPECT Scan • PET = Positron Emission Tomography • Single Photon Emission Computed Tomography • X-rays/MRI with Radioisotopes 56 57 58 • 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. 59 60 ANGIOGRAPHY/ CARDIOVASCULAR INTERVENTIONAL TECHNOLOGY is a specialized radiographic examination where the images of the blood vessels of the body are demonstrated by injection of contrast media. CARDIAC-INTERVENTIONAL RADIOGRAPHY • Mike Smith, RT (R) (CI) • POST PRIMARY EXAM BEGAN IN JANUARY 2003 62 INTERVENTIONAL RADIOGRAPHY • ANGIOGRAPHY • CARDIAC CATH • + MANY OTHERS • RT (CV) (CIT) (CVIT) 63 ANGIOGRAPHY is a specialized radiographic examination where the images of the blood vessels of the body are demonstrated by injection of contrast media 64 Cardiovascular Interventional Radiography • Jane Smith, RT (R) (CVI) • Angiography • 1991 began post primary exam for CVIT Radiographers 65 66 Angiography of Heart vessels • http://images.google.com/imgres?imgurl=http://w ww.nhlbi.nih.gov/health/dci/images/stent_resten osis.gif&imgrefurl=http://www.nhlbi.nih.gov/healt h/dci/Diseases/stents/stents_all.html&usg=__xDl bsaX9JhuYbpVojLcz19aprI=&h=513&w=450&sz=59&hl=en&start=20&tbnid =vWwqaG-RNW7MM:&tbnh=131&tbnw=115&prev=/images%3Fq% 3Dabdominal%2Bstents%26gbv%3D2%26hl%3 Den 67 Angiography 68 VASCULAR-INTERVENTIONAL RADIOGRAPHY • JOE CAR, RT (R) (VI) • POST PRIMARY EXAM BEGAN IN JANUARY 2003 69 70 71 71 NUCLEAR MEDICINE use radioactive isotopes to make images 72 Nuclear Medicine • RT (NM) • ARRT or NMTCB 73 NM – Images collected after injections of a RADIOISOTOPE 74 The tracer travels into the blood vessels until it arrives to the bone 75 PET Scan & SPECT Scan • PET = Positron Emission Tomography • Single Photon Emission Computed Tomography 76 77 Prostate cancer metastasized in bones 78 PET NUCLEAR MED + CT or MRI- co-registration 79 80 81 82 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 83 84 85 RADIATION THERAPY • branch of Radiology that involves the treatment of disease by means of high energy x-rays (GAMMA) or radioactive substances 86 Radiation Therapy • RT (T) = Registered technologist in radiation therapy technology • Medical dosimetrists are involved in treatment planning and dose calculations • 1-4 year program 87 88 ULTRASOUND uses a technique similar to Navy SONAR to produce diagnostic images. 89 ULTRASOUND Cypress College Orange Coast LLU 1 – 2 years 90 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 91 Ultrasound beam is transmitted and reflected – as special crystal at the end of the transducer can determine the type of tissue Determines depth 92 Uses SOUND WAVES (NOT X-RAYS) “real time” images 93 ULTRASOUND uses a technique similar to Navy SONAR to produce diagnostic images. 94 19 Week fetus • http://images.google.com/imgres?imgurl=http://e mbryology.med.unsw.edu.au/movies/usound/19 weeklabel2.jpg&imgrefurl=http://embryology.me d.unsw.edu.au/movies/usound/Hum19w4D.htm& usg=__EfDiZ2qdLFEQ_ZGPy9YS628QyPI=&h= 379&w=358&sz=11&hl=en&start=71&tbnid=QqS TbyckVIjYM:&tbnh=123&tbnw=116&prev=/images%3Fq %3Dfetal%2Bultrasound%26gbv%3D2%26ndsp %3D20%26hl%3Den%26sa%3DN%26start%3D 60 95 96 97 98 2D vs. 3D/4D 99 U/S & the “real thing” 100 Breast Sonography • Post Primary Exam • Valuable for Technologists that specialize in Mammography 101 VASCULAR ULTRASOUND 102 New - RA • • • • • • • Radiology Assistant (Like PA) Weber State (On line – Utah) LLU 3 others in US (2007 – more) $$$$ NEW GRADS = 100 K/YEAR (?) PART OF RADIOLOGIST GROUP As of 2007 – NOT APPROVED BY STATE to Work as RA in California 103 Additional Opportunities • • • • • Education Administration Management (QM) Commercial Radiologist Assistant = RA 104 RADIOLOGY ASSISTANT RA • LLU • 2 YRS RT • BA DEGREE • WEBER STATE • 6YR RT 105 OTHER PATHWAYS • SALES • APPLICATIONS SPECIALIST • INDUSTRIAL X-RAY • MANAGEMENT (DEGREE) • EDUCATON 106 TRAVELING TECHNOLOGIST = SEE THE WORLD AND GET $$$ 107 Other working opportunities… • Registry (local) • Registry (out of state) • X rays taken around the world !! 108 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 109 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 110 Professional Organizations • ASRT – American Society of Radiologic Technologist • CSRT – California Society Society of Radiologic Technologists • RTEC – Radiologic Technology Educators of California • International Societies, other state societies, other modalities 111