The International Council for Certification of Cardiovascular Specialists and Assistants, Inc (ICCCSA) Reveal the Proposed Scope of Practice for Registered Cardiovascular Specialist Assistants (RCSA); Registered Cardiac Medical Specialists (RCMS); Registered Vascular Medical Specialists (RVMS).

Section 1. Scope of Practice for Registered Cardiac Medical Specialists (RCMS) and Registered Vascular Medical Specialists (RVMS)

A. A RCMS or RVMS:
1. Functions in the invasive and/or (or both) interventional cardiovascular medical imaging settings in a medical facility that offers complete medical care services.
2. Is a board certified and/or board eligible physician who is licensed by state or country practice medicine in one of the following cardiovascular specialties:
a. Invasive cardiologist
b. Interventional cardiologist
c. Cardiothoracic surgeon
d. Interventional radiologist
e. Neurosurgeon
f. Orthopedic surgeon
g. Surgeon
h. Vascular surgeon
3. Performs invasive and interventional cardiovascular procedures that he or she has been granted privileges by the facility’s credentialing committees to perform invasive and interventional cardiovascular procedures that s/he has been trained to perform through approved fellowship and/or residency programs.
4. Cannot perform procedures that are out of his or her scope of practice as approved by the facility.
5. Demonstrates the highest level of skill in clinical practice through knowledge in innovative ways that enhances the quality of patient’s services.
6. Maintains excellent communication through therapeutic professionalism with patients, patients’ families, careers, public, and other professionals.
7. Is proactive with the clinical governance agenda in patient services.
8. Provides the highest level of clinical leadership to other practitioners, cardio- cardiovascular specialist assistants, and other support staff members within the multidisciplinary team.
9. Develops and promotes outstanding patient services.
10. Contributes as a high-level resource that provides multicultural support and guidance to the patient and family units as well as the local, national, and international medical communities.
11. Develops and promotes a seamless service of medical care.
12. Contributes to the development of national guidelines that enhance management of patients.
13. Advances education, continuing education, and research that enriches the daily practice and influences the pathways for better patient care.
14. Exercises autonomy in decision-making in the role of a primary caregiver with a focus on patient assessment, patient management, and in a broad range of diagnostic and interventional medical imaging procedures.
15. Functions in a clinical role of a licensed physician who has been credentialed with technical allied health credentials to perform cardiovascular procedures with safe use of ionizing and non-ionizing equipment and use instrumentation needed to produce quality images of the cardiovascular systems of patients.
16. Must be recertified every seven (7) years by performing procedures on the “virtual patient” at one of the national or international training sites in the United States and must pass the “hands-on” examination with an excellent rating between a 4.0-5.0 scale level through the International Council for Certification of Cardiovascular Medical Specialists and Assistants, Inc.
17. Must pass separate certifications for the following areas of the body:
a. Left heart and coronary angiography
b. Percutaneous coronary intervention
c. Neck, carotid, and cerebral angiography
d. Thoracic cavity angiography and interventional studies
e. Abdominal angiography and interventional studies
f. Pelvic arteriography and interventional studies
g. Lower extremity arteriography and interventional procedures
h. Upper extremity arteriography and interventional procedures
i. Upper and lower extremity venography and interventional studies
j. Radial access approach
k. Intravascular ultrasonography (IVUS)
l. Intra-aortic balloon insertion and management therapy
m. Vascular access site closure device insertions
18. Must have the following skill sets:
a. Assesses and evaluates the physiological and psychological responsiveness of each patient
b. Participates in patient management, which includes prescriptive powers for imaging procedures
c. Administers intravenous and oral medications or contrast media
d. Documents all medications in the chart
e. Performs dynamic and static fluoroscopy
f. Performs procedures with ionizing radiation with focus on radiation safety measures for occupational workers, patients, support staff members, and self at all times
g. Performs procedures with the highest level of confidence and competency
h. Provides detailed technical reports that justifiably create diagnostic results for approved third party reimbursement requirements
i. Maintains professional values congruent with the Code of Ethics and Scope of Practice
j. Adheres to national, institutional, and/or departmental standards, policies and procedures that influence the continuity of patient care was well as standards of patient care.

Section 2. Scope of Practice for Registered Cardiovascular Specialist Assistants (RCSA)

A. An RCSA:
1. Functions in the invasive and/or (or both) interventional cardiovascular medical imaging settings in a medical facility that offers complete medical care services
2. Is an advanced level physician extender who has been specifically educated and trained to perform invasive and interventional cardiovascular procedures under the direct supervision of any of the following board certified or board eligible licensed physicians:
a. Invasive cardiologist
b. Interventional cardiologist
c. Cardiothoracic surgeon
d. Interventional radiologist
e. Neurosurgeon
f. Orthopedic surgeon
g. Surgeon
h. Vascular surgeon
3. Performs invasive and interventional cardiovascular procedures that he or she has been granted non-physician staff privileges by the facility’s credentialing department to perform.
4. Cannot perform procedures that are out of his or her scope of practice as approved by the his/her employer.
5. Demonstrates the highest level of skill in clinical practice through knowledge in in innovative ways that enhances the quality of patient’s services.
6. Maintains excellent communication through therapeutic professionalism with patients, patients’ families, careers, public, and other professionals.
7. Is proactive with the clinical governance agenda in patient services.
8. Provides the highest level of clinical leadership to other practitioners, cardiovascular specialist assistants, and other support staff members within the multidisciplinary team.
9. Develops and promotes outstanding patient services.
10. Functions as a high level resource that provides multicultural support and guidance to the patient and family units as well as the local, national, and international medical communities.
11. Develops and promotes a seamless service of medical care.
12. Contributes to the development of national guidelines that enhance management of patients.
13. Advances education, continuing education, and research that enriches the daily practice and influences the pathways for better patient care.
14. Exercises autonomy in decision-making in the role of a primary caregiver with a focus on patient assessment; patient management; and in a broad range of diagnostic and interventional medical imaging procedures.
15. Functions in a clinical role of a licensed or certified physician extender who has been credentialed with technical allied health credentials to perform cardiovascular procedures with safe use of ionizing and non-ionizing equipment, and use the instrumentation need to produce quality images of the cardiovascular systems of patients.
16. Must be recertified every seven (7) years by performing procedures on the “virtual patient” at one of the national or international training sites in the United States and must pass the “hands-on” examination with an excellent rating between a 4.0-5.0 scale level through the International Council for Certification of Cardiovascular Medical Specialists and Assistants, Inc.
17. Must pass separate certifications for the following areas of the body:
a. Left heart and coronary angiography
b. Percutaneous coronary intervention
c. Neck, carotid, and cerebral angiography
d. Thoracic cavity angiography and interventional studies
e. Abdominal angiography and interventional studies
f. Pelvic arteriography and interventional studies
g. Lower extremity arteriography and interventional procedures
h. Upper extremity arteriography and interventional procedures
i. Upper and lower extremity venography and interventional studies
j. Radial access approach
k. Intravascular ultrasonography (IVUS)
l. Intra-aortic balloon insertion and management therapy
m. Vascular access site closure device insertions
18. Must have the following skill sets:
a. Assesses and evaluates the physiological and psychological responsiveness of each patient.
b. Participates in patient management, which includes prescriptive powers for imaging procedures.
c. Administers intravenous and oral medications or contrast media.
d. Documents all medications in the chart.
e. Performs dynamic and static fluoroscopy.
f. Performs procedures with the highest level of confidence and competency.
g. Provides detailed technical reports that justifiably create diagnostic results for approved third party reimbursement requirements.
h. Maintains professional values congruent with the Code of Ethics.
i. Adheres to national, institutional, and/or departmental standards, policies and procedures that influence the continuity of patient care as well as standards of patient care.

Section 3 – Level of Practice of a RCMS, RVMS and RCSA

A. Roles of RCMS or RCSA
1. Must hold appropriate certifications in medicine or a recognized allied health field
2. Must comply with the requirements of any national or international certification agency
3. Must exhibit excellent clinical judgments with skill sets that adhere with this scope of professional practice
4. Must have willingness to continue professional development through lifelong learning processes without reproach
5. Must function in a partnership as a team worker, as a peer, and leader in a multi-professional team
6. Must demonstrate sound clinical skills in performing examinations as a RCSA
7. Must demonstrate sound clinical skills in performing examinations as an advanced level allied care professional certified as a RCSA
8. Must exhibit leadership abilities to supervise and provide guidance to the support staff members and other team members so the highest continuity and standards of care are achieved at all times.
9. Exhibits the abilities based on education and experiences to modify practice and protocols on clinical indications especially in adverse situations or life-threatening events
10. Demonstrates the abilities to function at an excellent level in evidence-based practices
B. Basic Skills and Judgments
1. Excellent complex interpersonal dynamic skills
2. Ability to advocate for patients and their family units
3. Excellent clinical reasoning skills needed to interpret data
4. Ability to assess and monitor the psychological and physical welfare of patients
5. Ability to make modifications of a requested examination or make such changes as deemed by the attending physician to techniques based on clinical indications or image appearances
6. Ability to make sound suggestions on the sequelae of treatment through the use of ionizing (X-radiation) and non-ionizing radiation (MRI and ultrasonography)
7. Ability to suggest suitable patient management strategies for appropriate referral care
8. Ability to make judgments in respect of procedural outcomes that directly impacts the mechanisms of patient care and management of patients
9. Exhibits advanced skills to complete a verbal or written comment on diagnostic images completed with ionizing and non-ionizing radiation
C. Principles of practice as an RCMS, RVMS or RCSA
1. Demonstrates advanced level psychomotor skills that were supported by highly developed knowledge, clinical, and technical experience
2. Exhibits highly developed judgment and decision-making skills
3. Is able to communicate highly complex, sensitive, and contentious information
4. Is able to function in an identified complex field of practice
5. Recognized by attending physicians, referring physicians, employers, and peers as a major resource in the field
6. Focuses on lifelong learning
7. Audits and addresses risks of own practice through established quality assurance policies and procedures of the medical entity
8. Is able to function across professional and organizational boundaries
9. Provides outstanding patient management within the clinical site of practice
10. Provides highly skilled patient care in the medical image specialty
11. Contributes to research and utilization of data that supports and helps develop practice
12. Remains autonomous, reflective, and independent in thinking and with outcomes.

_______________________

RCMS, RVMS, RCSA Credentials Awarded

The following cardiac and vascular medical specialists, along with allied healthcare professionals, have met the criteria set forth by the International Council for Certification of Cardiovascular Specialists and Assistants Incorporated. Physicians who perform cardiology procedures have been awarded the Registered Cardiac Medical Specialist (RCMS) credential. Medical specialists who perform invasive and/or interventional vascular procedures other than cardiac procedures have been awarded the Registered Vascular Medical Specialist (RVMS) credential.

Allied health professionals who perform or directly assist cardiologists and/or other cardiovascular medical specialists during procedures have been awarded the Registered Cardiovascular Specialist Assistant (RCSA) credential. We congratulate these health professionals who also contributed to the development of the core curricula for training and certification of cardiac and vascular medical specialists, as well as the cardiovascular special assistant program.

The Board of Directors of the Council wholeheartedly thank all of these outstanding representatives of the cardiovascular medical imaging community for their contributions over the past three years. Without their willingness to share their knowledge, experience, and wisdom, gratefully compiled and published in Cath Lab Digest in August 2008, September 2008, August 2009, and December 2009, the suggested curricula could not have been completed.

The Board of the Directors express their gratitude to the editorial staff at Cath Lab Digest for their expert preparation and final layouts of all of the manuscripts that pertain to the development of the advanced practice physician extender program. This program is dedicated to providing a higher set of patient care standards, focused on patient safety in our invasive cardiovascular procedure and surgical suites.

Aaron Price Sgt USA RCSA RCIS RCES
Adalberto Perez RCSA Sgt (P) CVT
Adele Serio RN BSN RCSA RCIS,
Aldo Carrillo RCSA BS RPA/RA RT(R)(CT)
Alexander Andreu RCSA RT(R) AS
Alicia Romero, MD RCMS RVMS
Amanda Walters RCSA RT(R) AS
Amar Patel, MD RCMS RVMS
Amy L. Elsass MD RCMS RCVS
Andrew Kremer HMC USN RCSA RCIS CCT
Arvilla Woodington RCSA BS
Barry Horsey RCSA RCIS
Barry J Henry MD RVMS
Barry McDaniel RCSA PA/RA RT(R)
Benjamin Ochoa SSgt USA RCSA RCIS RCES
Bhawna Oberoi BSRS RCSA RPA RT(R) (M)
Brent Rodriquez, RCSA RCIS RCPT RPFT BS
Calvin Carter RCSA RPA/RA RT(R)(VI)
Carol McGee RCSA RPA/RA RT(R) (CV)
Chris Hebert RT(R) RCSA RCIS
Christina Hill RCSA RT(R)
Christine Kauffman, RCSA RT(R) AS
Christine Testa RCSA APRN MSN
Christopher Graham, Sgt USA RCSA CVT
Christopher Haesler SSgt USA, RCSA CVT
Christopher Logan RCSA RCIS RCES,
Chuck Gibaut BS RCSA RCP RCIS
Chuck Williams, BS RCSA RPA/RA RCIS RT(R) (CV) (CI)
Clare Brady RCSA RPA/RA RT(R)
Claudia Poolson RCSA BS RPA/RA RT(R)
Claudio C Canto RCSA RPA/RA RT(R)
Constantin Cope MD RVMS
Craig Cummings RCSA RCIS FSICP
Craig Walker MD RCMS RVMS
Craig Wolfe RCSA RPA/RA RT(R)(VI)
Cynthia Lynady RCSA RCIS RCES
Daniel R. Jones RCSA RCIS BS
David E. Allie MD RCMS RVMS
David Clapp RT(R) RCSA
David Pyle RCSA RPA/RA RT(R)
David Schultz MD RCMS
Dean C Burdge RCSA PA/RA RT(R)
Deborah Curl RN BSN RCSA,
Deborah Peters RCSA RPA RT(R) (CV)
Dereck Carver RCSA RCIS AS
Derreck Johnson SSgt USA RCSA RCIS RCES
Diane Steffen RCSA RPA/RA RT(R)
Don Monroe RCSA RPA/RA RT(R)
Dongming Hou MD RCMS RVMS
Donna Hunt RCSA RCIS
Douglas C Morris MD RCMS
E. J. Mike RCSA RPA RT(R)
Eileen Ferguson RCSA RPA RT(R)(VI)
Eileen Taylor RCSA RPA/RA RT(R)(VI)
Fernando Escarzaga RCSA RPA/RA RT(R)
Gary Chaisson, RCSA RT(R)
Gary Lane MD RCMS
George Benetti RCSA RPA/RA RT(R)(VI)
George Soliman, MD RCMS
Gerald Ingraham RCSA RPA/RA RT(R)(CV)
Greg Traynor RCSA RCIS EMT-P
Gregory Monroe BS RCSA RCIS
Harrell Carmicheal SFC USA RCSA RCIS EMT-B
Harry Soto RCSA RPA/RA RT(R)
Harvey A Koolpe MD1 RVMS
Harvey McKinley RCSA RCIS EMT-P
Heather Grizzle RCSA RPA/RA RT(R)(VI)
Horace R Gillins BS RCSA CVT
Howard Sleath Sgt USA RCSA RCIS RCES EMT-B
J. George Sanchez RCSA RPA/RA RT(R)
Jack P. Chen MD FACC FSCAI FCCP RCMS
Jackson Thatcher MD FACC FSCAI RCMS
James R LePage MD RCMS RVMS
James Satrang RCSA RT(R)
Jane C. Wilson RCSA RN BSN
Jason Mays RCSA AS CVT
Jason Wilson RCSA RCIS,
Jeff Davis RCSA RRT RCIS FSICP
Jeff Mays RN RCSA ASN
Jeffrey Mays RCSA RCIS AS
Jennifer Malecki RN RCSA ASN
Jeremy Smallwood RCSA RPA/RA RT(R)(VI)
Jerome Aberra Sgt USA RCSA RCIS RCES
Jill Kathe RN RCSA BS ASN
Jim Todd BS RCSA RRT
Joe Brown RCSA RCPT
Johanna Jiminez Sgt (P) USA RCSA CVT
John H. Kathe MD RVMS
Jonathon Lopez SSgt USA RCSA RCIS RCS EMT-B
Jose Nino Sgt (P) USA RCSA CVT
Juan Munoz RCSA RPA/RA RT(R)(CV)
Judy Putkamer RCSA RPA/RA RT(R)(M)
Julie Logan RN RCSA
Justin White SSgt USA RCSA CVT
Kacie Reynolds RCSA CVT AS
Karen Sidorsky RCSA RPA RT(R)(CV)
Kathy A. Groce RCMS RN MSN RCPT
Kelly J Broxton RCSA RCIS RT(R) AS
Kenneth A. Gorski RN RCSA RCIS FSICP
Kevin Wynn Sgt USA RCSA CVT
Kim Garwood RCSA RPA/RA RT(R)
Kim Nester RN RCSA BSN
Kim Stracener RCSA RPA RT(R)(VI)
Lanier Hall BS RCSA RPA/RA RT(R)
Laura Murphy RN BSN RCSA
Lindsey Ferguson RN RCSA
Lewis W Stark RCSA RPA/RA RT(R)(CV)
Linda Cook-Yentes RCSA RPA/RA RT(R)(CV)
Linwood McNeil RT(R) AS, RCSA
Lisa Higgins RN RCSA MSN APRN-C
Lorena Hendry PA-C RCSA BS
Manuel Viamonte, Jr. MD RCMS RVMS
Marcene Compton BS RCSA RPA RT(R)
Marco A Serrano RCSA RPA/RA RT(R)
Matthew Harris Sgt (P) USA RCSA CVT
Melissa Broddle RCSA RT(R) AS
Melissa Weissinger RCSA RT(R)
Micheal Bowen RCSA APRN MSN
Micheal Guiry PA-C RCSA BS
Micheal McDaniel MD RCMS RVMS
Micheal Reiser MD RVMS
Micheal Scott MD RVMS
Michele Voeltz MD RCMS RVMS
Michelle Luedee RCSA RT(R)
Mike Stringer RCSA RPA/RA RT(R)
Mireya Canate SSgt USA RCSA CVT CS EMT-B
Mohammad Hussain RCSA RPA/RA RT(R)
Monica Bush SSgt (P) USA RCSA RCIS
N. Henry Pevsner, MD RVMS
Nathan Braun RCSA RPA/RA RT(R)
Neil E. Holtz RCSA RCIS BS EMT-P
Nicole Geiger RCSA RCIS AS
Patricia Adams RCSA CVT AS
Patricia Thomas MBA RCSA RCIS FSICP
Patrick Hoier BS RCSA RCIS FSICP
Pattie Freschett RN RCSA RCIS BSN BBA
Phyllis Williams RN RCSA ASN CEN
Puvi Seshiah MD RCMS
Rachel Koolpe RCSA, BS
Ray Lenius MEd RCSA RCIS
Regina Deible RN RCSA BSN
Rhoda Hammer RN RCSA MS BSN RCIS
Richard Chen MD RCMS
Richard Matthews RCSA RPA/RA RT(R)
Richard Oblak RCSA RPA/RA RT(R)(CV)
Robert Biederman MD RCMS
Robin Copeland RN RCSA BSN
Ronald B Williams BA RCSA RT(R) (MR),
Ronald Gomick Sgt (P) RCSA RCIS RDCS
Sandy Watson RN RCSA
Shataundia Reese RN RCSA BSN
Sheila Debastiani RCSA RT(R)
Shelly Ryan RCSA RCSA
Shirley Yearly RCSA RPA/RA RT(R),
Siro Buendia RN RCSA
Stephanie Williams RN RCSA ASN
Stephen Knight RCSA RPA/RA RT(R)
Steven K. Zegar RCSA RPA RT(R)
Susan Guinard RCSA RPA/RA RT (R)(CV),
Susan Steinbis APRN RCSA MSN
Taekyung Kim SSgt USA RCSA RCIS CS EMT-B,
Teresa B Waters MBA BS RCSA RT(R)
Terry Scott RN RCSA BSN
Tim D’Augustino RCSA RPA/RA RT(R)(CI)
Tim Rohrschneider RCSA BMSc RT(R)
Tracy Schneider APRN RCSA MSN
William A Martin MD RCM
Kim Garwood RCSA RPA/RA RT(R)
Kim Nester RN RCSA BSN
Kim Stracener RCSA RPA RT(R)(VI)
Lanier Hall BS RCSA RPA/RA RT(R)
Lewis W Stark RCSA RPA/RA RT(R)(CV)
Linda Cook-Yentes RCSA RPA/RA RT(R)(CV)
Lisa Higgins RN RCSA MSN
Lorena Hendry PA-C RCSA BS
Manuel Viamonte, Jr. MD RCMS RVMS
Marcene Compton BS RCSA RPA RT(R)
Marco A Serrano RCSA RPA/RA RT(R)
Marsha Holton RN BS RCSA RCIS
Matthew Harris Sgt (P) USA RCSA CVT
Melissa Broddle RCSA RT(R) AS
Melissa Weissinger RCSA RT(R)
Micheal Bowen RCSA APRN MSN
Micheal Guiry PA-C RCSA BS
Micheal McDaniel MD RCMS RVMS
Micheal Reiser MD RVMS
Micheal Scott MD RVMS
Michele Voeltz MD RCMS RVMS
Michelle Luedee RCSA RT(R)
Mike Stringer RCSA RPA/RA RT(R)
Mireya Canate SSgt USA RCSA CVT CS EMT-B
Mohammad Hussain RCSA RPA/RA RT(R)
Monica Bush SSgt (P) USA RCSA RCIS
Nathan Braun RCSA RPA/RA RT(R)
Neil E. Holtz RCSA RCIS BS EMT-P
Nicole Geiger RCSA RCIS AS
Patricia Adams RCSA CVT AS
Patricia Thomas MBA RCSA RCIS FSICP
Patrick Hoier BS RCSA RCIS FSICP
Pattie Freschett RN RCSA RCIS BSN BBA
Phyllis Williams RN RCSA ASN CEN
Puvi Seshiah MD RCMS
Rachel Koolpe RCSA, BS
Ray Lenius MEd RCSA RCIS
Regina Deible RN RCSA BSN
Rhoda Hammer RN RCSA MS BSN RCIS
Richard Chen MD RCMS
Richard Matthews RCSA RPA/RA RT(R)
Richard Oblak RCSA RPA/RA RT(R)(CV)
Robert Biederman MD RCMS
Robin Copeland RN RCSA BSN
Ronald B Williams BA RCSA RT(R) (MR),
Ronald Gomick Sgt (P) RCSA RCIS RDCS
Sandy Watson RN RCSA
Shataundia Reese RN RCSA BSN
Sheila Debastiani RCSA RT(R)
Shelly Ryan RCSA RCSA
Shirley Yearly RCSA RPA/RA RT(R),
Siro Buendia RN RCSA
Stephanie Williams RN RCSA ASN
Stephen Knight RCSA RPA/RA RT(R)
Steven K. Zegar RCSA RPA RT(R)
Susan Guinard RCSA RPA/RA RT (R)(CV),
Susan Steinbis APRN RCSA MSN
Taekyung Kim SSgt USA RCSA RCIS CS EMT-B,
Teresa B Waters MBA BS RCSA RT(R)
Terry Scott RN RCSA BSN
Tim D’Augustino RCSA RPA/RA RT(R)(CI)
Tim Rohrschneider RCSA BMSc RT(R)
Tracy Schneider APRN RCSA MSN
William A Martin MD RCM
Tracy Simpson, RN BSN RCSA RCIS FSICP
Tressie Brooks RN RCSA BSN
Trevor Smith HM1 USN AAS CVT RCSA RCIS RCES CCT MTS
Vicki Ward RCSA RPA/RA RT(R)(VI)
Wayne Cochran BS RCSA RCIS
Wes Todd RCSA RCIS BS
William Embil RCSA BS