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This position is located in the imaging section of the Clinical Support Service Line. Incumbent will independently performs routine and complex ultrasound examinations. Evaluates the nature of critical and emergency procedures, and rearranges patients scheduled to accommodate them. Maintains records and electronic files of patients examined. Cross-indexes interesting cases for teaching purposes. Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Education. There are no specific educational requirements for this occupation. Education may be substituted for experience only at the GS-4 and GS-5 levels. English Language Proficiency. Medical Instrument Technicians must be proficient in spoken and written English in accordance with VA Handbook 5005, Part II, Appendix G27. Licensure or Certification. Licensure or Certification is not required for this occupation; however, it is strongly desirable at GS-6 or above as evidence of possession of the essential knowledge, skills, and abilities. For certain functional areas at the higher levels or supervisory assignments, specific certifications appropriate to the specialty are indicated in this standard under "Titles and Certification/Registrations". May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grade Determinations: GS-6 (a) Experience. At least 1 year of experience comparable to the next lower grade level which demonstrates the knowledge, skills, abilities, and other characteristics related to the duties of the positions to be filled. In addition, the candidate must demonstrate the following KSAs: (b) Demonstrated Knowledge, Skills, and Abilities 1- Knowledge of medical terminology and human anatomy in order to receive and interpret physician requests for routine, standardized ultrasonography procedures. 2- Knowledge of tissue harmonics and soundwave propagation within the body to adjust TGC (Time Gain Compensation) for optimal image quality. 3- Knowledge of the physics of velocity, frequency of soundwaves, and their physical properties. 4- Ability to set up and adjust the ultrasound equipment to meet the conditions of the examination and the patient and to operate the equipment for standardized, routine procedures. 5-Ability to interact with patients explaining procedures and positioning the patient for the procedure. ( c) Certification. Basic Cardiac Life Support (BCLS) certification is desirable. ( d) Assignment. At this level, medical instrument technicians ( diagnostic ultrasound) perform examinations which are routine and standardized in nature. They position the patient as needed for the best test results, set up and adjust the ultrasound equipment to meet the condition of the examination and patient, move and adjust depths and types of scan in accordance with procedures, perform operator preventive maintenance and care of equipment, and assist higher graded technicians in performing more complicated examinations. GS-7 (a) Experience. At least 1 year of experience comparable to the next lower grade level which demonstrates the knowledge, skills, abilities, and other characteristics related to the duties of the positions to be filled. This would be experience which provided the individual with the knowledge, skills, and abilities to independently conduct difficult but standardized diagnostic ultrasonography examinations. In addition, the candidate must demonstrate the following KSAs: Demonstrated Knowledge, Skills, and Abilities 1- Ability to set up and adjust the ultrasound equipment to meet the conditions of the examination and the patient and to operate the equipment for more complex, but standardized procedures. 2- Knowledge of zoom, expansion, prospectus, color Doppler, and pulsed echo Doppler. 3- Knowledge of the digital transmission of images. 4- Ability to alter standard, but complex procedures and protocols to meet patient needs and physical limitations. ( c) Certification. Basic Cardiac Life Support (BCLS) and Advanced Cardiac Life Support (ACLS) certifications are desirable. ( d) Experience. At this level the medical instrument technician ( diagnostic ultrasound) performs complex, standardized procedures independently. They have the knowledge to alter procedures, equipment settings, transducers used, etc., to accommodate patient needs and still produce a quality image for diagnostic purposes. They will also be required to assist with the performance of more complicated procedures and non-standardized procedures in a developmental capacity. GS-08 Requirements: (a) Experience. At least 1 year of experience comparable to the next lower grade level which demonstrates the knowledge, skills, abilities, and other characteristics related to the duties of the positions to be filled. This would be experience which provided the overall knowledge, skills, and abilities to conduct diagnostic ultrasound examinations in complex and unusual cases. In addition, the candidate must demonstrate the following KSAs: (b) Demonstrated Knowledge, Skills, and Abilities 1. Ability to perform diagnostic ultrasound examination on multiple areas of the body, including, but not limited to, the abdomen, pelvis, transvaginal, chest, small parts, thyroid, breast, and scrotum. 2. Ability to perform vascular studies such as vertebral, renal artery, aortic aneurysm, portal-systemic shunts, etc. 3. Ability to assist radiologists with biopsy procedures determining the location, depth, and required needle angle for the lesion to be sampled. 4. Ability to assist in surgical procedures and fluid aspirations. (c) Certification. Basic Cardiac Life Support (BCLS) and Advanced Cardiac Life Support (ACLS) certifications are desirable. (d) Assignment. This represents the full performance level for medical instrument technician ( diagnostic ultrasound). At this level the technician is required to perform a full range of procedures including special complicated examinations for which there are no standard instructions or procedures. They perform independent portable ultrasound examinations in the intensive care units, emergency room, surgery, and throughout the Medical Center when required. They also work independently on evenings, nights, and weekend tours of duty as scheduled and/or when on call. Please note: Education may be substituted to meet the GS-4 and GS-5 levels for progressive experience/education as follows: GS-4: Successful completion of two years of education above high school or an associate's degree with a major field of study directly related to the medical instrument technician occupation. GS-5: Successful completion of 4 academic years above high school leading to a bachelor's degree with courses related to the occupation, or a bachelor's degree in a major field of study appropriate to medical instrument technician functions. References: VA Handbook 5005 Part II, Appendix G27, Medical Instrument Technician Qualification Standards. Physical Requirements: Lifting (15 lbs and over); carrying (up to 20 lbs); pulling and pushing (up to 2 hours); reaching above shoulder; standing and walking (up to 3 hours); bending (up to 1 hour); use of fingers/hands; ability for rapid mental and muscular coordination simultaneously; near vision correctable at 13 - 16"; hearing (aide permitted) ["CLINICAL RESPONSIBI LITIES A. Advises radiologists or referring physician of significant abnormalities that would require their immediate attention and visualization while the patient is undergoing examination. B. Performs ultrasound examinations of the abdomen, neck, chest and extremities, retroperitoneal space for the purpose of acquiring high quality examinations that assist in the diagnosis and treatment of patient medical disorders. C. Participates in the training of physicians, students and radiology technicians so that these individuals may acquire an understanding of the principles of ultrasound and how it relates to other diagnostic exams. D. Performs routine clerical procedures for the purpose of maintaining accurate ultrasound records so that easy recall of patient examinations may be achieved . This requires maintaining a diagnostic log , patient schedule log, and procedure log, editing and when necessary registering patients in the Radiology Information System (RIS) E. Makes multiple simultaneous settings and adjustments in operation of equipment to insure accurate results. On the basis of radiologic findings, determines necessary ultrasonic procedures to yield definitive diagnostic findings. F. Assists the radiologist in the performance of cyst punctures , aspiration biopsies (liver, kidneys, thyroid), and catheter placements for the purpose of diagnostic treatment using ultrasound techniques. This requires the use of surgical sterile techniques, syringes, needles, contrast, etc. G. Develops and maintains patient prep procedures so that patients and wards understand the proper preparations for ultrasound examinations in an effort to minimize delays of examinations. These preps are disseminated either by written preparation information or by telephone conversation. H. Explains examinations to be performed to the patients so that an understanding of the purpose of the study as well as any requirements of the patients are thoroughly understood. This is done so that an adequate ultrasound study may be obtained in an effort to get diagnostic examinations for the purpose of treatment and diagnosis of disorders. Obtains consent from the patient or authorized person to perform invasive procedures. I. Gathers related information such as patient chart, x-rays , CT's, and MR l's etc., so that correlation of examinations to other studies may be made by the radiologist in diagnosis and recommendation of treatment for medical disorders. J. Distributes ultrasound examinations and related information to the radiologist responsible for the interpretation of the exams. This is done so that treatment based on diagnosis may be effectuated in a timely manner. K. Performs quality assurance testing on the ultrasound unit using phantoms, test tools, test check lists, etc. for the purpose of assuring peak performance of the ultrasound equipment. Maintains the quarterly records of the quality assurance testing so that easy reference is available should servicing be necessary. L. The incumbent must be aware of and practice the safety policies/procedures of the medical center, and participate in quality assurance activities as directed. M. Performs irregular hour emergency scans on standby, 24 hours per day coverage. Requires the technologist be available within 45 minutes from receipt of call so that proper and effective emergency care can be given to the patient. N. The primary age of patients treated and cared for are normally at the geriatric level ,i.e. 60 years of age or older, although occasionally there may be younger patients between the ages of 18-60 years of age that require care. The position requires the incumbent to possess or develop an understanding of the particular needs of these types of patients. Sensitivity to the special needs of all patients in respect to age, developmental requirements, and culturally related factors must be consistently achieved. Work Schedule: Intermittent: Schedule will vary, including on-call rotations Financial Disclosure Report: Not required"]

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