Until this past April I worked for approx 3 years in a major cardiac medical center, working the evening shift for the vascular lab. Most of my patients were inpatients/pre-op CABG carotid duplex studies. Most of those patients also got cardiac echos earlier in the day. When I told the patient what I was going to do ("look at the arteries in your neck"), AT LEAST half of the patients told me "they already did that today". After some investigating, I found out that the echo techs were doing the "quick scan" to check for carotid disease. Like I heard at the SVT meeting in Pittsburgh, there are too many Cardiologists out there, they are running out of turf, so where do they go? Peripheral Vascular is where they go. Lets put a stent here, and a stent there.....and no more vascular disease. -----Original Message----- From: Larene Collins [mailto:[log in to unmask]] Sent: Tuesday, August 14, 2001 6:09 PM To: [log in to unmask] Subject: Story I was just approached by an ex-echocardiographer who wants to learn to do carotid studies. No previous training in vascular U/S. Evidently she is being asked to do a "quick scan" of the carotids when she does an echo, to determine if the patient needs further vascular evaluation. It sounded to me, however, like she thought that she would be ready to perform formal carotid studies when she was finished "training." Her plan is to read Zweibel and watch me perform one carotid study, and then PRESTO!!! ZAPPO!!! instant vascular technologist. This bothers me so much...should it?? Could I lose my job to an idiot like this??? I'm sorry...but have I marched down to cardiology talking about how I can do echoes, though I have little or no training, just because I am a vascular technologist??? I wouldn't even dare! More than once the echo tech here has gotten people all worked up with his vascular "findings" while performing his quickie vascular scans after doing an echo. ER sent a patient to me after the echo tech had found acute IVC thrombus. What I in fact found was sluggish flow which resulted in intraluminal echoes made by very low velocity RBCs, but a widely patent IVC. I was sure he must know what he was talking about since he was ABSOLUTELY SURE he had seen thrombus, and because he has 20+ yrs experience as an echo tech. I looked and looked and looked because I knew he must be right and I HAD to be wrong. But, there was no thrombus. That was the first in a continuing series of similar incidents. Has anyone else had experience with this? Is this standard operating procedure to have someone do a quickie carotid screening by untrained personnel to determine whether or not someone needs further evaluation? Who needs clinical skills, I guess? Am I being too hard-nosed and proud about this? Maybe there really isn't anything to doing carotids...? Larene