Electrocardiograms (EKG's) are graphic tracings of heartbeats recorded by an instrument called an electrocardiograph. These tracings indicate the electrical impulses transmitted by the heart muscle during and between heartbeats. EKG technicians operate the electrocardiograph to produce the tracings for review by a physician.
Physicians order electrocardiograms to help diagnose certain forms of heart disease, monitor the effect of drug therapy, and analyze changes in the condition of a patient's heart over a period of time. The test is done before most kinds of surgery, including outpatient surgical problems. Some physicians use electrocardiograms as a routine diagnostic procedure for persons who have reached certain age. In many fields, electrocardiograms are required as part of pre-employment physical examinations.
Since the equipment is mobile, EKG technicians can record electrocardiograms in a doctor's office, in a hospital heart station (cardiology department), or at the patient's bedside. After explaining the procedure to the patient, the technician attaches 10 electrodes to the chest, arms, and legs of the patient. Normally the technician applies a gel between the electrodes and the patient's skin to facilitate the passage of the electrical impulses. By manipulating switches on the electrocardiograph and positioning the electrodes across the chest, the technician obtains a recording of the heart's electrical action. A stylus or ink pen records the tracings on graph paper. The test is usually performed while the patient is resting or while exercising. The technician must know the anatomy of the chest and heart to select the exact locations for the chest electrodes. Electrodes placed in the wrong location result in an inaccurate reading.
After the recording is completed, the technician prepares the electrocardiogram for analysis by a physician, usually a heart specialist. The most advanced EKG equipment employs a computer to analyze the tracing, and the technician may need to enter information into the console using a keyboard. Technicians must be able to recognize and correct any technical errors, such as crossed leads, incorrect lead placement, or electrical interference, that prevent an accurate reading. They also must call the doctor's attention to any significant deviations from the average normally recorded by the technique used. Physicians then review the recordings and study these and other deviations identified.
Some EKG technicians schedule appointments, type doctor's interpretations, maintain patients EKG files, care for equipment, and perform or assist in more specialized cardiac testing.
Cardiology is one of the most rapidly developing fields in medicine today, and new procedures for diagnosing and treating heart and circulatory problems are being introduced all the time. These have raised skill requirements and created new occupations in the areas of cardiovascular and cardiopulmonary technology. For example, recognition of the value of monitoring heart action while the patient is normally active has led to widespread use of 24-hour ambulatory monitoring (also called Holter monitoring, after the physician who developed the equipment) and exercise stress testing--a test that records the EKG during physical activity. Technicians who perform these tests need special training. EKG technicians perform a relatively simple task and do not have the skills to assist in the newer cardiac procedures unless they complete additional training.
Technicians generally work a 5-day, 40-hour week, which may include Saturdays and Sundays. Those in hospitals and private clinics also may work evening hours. A lot of time is spent walking and standing. The work can become hectic.
Electrocardiograph technicians held about 18,750 jobs in 1990. Most worked in hospital cardiology departments. Those in hospitals and private clinics also may work evening hours. A lot of time is spent walking and standing. The work can become hectic.
Training, Other Qualifications, and Advancement
EKG Technicians are trained on the job, as a rule. Training usually is conducted by an EKG supervisor or a cardiologist and lasts no more than 4 to 6 weeks for the basic "resting" EKG. Training for specialized EKG testing is much more extensive--usually 12 to 24 months--and involves in-depth study of cardiovascular anatomy and physiology.
Applicants for trainee positions generally must be high school graduates. High school courses recommended for students interested in this field include health, biology, and typing. Familarity with medical terminology can be acquired in classes on human anatomy and physiology and by studying a medical dictionary. Applicants for EKG training must be reliable, have mechanical aptitude, ability to follow detailed instructions, and presence of mind in emergencies. A pleasant, relaxed manner for putting patients at their ease is an asset.
There are no licensing requirements for EKG technicians; acquiring credentials-- available through the National Board of Cardiovascular Testing--is voluntary.
Opportunities for advancement are good for technicians who become proficient in more complex procedures. Increasingly, experienced EKG technicians are being trained to perform or assist with a wide range of cardiac tests, enabling them to advance to positions as monitor technicians, Holter monitor technicians, stress testing technicians, or echocardiography technicians. Individuals with the requisite experience and training may eventually be upgraded to jobs as noninvasive or invasive cardiovascular technicians. Promotion to supervisory positions is possible, too. Employers generally encourage and may provide training to technicians to help them become competent in various procedures.
Employment of EKG technicians is expected to grow more slowly than the average for all occupations through the year 2000. Although cardiology is anticipated to grow, demand for EKG technicians is not likely to keep pace with growth in the number of cardiac tests and procedures performed. Nor will job growth be as rapid as in the more highly skilled cardiology occupations--a consequence of productivity gains associated with newer EKG equipment and efforts to streamline hospital staffing. Most job openings, therefore, will result from the need to replace technicians who transfer to other jobs or leave the labor force altogether.
Use of the EKG as a standard test in the diagnosis and treatment of heart disease is expected to continue, but advances in technology and computerization of hospital departments will substantially raise EKG technicians productivity. An EKG which used to take 15 minutes can now be performed in 5 minutes, thanks to new EKG equipment that records readings more quickly and relieves the technician from having to mount three separate graphs on a backboard for the physician to read. In addition, computerization has cut back dramatically on paperwork. Rather than spending time on clerical duties, technicians can use their time administering EKG's.
Employment of EKG technicians will be further constrained by hospitals efforts to cut labor costs. The equipment used for a resting EKG is so simple that the necessary skills can be mastered fairly quickly. Many hospitals are cutting back on EKG personnel by training registered nurses, respiratory therapists, and others to perform EKG procedures during off hours. Thus, some hospitals whose EKG departments formerly operated on a 24-hour basis have cut back to 8- or 12-hour coverage; emergency EKG's are handled by other hospital personnel. If this trend persists, it will dampen demand for EKG technicians in hospitals.
An increasing number of jobs will be in offices of cardiologists, cardiology clinics, health maintenance organizations, and other outpatient settings. Facilities such as these are expected to experience very rapid growth through the year 2000. Nonetheless, hospitals are likely to remain the dominant employer of EKG technicians.
Because entry requirements are minimal, the pool of prospective job seekers is very large. In some communities, individuals seeking positions as EKG technicians may find that employers prefer applicants with previous EKG experience or formal training, including Armed Forces training. Individuals with training in Holter monitoring or stress testing in addition to basic EKG's may enjoy more favorable job prospects than those without these additional skills.
EKG technicians employed in hospitals, medical schools, and medical centers earned starting salaries of about $14,200 a year in 1990, according to a survey by the University of texas Medical Branch. EKG technicians who perform more sophisticated tests are paid more than those who perform only basic ones. Some experienced EKG technicians earned as much as $25,710 a year.
EKG technicians in hospitals receive the same fringe benefits as other hospital personnel, including health insurance, pension benefits, vacations, and sick leave. Some institutions provide tuition assistance, uniforms, and other benefits.
Workers in other occupations requiring operation of diagnostic or therapeutic equipment include audiometrists, electroencephalographic (EEG) technologists and technicians, radio logic technologists, clinical laboratory technologists and technicians, cardiovascular technologists, cardiopulmonary technologists, and electroneurodiagnostic technicians.
Source of Additional Information
Local Hospitals can supply information about employment opportunities.
For a list of training programs in cardiovascular technology, contact:
American Cardiology Technologists Association, Inc., 1980 Isaac Newton Square South, Reston, VA 22090.
National Alliance of Cardiovascular Technologists, 5 West Hargett St., Suite 1100, Raleigh, NC 27601.
For a list of training programs in cardiopulmonary technology, contact:
National Society for Cardiovascular and Cardiopulmonary Technology, 1133 15th St. NW, Suite 1000, Washington, D.C. 20005.
For information about acquiring credentials in cardiovascular technology, contact:
National Board of Cardiovascular Test, Inc., 5 Cold Hill Rd. South, Suite A-2, Box 158, Mendham, NJ 07945.
For information about acquiring credentials in cardiopulmonary technology, contact:
Cardiovascular Credentialing International, 2801 Far Hills, #309, Dayton, OH 45419.