The International Council for Certification of Cardiovascular Specialists and Assistants, Inc (ICCCSA) (Full title below)

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

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