This position is eligible for the Education Debt Reduction Program (EDRP), a student loan reimbursement program. To participate in the program, you must meet specific individual eligibility requirements in accordance with VHA Policy 1021 and submit your application within four months of appointment. The final award amount (up to $200,000) and eligibility period (one to five years) is determined by the VHA Education Loan Repayment Services office. A copy of the position's grade level Assignment Title and Qualification Requirements are below. Additional qualifications for this position can also be found in VA Handbook 5005/15, JUNE 7, 2012, Part II, Appendix G27. Diagnostic Ultrasound Technicians operate diagnostic ultrasonic scanning equipment to produce cross sectional and two dimensional pictures of internal organs and body structures used to diagnose diseases and other medical conditions. Registration is offered by Cardiovascular Credentialing International (CCI) or by the American Registry of Diagnostic Medical Sonographers (ARDMS). (See Appendix C) Positions should be assigned to the Diagnostic Radiologic Technologist (DRT), GS-647 series, when both ultrasound and other modalities which require the delivery of ionizing radiation are performed. Positions in which ultrasound duties are performed exclusively (no other modalities are performed), should be assigned to the Medical Instrument Technician, GS-649 series, since ultrasound duties solely do not require the delivery of ionizing radiation. Vascular technicians or vascular sonographers operate diagnostic equipment using ultrasound to record vascular information such as vascular blood flow, blood pressure, limb volume changes, oxygen saturation, cerebral circulation, peripheral circulation, and abdominal circulation. Registration is offered by Cardiovascular Credentialing International, (CCI) as a Registered Vascular Specialist (RVS) or by the American Registry of Diagnostic Medical Sonographers (ARDMS) as a Registered Vascular Technologist (RVT). (See Appendix K) Creditable Experience - Knowledge of Current Medical Instrument Technician Practices. To be creditable, the experience must have required the use of knowledge, skills, abilities and other characteristics associated with current Medical Instrument Technician practice appropriate to the identified specialty area. [Specialized developmental experience obtained under supervision of appropriately certified individuals may be credited at higher levels and is addressed in individual appendices.] Quality of Experience. Experience is only creditable if it is equivalent to at least the next lower grade level and is directly related to the position/specialty to be filled. Appendix C - Medical Instrument Technician (Diagnostic Ultrasound) NOTE: Positions should be assigned to the DRT, GS-647 series, when both ultrasound and other modalities which require the delivery of ionizing radiation are performed. Positions in which ultrasound duties are performed exclusively (no other modalities are performed), should be assigned to the Medical Instrument Technician, GS-649 series, since ultrasound duties solely do not require the delivery of ionizing radiation. Medical Instrument Technician (Diagnostic Ultrasound) GS-9. In addition to the core competencies defined at the GS-8 full performance level, positions at this grade may be lead, supervisory, or non-supervisory with specialized advanced knowledge and assignments. (a) Experience. At least 1 year of experience comparable to the next lower grade level, which is directly related to the duties of the position to be filled, and must fully meet the KSAs at that level. This would be specialized experience which demonstrates possession of the knowledge required in order to provide all aspects of diagnostic ultrasonography services. In addition, the candidate must demonstrate the following technical KSAs and the potential to acquire the assignment specific KSAs designated by an asterisk (*): (b) Demonstrated Knowledge, Skills, and Abilities. KSAs 1, 2, and 3 are appropriate for all positions at this level. KSAs 4 and 5 are to be used in accordance with their appropriateness for the specific assignment. 1. Knowledge of the more complex examination and treatment procedures and techniques in order to provide training and supervision in these procedures, to evaluate and initiate performance improvement projects, and to write policies, procedures, and protocols that pertain to diagnostic ultrasonography. *2. Knowledge of JCAHO and other regulatory requirements. 3. Ability to communicate effectively and professionally with employees at varying grade levels. *4. Ability to manage and supervise employees. *5. Ability to provide, or provide for, staff development and training. Certification. Registration by Cardiovascular Credentialing International (CCI) or by the American Registry of Diagnostic Medical Sonographers (ARDMS) is highly desirable. Basic Cardiac Life Support (BCLS) and Advanced Cardiac Life Support (ACLS) certifications are also desirable. Physical Demands: Describe Physical Demands of the Position. Physical activity includes sitting, standing (up to 8 hours), walking, heavy lifting (45 pounds or over), reaching above the shoulder, and repeated bending Information Technology: Uses word processing software to execute several office automation functions such as storing and retrieving electronic documents and files; activating printers; inserting and deleting text, formatting letters, reports, and memoranda; and transmitting and receiving e-mail. Uses the Veterans Health information and Technology Architecture (VistA) to access information in the Medical Center Computer System. ["Lists the major duties and responsibilities of the position: Receives and interprets requests for all ultrasound procedures. Incumbent performs ultrasound studies, records, and processes images for interpretation by the Vascular Surgeon or staff Radiologist. The spectrum of exams performed can include abdomen for tumor, cysts, abscesses, hematomas, inflammatory processes such as pancreatitis or acute cholecystitis, retroperitoneum, aorta, kidneys, adrenals, and nodes. Pelvic exams including trans-vaginal for uterus and ovaries may be performed. In addition, prostate exams may be performed using the trans-rectal transducer. Small parts including scrotum, breasts and thyroids may be examined. Ultrasound guided biopsies are also included. Incumbent also performs many different exams related to vascular technology which include but are not limited to:\n- Carotid Duplex\n- Aortic duplex, US of EVAR\n- US of superficial and deep veins for DVT, thrombophlebitis, reflux\n- Evaluate IVC filter\n- Surveillance of iliac artery or venous stents, arterial outflow stents, evaluate any stent arterial or venous\n- Evaluate for foreign bodies\n- Renal stenosis, renal bypass\n- Mesenteric duplex of stents, stenosis, evaluate for ischemia\n- Evaluate hepatic arterial and venous flow, splenic flow\n- US of inflow and outflow bypasses\n- Evaluate for hematoma, seroma, AVF, PSA\n- AVF surveillance\n- Vein maps\n- PVRs\n- Evaluate accurately- any artery or vein in the body Knows and understands the principles of ultrasound and the highly specialized equipment well enough to\nessentially approve the acceptability or rejectability of each scan. This includes preparation and supplies,\nscanning motions, TCG (Time Compensated Gain), zoom or expansion, hard copy, picture-oriented\nexamination, organ-oriented examination, and initial interpretation the examination. Interpreting the\nexamination requires identifying normal and pathologic appearances. Pathologic appearance includes\nintraluminal echoes that shadow, polyp, carcinoma, thick wall, size, obstructing lesions, common duct stone, tumor, benign strictures, texture, solid mass, cystic mass to name just a few. Initial interpretation will be forwarded by the Ultrasound Technologist to the Vascular Surgeon or staff Radiologist before final interpretation is made. Controls technical factors on ultrasound unit, which will affect time, gain, amplitude, velocity, frequency,\nattenuation, absorption, reflection, scattering, refraction, and diffraction.\nReceives and identifies patients, explains methods of procedures, assists movement of patients to and from wheelchairs, carts and tables, positions the patient, and performs examinations requested.\nCoordinates and performs all examination scheduling. Evaluates the nature of critical and emergency\nprocedures and rearranges priorities to accommodate them. Maintains records of patients treated, exams\nperformed, scans taken, etc. He/She receives and interprets requests or instructions for procedures from Vascular Surgeon, Radiologist or Medical Officers. Independently carries out the requests made by physicians, adjusting, and utilizing\nappropriate CPT codes for exams. Employee understands and carries out the requests made by physicians and only rarely seeks assistance of a higher graded technologist when a unique or new procedure is required. Secures the confidence and cooperation of patients during procedures. Explains procedures, positions\npatients for desired results, and cushions and shields patients as appropriate. Varies procedures or positions to compensate for and adjust to patients' medical conditions. Independently explains procedures and positions patients for very difficult procedures. Administers contrast materials orally, by enema, under supervision. Prepares contrast materials under the direction of the Vascular Surgeon or staff Radiologist for the purpose of performing exams requiring injectable solutions such as IVP, cystogram, cholangiograms fistulagrams and arthrography and for the purpose of performing oral and rectal exams of the GI tract. (In the case of injected media, a patient consent form must be obtained, when indicated.) These procedures require the use of needles, syringes, ionic and non-ionic contrast, barium, enema bags and gastrografin. The radiographer must know the effects and adverse reactions associated with these agents. Improper use or administration of the contrast materials run the risk of patient mortality; therefore, it is essential that a thorough understanding of usage be possessed by those who prepare it. Must continuously monitor the patient's condition. Adverse reactions on the part of the patient require immediate attention so that harm does not come to the patient. Employee must be knowledgeable in the procedures for handling adverse reactions including CPR certification and preparing incident reports in CPRS. Work Schedule: Will be discussed at interview\nFinancial Disclosure Report: Not required"]