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Letter from the Editor

An Extensive Set of Review Courses for the CCI Basic Science, Non-Invasive Echocardiography and Vascular, and ARDMS Ultrasound E

Neil E. Holtz, BS, EMT-P, CVT, Phyllis Williams, RN, AND, CEN, CVT, Pattie Freschett, RN, BSN, CVT, Charles O. Williams, BS, RPA, RT(R)(CV)(CI), RCIS, CPFT, CCT, FSICP
March 2008

Pegasus Lectures, Inc. presented an extensive board review courses for the Cardiovascular Credentialing International (CCI) Basic Science Review, Echocardiography, and American Registry of Diagnostic Medical Stenographers (ARDMS) Ultrasound Exams in Buckhead, Georgia, from Tuesday, January 30, through Sunday, February 3, 2008. The meeting opened with an introduction from Debbie Anderson, Marketing Director, Pegasus Lectures, Inc., who also introduced Marsha Holton, RN, CCRN, RCIS. Ms. Holton presented the material for allied healthcare professionals who plan to take the CCI Basic Science Review Exam prior to taking the cardiovascular invasive specialist exam or the non-invasive echo or vascular specialist exams.
Her lectures included the following topics:

1. Anatomy and Physiology I focused on structural components, cellular metabolism and energy production, transportation and exchange of gases, and the basic structural components of the thoraco-abdominal cavities.

2. Anatomy and Physiology II pertained to constituents of blood, and systemic, pulmonary and lymphatic circulation.

3. Anatomy and Physiology III reviewed the cerebral and neck vascular anatomy, cardiac vascular anatomy, thoraco-abdominal vascular anatomy, pelvic vascular anatomy, and peripheral vascular anatomy of the upper and\lower extremities. 4. Anatomy and Physiology IV was dedicated to electromechanical events that form the ECG patterns of the human heart and the cardiac cycle, which included correlation to intra-cardiac pressures and heart sounds.

5. Anatomy and Physiology V refreshed knowledge of left ventricular function that included stroke volume, heart rate, cardiac preload and afterload, cardiac output, cardiac index, contractility, venous return and parasympathetic sympathetic innervation.

6. Cardiovascular procedures and techniques review included basic cardiac life support, cardiac defibrillation, diagnostic examination, cardiac surgical inter-ventions, cardiac embryology, and body ergonomics in invasive and non-invasive medical imaging suites. Ms. Holton focused on the following congenital heart defects:

a) Atrial and ventricular septal defects; b) Coarctation of the aorta; c) Patent ductus arteriosus; d) Patent foramen ovale; e) Tetralogy of Fallot; f) Transposition of the great vessels; g) Tricuspid atresia; and h) Eisenmenger’s Syndrome.


She also emphasized the various surgical repair strategies that have been used to repair cardiac defects in children.

7. Patient care covered medical terminology, patient positioning, patient assessment, risk management, and standards and regulations.

8. Informed consent and the responsibility of the physician to provide sufficient information to a patient in order for them to make an intelligent decision to consent to a procedure, as well as how to protect a patient’s right to self-determination regarding a procedure that may be injurious were well discussed.

9. Cardiac pharmacology covered management of contrast media and medication reactions, local anesthesia, controlled substances, nitrates, oxygen, elements of moderate conscious sedation, alpha and beta stimulators, inotropes, anticoagulants, anti-arrhythmics, GP IIb/IIIa platelet inhibitors and medication reversal agents.

10. Quality improvement reviewed aseptic technique, how to surgically scrub for sterile procedures, and preventive maintenance needed to maintain sterility to prevent infection.

Over 130 cardiovascular technologists, nurses, sonographers, ultrasound students and several physicians attended the educational conference. Dr. Jean Gillan, from California, explained that she attended the review course because she uses ultrasound in her surgical practice and the state of California now requires physicians who perform ultrasound studies to be formally certified. In her situation, she would be taking the credentialing exam offered by the American Registry of Diagnostic Medical Stenographers (ARDMS).
In addition, many sonographers who have been performing echocardiography and ultrasound studies for years also attended, because they have been instructed by their employers that they now have to have certification due to Medicare requirements and an increasing number of third-party carriers, or face the loss of their positions. Many physicians are attending these technical courses to become certified in ultrasound procedures through ARDMS and/or CCI in order to adhere to their state medical board license requirements.


On Tuesday afternoon, Frank Miele, President, Pegagus Lectures Inc., began three one-hour lectures on the hemodynamics of the circulatory system with the use of ultrasound. This dynamic lecturer has authored or co-authored a textbook and several educational programs that are available on compact discs (See Table 1). On Wednesday, Mr. Miele presented an authoritative set of lectures on system units; descriptive statistics, quality and assurance (gold standard testing), key concepts of quality assurance; mathematics, which included twenty-two units of study; and the key concepts of mathematics. On Thursday, this amazing educator, who holds a triple major in physics, mathematics, and engineering from Dartmouth College, began his formal discussions on the physics of ultrasound and instrumentation that encompassed the day. Mr. Miele presented lectures on ultrasound physics and instrumentation, vascular physics and instrumentation, and cardiovascular physics, principles, and instrumentation throughout the entire six-day educational symposium. Each time a break was taken, he was immediately surrounded by the course participants, who asked him to elaborate on various aspects of a just-completed lecture.

On Friday, Saturday, and Sunday, the rest of the speaker bureau arrived to handle the board review material for the ultrasound subspecialties. Catherine Cart-Hoefer, RDMS, RDCS, RVT, RT, FSDMS, presented the exam board review on obstetrics and gynecology. Ms. Carr-Hoefer is the Assistant Director of Diagnostic Imaging, Good Samaritan Regional Medical Center, Corvailis, Oregon. She is renowned in breast ultrasound imaging and has written a textbook and ExamSim Suite CD on the subject. Robert DeJong, RMDS, RDCS, RVT, delivered outstanding review material on abdominal ultrasound imaging. He is the Radiology Technical Manager, Ultrasound, John Hopkins Medical Institution, Baltimore, Maryland. Mr. DeJong is an academic lecturer who teaches medical residents, radiology residents and ultrasound students.
The review material on vascular ultrasound was handled by Marsha M. Neumyer, BS, RVT. Ms. Neumyer is the CEO and International Director, Vascular Diagnostic Educational Services, Vascular Resource Associates, Harrisburg, Pennsylvania. She is a former assistant professor of surgery at the College of Medicine, Penn State University and was a founding member of the Intersocietal Commission for Accreditation of Vascular Laboratories. In addition, she has authored Vascular Technology ExamSim Suite Program that is available on CD (Table 1).
Terry Reynolds, BS, RDCS traveled from Arizona to present the board review program on fetal, pediatric, and adult echocardiography. Mr. Reynolds is the Director of the Cardiac School of Ultrasound, Arizona Heart Institute, Phoenix, Arizona. Terry has authored several textbooks which include The Echocardiographer’s Pocket Reference and The Pediatric Echocardiographer’s Pocket Reference (Table 1).
For educators in ultrasound, this corporation also offers an extensive weekend courses to assist educators who teach ultrasound physics how to cover ultrasound physics concepts and critical teaching topics. The seminar is divided into ultrasound physics content modules that cover: 1) Doppler; 2) bioeffects; 3) foundational and relational mathematics; and 4) transducers, artifacts, etc. In addition, the educational modules are directed towards critical teaching topics such as motivating and preparing students to sit for the credentialing exams, how to write good exams, how to improve test-taking strategies, how to incorporate physics labs, and how to create focused and results-oriented syllabuses. Another purpose of this seminar is for educators in ultrasound programs to network, share their experiences, strengths, and hope that create enthusiasm and motivation in students, and prepare them to enter the ever-changing theater of medical imaging as a certified echocardiographer or sonographer.

Pegagus Lectures, Inc. will be providing the CCI Science Exam Course in conjunction with their dynamic ultrasound exam review courses in Chicago, Illinois, from March 25-30, 2008; in Tampa, Florida from July 15-20, 2008; in Atlantic City, New Jersey, from August 19-24, 2008. They will present ultrasound review courses throughout 2008. Information about these scheduled programs can obtained through their website, www.PegagusLectures.com, by phone at 1-972-564-3056, or by e-mail at FMiele@PegasusLectures.com. In addition, this educational organization offers a written Pegasus Pass Guarantee, which provides a “free” unlimited return to a seminar if the one of their course attendees does not pass his or her credentialing exam. The mean average of point gain on exams by those who attend the course is twenty-three. Finally, if anyone has an interest in obtaining any educational material produced by Pegasus Lectures, Inc., please contact Debbie Anderson, Marketing Director, at DAnderson@PegasusLectures.com and/or at 1-972-564-3056.

Acknowledgements
Pegasus Lectures, Inc would like to express their appreciation to the authors, Neil Holtz, Phyllis Williams, Pattie Freschett, and Chuck Williams, for taking time to attend the conference and for their efforts in writing this article.

 

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