Registered Cardiovascular Invasive Specialist (RCIS)

Requires:  Passing the one-part Invasive Registry Examination

Who should apply:  Professionals working in the area of Cardiac Catheterization (Invasive)

Specialty Examination Fee:  $365

Effective July 1, 2013, Cardiovascular Credentialing International (CCI) removed the RCIS1 Qualification for First Time Applicants (also referred to as the On-the-Job Training qualification) that allows applicants who ONLY have two (2) years (full-time or full-time equivalent) working in Invasive Cardiovascular Technology, at the time of application, to qualify for CCI's Invasive Registry examination. Click here for a downloadable .pdf version of the press release.

 

Click here for information on ordering the Self Assessment Examination

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Registered Cardiovascular Invasive Specialist (RCIS)

Qualification Requirements

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 under which you are applying. Required documentation for each qualification is listed below. CCI reserves the right to request additional information.
Qualification Prerequisite Supporting Documentation
RCIS235-2013

A graduate of a diploma, associate, or baccalaureate academic program in health science
(includes, but not limited to, cardiovascular technology, ultrasound, radiologic technology,
respiratory therapy, or nursing)
AND
One year full-time work experience in invasive cardiovascular technology
AND
600* cardiac diagnostic/interventional procedures 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.

RCIS235-2013

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)
 

RCIS5

A graduate of a NON-programmatically accredited program in invasive cardiovascular technology 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 RCIS5. All clinical hours must be earned in a setting in which patients are being tested or medically treated.

RCIS5

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

RCIS4

Applicant must be a graduate of a programmatically accredited** program in invasive
cardiovascular technology.

RCIS4

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

* If an individual’s procedures were completed during a formal educational program, then those procedures completed WOULD count toward the minimum of 600 diagnostic/interventional procedures under qualification RCIS235-2013.

** 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

 

Click here for sample Employment Verification Letter, Student Verification Letter and Clinical Verification Letter (Graduates of Non-accredited Programs in Invasive Cardiovascular Technology).

 

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 (required for candidates applying on or after July 1, 2013).
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 or Vascular or Invasive),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 Invasive Cardiovascular Technology) 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 hour minimum under qualification RCIS5.

Exam Overview Sunday, November 08th 2009 11:32 PM

Registered Cardiovascular Invasive Specialist (RCIS)

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 Percentage of Examination
Conducting Pre-Procedural Activities 10%
Conducting Intra-Procedural Activities 40%
Conducting Invasive Procedures 40%
Conducting Post-Procedural Activities 10%
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.

Mathematics
• Calculation/conversion skills
• Units of measurement
• Shunt calculations, VOA
Medical terminology
Cardiovascular anatomy and physiology
Cardiovascular pathology and pathophysiology
Body mechanics
Regulatory and compliance standards
Patient care and assessment
Normal and abnormal lab values
ECG interpretation and analysis
Pharmacology and medication administration
Hemodynamic waveform recognition
• Angiography
• Radiation safety
• Operation of radiographic equipment
• IVUS
• ICE
Sterile technique
Universal precautions
Diagnostic and interventional procedures
• Cardiac procedures
• Vascular procedures
• Device implants
• Procedural indications, contraindications, and complications
Hemostasis
Emergency procedures and equipment
 

Task List

The task list below describes the activities which a Registered Cardiovascular Invasive Specialist is expected to perform on the job. All examination questions are linked to these tasks.

Duties and Tasks % of Exam
 
A Conducting Pre-Procedural Activities 10%
 1 Prepare procedure room (e.g., set up equipment, QC, QA)  
 2 Review patient chart (e.g., lab results, consent, verifying orders, medical record)   
3 Prepare patient for procedure (e.g., patient ID/verification, start IV, educate patient)  
 4 Set up sterile field (e.g., patient, procedure table, equipment)  
B Conducting Intra-Procedural Activities 40%
 1 Monitor vital signs of patients (e.g., heart rate rhythm, blood pressure, respiratory rate, O2 saturation)

5 Monitor ACT (Activated Clotting Time)
6 Ensure radiation safety (e.g., time, distance, shielding)
7 Position radiographic equipment (e.g., C arm, pan table, angles & views)
8 Acquire/interpret radiographic images (administer contrast)
9 Administer conscious sedation (e.g., levels, Aldrete, assessing effects)
10 Place arterial lines
11 Place venous lines
12 Perform intra-coronary injection
13 Perform cardiac outputs (e.g., TDCO)
14 Perform endomyocardial biopsy
15 Respond to intra-procedural emergency situations (e.g., anaphylaxis, cardiac arrest, cardiogenic shock, tamponade, ACLS)

 
 2  Evaluate hemodynamic data (e.g., pressure waveforms, CO, Fick, Shunt, PVR, SVR, valve areas)  
 3  Perform 12-lead ECG analysis (e.g., infarct, bundle branch, ischemia, tamponade)  
 4  Understand pharmacologic effects of medications (e.g., ACLS, recognize side effects/adverse reactions, pain management)  
C Performing Invasive Procedures 40%
 1 1 Perform adult cardiac catheterization
2 Perform Intra-vascular ultrasound (IVUS)
3 Perform Intra-cardiac echocardiography (ICE)
4 Perform Fractional Flow Reserve (FFR)
5 Perform device implants (e.g., pacemaker, ICD)
6 Perform coronary balloon angioplasty (including CTO devices)
7 Perform peripheral interventions (e.g., carotids, renals, SFAs, vena cava filters)
8 Perform coronary stenting
9 Perform rotational atherectomy
10 Perform laser interventional procedures
11 Perform IABP insertion (intra-aortic balloon pump)
12 Insert and operate transvenous temporary pacemaker
13 Perform pericardiocentesis
14 Perform transcatheter valve repair/replacement
15 Perform structural heart disease interventions (e.g., ASD/PFO, VSD, PDA)
16 Perform percutaneous valvuloplasty
17 Operate thrombectomy equipment (e.g., Angiojet, aspiration catheter)
18 Implant percutaneous left ventricular assist device (e.g., LVAD, Impella)
19 Assist with transseptal puncture
20 Insert distal protection devices
 
 2    
 3    
Duties and Tasks % of Exam
 
D Conducting Post-Procedural Activities 10%
  1 Obtain femoral hemostasis with manual pressure
2 Obtain femoral hemostasis with collagen closure device
3 Obtain femoral hemostasis with mechanical device
4 Obtain radial hemostasis manually or with mechanical device
5 Manage access site complications
6 Respond to post-procedure emergency situations (e.g., vasovagal, anaphylaxis, retroperitoneal bleed)
 
     
     
     
     
     
     
     
     
     
Total   100%
  1. Based on the following data: O2 Consumption = 250 ml/min., AO = 21.0 vol. %, PA = 16.0 vol. %, BSA = 1.8 M2. What is the approximate cardiac output for the patient?
    1. 2.5 L/min.
    2. 4.0 L/min.
    3. 5.0 L/min.
    4. 6.0 L/min.
  2. Based on the following data: O2 Consumption = 250 ml/min., AO = 21.0 vol. %, PA = 16.0 vol. %, BSA = 1.8 M2. What is the approximate cardiac index for the patient?
    1. 2.22 L/min./M2
    2. 2.77 L/min./M2
    3. 3.00 L/min./M2
    4. 3.33 L/min./M2
  3. If T-wave sensing occurs in ventricular demand or synchronous pacing, what must be done to the programmable generator?
    1. Increase pulse width
    2. Decrease pulse width
    3. Longer refractory period
    4. A shorter refractory period
  4. If a patient had a large S-wave in lead VI and a large R-wave in V5, you might suspect:
    1. LVH
    2. IV Strain
    3. Hyperkalemia
    4. Anterior Infarction
  5. What is most likely indicated from the following oximetry samples?
    Position, Saturation %, Position, Saturation %
    SVC, 70%, RV, 86%
    IVC, 71%, PA, 86%
    Hi RA, 78%, LA, 94%
    Mid RA, 86%, LV, 94%
    Low RA, 83%, AO, 94%
    1. ASD with left to right shunt
    2. PDA with left to right shunt
    3. VSD with left to right shunt
    4. Tetralogy of Fallot with bidirectional shunt

 

 

Answers:
1. c 2. b 3. c 4. a 5. 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. Aehlert, Barbara. ECGs made easy. 4th ed. St. Louis: Mosby, 2009.
2. Baim, Donald S., and William Grossman. Grossman’s cardiac catheterization, angiography, and intervention. 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2006.
3. Daily, Elaine Kiess, and John Speer Schroeder. Techniques in bedside hemodynamic monitoring. 5th ed. St. Louis: Mosby, 1994.
4. Darovic, Gloria Oblouk. Hemodynamic monitoring: invasive and noninvasive clinical application. 3rd ed. Philadelphia: W.B. Saunders Co., 2002.
5. Kern, Morton J.. The cardiac catheterization handbook. 4th ed. Philadelphia, PA: Mosby, 2003.
6. Safian, Robert D., and Mark Freed. The manual of interventional cardiology. 3rd ed. Royal Oak, Mich.: Physicians’ Press, 2001.
7. Watson, Sandy, and Kenneth A. Gorski. Invasive cardiology: a manual for cath lab personnel. 3rd ed. Sudbury, MA: Jones and Bartlett Learning, 2011.

 

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