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TASK INVENTORY FOR VASCULAR-INTERVENTIONAL RADIOGRAPHY ® ARRT Board Approved: July 2014 Implementation Date: July 2015 Certification requirements for vascular-interventional radiography (VI) are based on the results of a comprehensive practice analysis conducted by The American Registry of Radiologic Technologists® (ARRT®) staff and the Practice Analysis Advisory Committee. The purpose of the practice analysis is to identify job responsibilities typically required of staff vascular-interventional radiographers at entry into the profession. In 2013, the ARRT did an interim update and reviewed a select number of tasks that were of interest. The results of the practice analysis and interim update are reflected in this document. The purpose of the task inventory is to list or delineate those responsibilities. The task inventory is the foundation for both the clinical experience requirements and the content specifications. Basis of Task Inventory The practice analysis survey was used to identify the responsibilities typically required of staff technologists who perform VI. When evaluating survey results, the advisory committee applied a 40% guideline. That is, to be included on the task inventory, an activity must have been the responsibility of at least 40% of staff technologists who perform VI. The advisory committee could include an activity that did not meet the 40% criterion if there was a compelling rationale to do so (e.g., a task that falls below the 40% guideline but is expected to rise above the 40% guideline in the near future). Application to Clinical Experience Requirements The purpose of the clinical experience requirements is to verify that candidates have completed fundamental clinical procedures in VI. Successful performance of these fundamental procedures, in combination with mastery of the cognitive knowledge and skills covered by the VI examination, provides the basis for acquisition of the full range of clinical skills required in a variety of settings. An activity must appear on the task inventory to be considered for inclusion in the clinical experience requirements. For an activity to be designated as a mandatory requirement, survey results had to indicate that the vast majority of technologists who perform VI performed that activity. The advisory committee designated clinical activities performed by fewer technologists, or which are carried out only in selected settings, as elective. The clinical experience requirements are available from ARRT’s website (www.arrt.org) and appear in the Vascular-Interventional Radiography Certification Handbook. Application to Content Specifications The purpose of the ARRT VI Examination in is to assess the knowledge and cognitive skills underlying the intelligent performance of the tasks typically required of staff technologists who perform VI. The content specifications identify the knowledge areas underlying performance of the tasks on the task inventory. Every content category can be linked to one or more activities on the task inventory. Note that each activity on the task inventory is followed by a content category that identifies the section of the content specifications corresponding to that activity. The content specifications are available from ARRT’s website (www.arrt.org) and appear in the VascularInterventional Radiography Certification Handbook. Copyright © 2015 by The American Registry of Radiologic Technologists. All rights reserved. Reproduction in whole or part is not permitted without the written consent of the ARRT Content Categories Activity 1. Maintain inventory of sterile supplies and medications. 2. Prepare materials or trays with medications and materials for special treatments or procedures according to standard order. 3. Prepare treatment or examination equipment for sterilization. 4. Provide regular daily maintenance and cleaning of the automatic pressure injector. 5. Monitor performance and dependability of the automatic pressure injector on a continual basis as related to programmed injection parameters. 6. Inspect, prepare, and troubleshoot all equipment components of the procedure room. 7. Verify presence of appropriate signed informed procedural consent. 8. Verify patient’s identification. 9. Obtain information about the patient which might indicate a risk of drug or contrast reaction prior to any procedure, using patient records or by questioning patient. 10. Measure and record vital signs of patient prior to the procedure to establish a baseline. 11. Participate in pre-procedural time-out activity. 12. Prepare the access site to include the required sterile drapes and covers. 13. Provide for patient comfort and cooperation by familiarizing patient with the equipment and procedural aspects of the examination and by responding to questions, and by providing general physical and emotional support. 14. Physically prepare the patient for the examination to include ECG electrodes and physiological monitoring equipment. In conjunction with supervising physician, select the appropriate contrast agent: 15. ionic 16. nonionic 17. a. low osmolality 18. b. isosmolar 19. 20. CO2 Set-up or operate the automatic pressure injector for administering contrast media. Prepare or assist in administering (e.g., obtain medication, fill syringe, etc.) the following types of injectable medications according to physician’s orders: 21. analgesics 22. anticoagulants 23. IV conscious sedatives ARRT, Page 2 Content Categories Activity 24. thrombolytics 25. vasoconstrictors 26. vasodilators 27. Monitor patient’s vital signs and ECG readings. 28. Recognize patient emergencies (seizure, cardiac distress, etc.). 29. Respond to patient emergencies (e.g., CPR, defibrillation). 30. Monitor and maintain medical equipment (e.g., IVs, oxygen) used during the procedure. 31. Use sterile or aseptic technique as required to help prevent infection. 32. Handle blood and body fluids in a manner appropriate to biohazardous materials. 33. Position the patient and/or imaging equipment to achieve desired projections. 34. Adjust exposure factors (e.g., mA, kVp, sec.) as required to obtain quality image while minimizing dose. 35. Employ special image-enhancement techniques (magnification, filtration, etc.) during procedure to improve image quality. 36. Initiate digital acquisition of the radiographic images. Process images as required: 37. digital processing 38. 3D reconstruction 39. Assist with ultrasound guidance for vascular access or organ access/biopsy. 40. Adjust and calibrate the pressure transducers used for intravascular pressures and/or intraventricular pressures. 41. Scrub-in with the physician. 42. Record and maintain all procedural data. (e.g., radiographic exposure factors, injection data, elapsed fluoroscopic time, physiologic data, administered medications, and complications). Assist with or perform the following procedures: Neurologic Diagnostic Procedures 43. cerebral arteriography 44. carotid arteriography 45. spinal arteriography ARRT, Page 3 Content Categories Activity Interventional Procedures 46. embolization 47. thrombolysis 48. thrombectomy 49. angioplasty 50. stent placement 51. distal protection device placement 52. foreign body retrieval 53. vertebroplasty 54. kyphoplasty 55. discography Thoracic Diagnostic Procedures 56. aortography 57. pulmonary arteriography 58. pulmonary pressure measurement 59. superior vena cava (central venography) Interventional Procedures 60. chest tube placement 61. thoracentesis 62. endograft placement 63. embolization 64. thrombolysis 65. thrombectomy 66. angioplasty 67. stent placement 68. biopsy 69. drainage procedures 70. foreign body retrieval 71. thermal ablation ARRT, Page 4 Content Categories Activity Abdominal Diagnostic Arterial Procedures 72. aortography 73. pelvic 74. renal 75. adrenal 76. reproductive 77. celiac 78. superior mesenteric artery (SMA) 79. inferior mesenteric artery (IMA) Diagnostic Venous Procedures 80. pelvic 81. inferior vena cava 82. renal 83. adrenal 84. gonadal 85. venous sampling 86. hepatic 87. portal Interventional Procedures 88. caval filter placement 89. caval filter removal 90. endograft placement 91. paracentesis 92. thrombolysis 93. thrombectomy 94. angioplasty 95. stent placement 96. foreign body retrieval 97. TIPS ARRT, Page 5 Content Categories Activity 98. chemoembolization 99. radioembolization 100. embolization (other) GU and GI, non vascular GU Interventional Procedures 101. nephrostomy 102. ureteral dilatation/stents 103. percutaneous renal stone extraction 104. drainage procedures 105. thermal ablation GI Interventional Procedures 106. percutaneous biliary stone extraction 107. percutaneous transhepatic cholangiogram 108. biliary drainage/stenting 109. cholecystostomy 110. gastrostomy/gastrojejunostomy 111. drainage procedures 112. biopsy (percutaneous or transvascular) 113. thermal ablation Peripheral Diagnostic Arterial Procedures 114. upper extremity 115. lower extremity Diagnostic Venous Procedures 116. upper extremity 117. lower extremity Interventional Procedures 118. embolization 119. thrombolysis 120. thrombectomy ARRT, Page 6 Content Categories Activity 121. angioplasty 122. stent placement 123. atherectomy 124. foreign body retrieval Dialysis Management 125. hemodialysis graft/fistula study 126. thrombolysis 127. thrombectomy 128. angioplasty 129. stent placement Venous Access 130. PICC lines 131. temporary dialysis catheter 132. tunneled dialysis catheter 133. port placement 134. central lines 135. peripheral IV Follow-Up Patient Care 136. deploy vascular closure device 137. apply pressure to arterial or venous puncture site 138. apply dressing to puncture 139. explain post-procedure care instructions to patient ARRT, Page 7