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

 

Qualification Prerequisite (All applicants must fulfill one of the following) Supporting Documentation
RCS1-2013
Two years of full-time or full-time equivalent work 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 or full-time equivalent 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)

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.

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.

 

IMPORTANT: If an individual’s clinical hours 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. All clinical hours must be earned in a setting in which patients are being tested or medically treated.

RCS5

Completion certificate and/or 

educational transcript

AND

Student Verification Letter

AND

Clinical Experience Letter

 

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

RCS6
Active ultrasound credential holder with six (6) months of full-time or full-time equivalent work experience in cardiac ultrasound. The applicant must have participated in a minimum of 100 cardiac ultrasound studies* at the time of application.


In the verification letter, the medical director(s) and/or clinical supervisor must confirm the number of studies performed during the applicant’s employment and/or during the academic program.

RCS6
Copy of wallet card showing date earned and active through date of ultrasound registry credential
AND
Employment Verification Letter (must confirm the number of studies performed during the applicant’s employment).
AND/OR
Clinical Experience Letter (only required for applicants submitting verification of the number of studies completed during a formal educational program)

 

* If an individual’s studies were conducted during a formal educational program, then those studies completed WOULD count toward the minimum cardiac ultrasound studies under qualifications RCS235-2013 and RCS6.
** 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.

 

Updated July 2016

 

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

Registered Cardiac Sonographer (RCS)

Examination Matrix

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 % of Examination
A. Preparing for Echocardiographic Procedure 5%
B. Performing Echocardiographic Imaging 23%
C. Evaluating Echocardiographic Findings 49%
D. Completing Post-Procedural Activities 7%
E. Applying the Physics of Ultrasound 16%
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 and 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 a Registered Cardiac Sonographer is expected to perform on the job. All examination questions are linked to these tasks.

Duties and Tasks % of Exam
 
A Preparing for Echocardiographic Procedure 5%
1 Verify echocardiographic order  
2 Prepare echocardiographic patient  
3 Prepare echocardiographic equipment  
     
B Performing Echocardiographic Imaging 23%
1 Perform 2D echo  
2 Perform M-mode  
3 Perform color Doppler  
4 Perform spectral Doppler  
5 Perform contrast echocardiography  
6 Perform exercise echocardiography  
7 Perform pharmacological echocardiography  
8 Assist with transesophageal echocardiography  
C Evaluating Echocardiographic Findings 49%
1 Identify normal anatomy, physiology, and hemodynamics  
2 Evaluate cardiac chambers  
3 Evaluate heart failure  
4 Evaluate cardiomyopathies  
5 Evaluate diastolic function  
6 Assess ischemic heart disease  
7 Assess aortic valve  
8 Assess mitral valve  
9 Assess tricuspid valve  
Duties and Tasks % of Exam
10 Assess pulmonic valve  
11 Evaluate pericardial disease  
12 Evaluate great vessels  
13 Evaluate diseases of the aorta  
14 Evaluate pulmonary hypertension  
15 Evaluate cardiac masses  
16 Recognize congenital heart disease  
     
D Completing Post-Procedural Activities 7%
1 Transfer echocardiographic data  
2 Document echocardiographic findings  
3 Communicate with healthcare team  
4 Provide post-examination instructions  
     
E Applying the Physics of Ultrasound 16%
1 Identify properties of ultrasound waveforms  
2 Recognize artifacts  
3 Identify properties of transducers  
4 Optimize resolution  
5 Optimize frame rate  
6 Optimize Doppler waveforms  
7 Optimize color Doppler  
8 Optimize 2D image  
     
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.

 

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