1. 1 A “Radiologic Technologist” (or Radiographer) Medical Professional –In a challenging field Safely uses x-rays to image anatomy –Positions –Using sophisticated technology –Practices radiation protection Provides quality-diagnostic images –Assists DR –Communicates with patient –Practices patient privacy

2. 2 Registered Technologist R.T. Dawn Charman, M.Ed., RT (R)(M), CRT(R)(F) Kelly Clark, M.S.R.T. RT (R)(CT), CRT(R)(F) Mina Colunga, B.S.R.T. RT (R), CRT(R)(F) ARRT – R.T. State of California– C.R.T.

3. 3 Radiologic Technologist ECC program is for an entry level into the profession Radiation Therapy and Nuclear Medicine would require additional education Certification/licenses ARRT- American Registry of Radiologic Technologies –Provides national certification CRT-- California Registered Technologist –After completing ARRT exam you pay a fee and get your California license to practice –A separate test is taken for fluoroscopy

4. 4 Certification vs. License ARRT –National certification R.T. –Must take an exam Pass with 75% –Can take this after completing program CRT –State Licensing –Must pass ARRT exam to get this –Pay fee to get radiography license (R) –Take fluoroscopy exam and pay a fee for (F) license

5. 5 All types of EXAMS & PEOPLE Infants Elderly All classes All ethnicity All backgrounds Head to toes Trauma Special procedures Critical patients Walk ins Surgery

6. 6 FIG. 4–2 Radiologic science professionals must use advanced critical thinking skills when handling all patient care situations. Elsevier items and derived items © 2007, 2003 by Saunders, an imprint of Elsevier Inc. Radiologic Technologist Must be able to communicate effectively with: Patients, staff, & peers Must use: good judgment Critical thinking skills

7. 7 Critical Thinking Involves sound, professional judgment Applied with high ethical standard And integrity

8. 8 Critical Thinking Analysis Synthesis Evaluation Critique Achieved through –Role Playing –Lab experiments –Case Studies

9. 9 Patient Communication Interacting with the patient Interacting with family and friends Methods of Effective Communication Age as a factor in Patient Interactions

10. 10 Communication & Adapting to Special Condition Patients Traumatized Patients Visually Impaired Patients Speech and Hearing Impaired Patients Non-English Speaking Patients Mentally Impaired Patients Substance Abusers

11. 11 Education in the Radiologic Sciences at ECC Didactic Curriculum (lecture) –Specifically describes the objectives –What the students will learn –How they will learn (instructional activities) Clinical –Hospital training –Apply didactic principals to clinical setting

12. 12 FIG. 5–1 The articulation of didactic, laboratory, and clinical instruction. (From Ford C, ed: Clinical education for the allied health professions, St Louis, 1978, Mosby.) RT Programs Didactic and Clinical Education

13. 13 Types of Diagnostic Exams Chest Extremities Skull/ Facial Spine Gastrointestinal Interventional

14. 14 Some studies of spinal trauma have recorded a missed injury rate as high as 33%.

15. 15 ComminutedOpen

16. 16 ELDERLY

17. 17 INFANTS & CHILDREN

18. 18 SURGERY

19. 19 Fluoroscopy

20. 20 TECHNOLOGIST FLUOROSCOPY Dawn Charman RT (R), (F) CONTRAST MEDIA (X-RAY DYE)

21. 21

22. 22

23. 23 ARRT Standards Accrediting Agencies JRCNMT Committee on Accreditation of Allied Health Education Programs (CAAHEP) – in collaboration with the Joint Review Committee on Education in Diagnostic Medical Sonography (JRC- DMS) Regional Institutional Accrediting Agencies (degree-granting divisions) WSAC

24. 24 Accrediting Agencies SCHOOLS/PROGRAMS JRCERT: Joint Review Committee on Education in Radiologic Technology HOSPITAL ACCREDITATION JCAHO :Joint Commission on Accreditation of Healthcare (Hospital) Organizations

25. 25 5 Primary Exams 1) 2) 3) 4) 5)

26. 26 Post Primary Cardiovascular- Interventional Radiography (CVIT) –Note: No longer available for new candidates Mammography (M) Computed Tomography(CT) Magnetic Resonance Imaging (MR) or (MRI) –Note: Both a primary and post- primary track Quality Management (QM) Sonography (US) or (RDMS) –Note: Both a primary and post- primary track Bone Densitometry (BD) Vascular Sonography Cardiac-Interventional Radiography (CI) Vascular-Interventional Radiography (VI) Breast Sonography Registered Radiologist Assistant (RA)

27. Beyond Diagnostic Radiography Advanced Modalities

28. MAMMOGRAPHY Dawn Charman, RT (M) RADIOGRAPHIC IMAGING OF THE BREAST Diagnostic for breast cancer

29. 29

30. 30 Bone Densitometry “low dose Radiation”

31. 31 BONE DENSITOMETRY JOE RUIZ, RT (R) (BD) POST PRIMARY EXAM BEGAN IN JANUARY 2001 ??? May also have certification w/o RT ???? MEASURING MINERAL CONTENT AND DENSITY OF BONES

32. 32

33. 33 CT SCAN & MRI

34. 34 Computed Tomography Jennifer Smith, RT (R) (CT) 1995 began post primary exam

35. 35 FIG. 1–9 A computed tomographic technologist uses a computerized x-ray system to produce sectional anatomic images of the body. (Courtesy of Philips Medical Systems.) CT SCANNER Uses –Radiation –Computer Rescontructs images –Some in 3-D

36. 36 C T SCANNER

37. 37

38. 38 Magnetic Resonance Imaging RT (R) (MRI) RT (T) (MRI) (MRI) 1995 ARRT began post primary exams

39. 39 MRI SIGNAL PRODUCTION Uses –Magnet field –radio waves

40. 40

41. 41 MRI SAFETY 1.Use non magnetic materials 2.Can cause harm to patient or employees 3.1 reported death from oxygen tank 1.6 years old

42. 42

43. 43

44. 44 RADIOGRAPHY VS MRI

45. Which one is MRI? CT? 45

46. Look for the signs…. 46

47. What are the differences between MRI and CT? CT Uses ionizing radiation Can be used on any patient Fast MRI Uses magnets and radiowaves Cannot be used on patients who have metal in their body Slow 47

48. Which is better? 48

49. What are the similarities between CT and MRI? 49

50. 50 Angiography

51. 51 ANGIOGRAPHY is a specialized radiographic examination where the images of the blood vessels of the body are demonstrated by injection of contrast media

52. 52

53. 53 INTERVENTIONAL RADIOGRAPHY 1)CI:________________________ 2)CVI:_______________________ 3)VI:________________________

54. 54 CARDIAC-INTERVENTIONAL RADIOGRAPHY Mike Smith, RT (R) (CI) POST PRIMARY EXAM BEGAN IN JANUARY 2003

55. 55 Cardiovascular Interventional Radiography Jane Smith, RT (R) (CVI) Angiography 1991 began post primary exam for CVIT Radiographers

56. 56 Angiography of Heart vessels http://images.google.com/imgres?imgurl=http://w ww.nhlbi.nih.gov/health/dci/images/stent_resten osis.gif&imgrefurl=http://www.nhlbi.nih.gov/healt h/dci/Diseases/stents/stents_all.html&usg=__xDl bsaX9JhuYbpVojLcz19apr- I=&h=513&w=450&sz=59&hl=en&start=20&tbnid =vWwqaG-RNW7M- M:&tbnh=131&tbnw=115&prev=/images%3Fq% 3Dabdominal%2Bstents%26gbv%3D2%26hl%3 Denhttp://images.google.com/imgres?imgurl=http://w ww.nhlbi.nih.gov/health/dci/images/stent_resten osis.gif&imgrefurl=http://www.nhlbi.nih.gov/healt h/dci/Diseases/stents/stents_all.html&usg=__xDl bsaX9JhuYbpVojLcz19apr- I=&h=513&w=450&sz=59&hl=en&start=20&tbnid =vWwqaG-RNW7M- M:&tbnh=131&tbnw=115&prev=/images%3Fq% 3Dabdominal%2Bstents%26gbv%3D2%26hl%3 Den

57. 57 VASCULAR-INTERVENTIONAL RADIOGRAPHY JOE CAR, RT (R) (VI) POST PRIMARY EXAM BEGAN IN JANUARY 2003

58. 58

59. 59 59

60. 60 NUCLEAR MEDICINE use radioactive isotopes to make images

61. 61 Nuclear Medicine RT (NM) ARRT or NMTCB

62. 62 NM – Images collected after injections of a RADIOISOTOPE

63. 63 The tracer travels into the blood vessels until it arrives to the bone

64. 64 PET Scan & SPECT Scan PET = Positron Emission Tomography SPECT= Single Photon Emission Computed Tomography X-rays/MRI with Radioisotopes

65. 65

66. 66

67. 67 PET Scan showing diffuse spread of prostate cancer to bone. PET has the advantage over traditional bone scanning in its ability to differentiate active from dormant disease.

68. 68

69. 69

70. 70 Prostate cancer metastasized in bones

71. 71 Co-registration: PET + CT or MRI

72. 72

73. 73

74. 74

75. 75 RADIATION THERAPY R.T.(T) 2 YRS ADDITIONAL EDUCATION CITY OF HOPE LLU CAL STATE LONG BEACH The branch of Radiology that involves the treatment of disease by means of high energy x-rays or radioactive substances

76. 76

77. 77

78. 78 RADIATION THERAPY branch of Radiology that involves the treatment of disease by means of high energy x-rays (GAMMA) or radioactive substances

79. 79 Radiation Therapy RT (T) = Registered technologist in radiation therapy technology Medical dosimetrists are involved in treatment planning and dose calculations 1-4 year program

80. 80

81. 81 ULTRASOUND uses a technique similar to Navy SONAR to produce diagnostic images.

82. 82 ULTRASOUND Cypress College Orange Coast LLU 1 – 2 years

83. 83 Diagnostic Medical Sonographers RT (R) (S) or RT (S) or (RDMS) American Registry of Diagnostic Medical Sonographers ARRT in 1999 began post primary exam ARRT in 2005 began primary exam

84. 84 Determines depth Ultrasound beam is transmitted and reflected – as special crystal at the end of the transducer can determine the type of tissue

85. 85 Uses SOUND WAVES (NOT X-RAYS) “real time” images

86. 86 ULTRASOUND uses a technique similar to Navy SONAR to produce diagnostic images.

87. 87 19 Week fetus http://images.google.com/imgres?imgurl=http://e mbryology.med.unsw.edu.au/movies/usound/19 weeklabel2.jpg&imgrefurl=http://embryology.me d.unsw.edu.au/movies/usound/Hum19w4D.htm& usg=__EfDiZ2qdLFEQ_ZGPy9YS628QyPI=&h= 379&w=358&sz=11&hl=en&start=71&tbnid=QqS TbyckVI- jYM:&tbnh=123&tbnw=116&prev=/images%3Fq %3Dfetal%2Bultrasound%26gbv%3D2%26ndsp %3D20%26hl%3Den%26sa%3DN%26start%3D 60

88. 88

89. 89

90. 90

91. 91 2D vs. 3D/4D

92. 92 U/S & the “real thing”

93. 93 Breast Sonography Post Primary Exam Valuable for Technologists that specialize in Mammography

94. 94 VASCULAR ULTRASOUND

95. 95 New - RA Radiology Assistant (Like PA) Weber State (On line – Utah) LLU 3 others in US (2007 – more) $$$$ NEW GRADS = 100 K/YEAR (?) PART OF RADIOLOGIST GROUP As of 2007 – NOT APPROVED BY STATE to Work as RA in California

96. 96 Additional Opportunities Education Administration Management (QM) Commercial Radiologist Assistant = RA

97. 97 RADIOLOGY ASSISTANT RA LLU 2 YRS RT BA DEGREE WEBER STATE 6YR RT

98. 98 OTHER PATHWAYS SALES APPLICATIONS SPECIALIST INDUSTRIAL X-RAY MANAGEMENT (DEGREE) EDUCATON

99. 99 TRAVELING TECHNOLOGIST = SEE THE WORLD AND GET $$$

100. 100 Other working opportunities… Registry (local) Registry (out of state) X rays taken around the world !!

101. 101 Variety of Work Settings physicians offices, clinical outpatient facilities, free standing imaging centers, mobile imaging centers portable services to rehabs Mammo’s to under privileged areas Urgent care

102. 102 SALARY RANGES RT’s NEW R.T. = $ 25 -$38 PER HOUR ON-CALL + O.T. $45,000 – $60,000 YR ADVANCE SPECIALTIES $ 30 - $50 PER HOUR A GREAT SHORTAGE IN ALL HEALTH CARE – A GREAT NEED TO AQUIRE NEW TECHNOLOGIST TO THIS AREA

103. 103 Professional Organizations ASRT – American Society of Radiologic Technologist CSRT – California Society Society of Radiologic Technologists RTEC – Radiologic Technology Educators of California International Societies, other state societies, other modalities