Training for Healthy Hearts

By Petty Officer 1st Class (FMF/CAC) Aldrin Augustus, Cardiovascular Instructor and Navy Service Lead, Cardiovascular Technician Program, Medical Education and Training Campus

Petty Officer 1st Class (FMF/CAC) Aldrin Augustus, instructor and Navy service lead for the cardiovascular technician (CVT) program at the Medical Education and Training Campus, instructs Navy Petty Officer 3rd Class Chessa Sheppard and Army Spc. Victoria Belbusti on using the state of the art Cardiac catheterization simulator during a portion of their CVT didactic training. The Simulator is used to demonstrate concepts learned in the classroom and exposes students to hands on training that they will be expected to perform. (Photo by Lisa Braun)

As a Navy Cardiovascular Technician (CVT) I am one of the most highly specialized, medically trained enlisted professionals in the Navy.   The training I deliver at the Medical Education and Training Campus (METC) is one of a kind! In a matter of just 13 months students graduate with the knowledge and skills to function in a specialized field. Our students learn both invasive and noninvasive aspects of cardiology. When compared to our civilian counterparts, theirs are two-year, associate’s degree programs, but their students are only trained on either non-invasive or invasive cardiology. Navy CVTs are trained to do both.

As a CVT I work under the direction of a cardiologist assisting with cardiac emergencies and examination studies in both diagnostic and invasive settings, so it’s no secret that the training is quite demanding. The METC CVT program is an intensive program consisting of five months of didactic Phase 1 training at the METC, located at Joint Base San Antonio-Fort Sam Houston, followed by eight months of clinical training at Naval Medical Center San Diego. Throughout this time students receive training in anatomy and physiology, physics, echocardiography, advanced cardiac life support, electrophysiology and cardiac catheterization. Students are also trained to perform exercise stress testing, electrocardiograms, and interpretation of the heart’s rhythm. These are all valuable tools that allow CVTs to assist the cardiologist in diagnosis and treatment of cardiac disease before it becomes life threatening.

After six years as a CVT I am personally proficient in recognizing cardiac rhythm disturbances that could indicate a life threatening medical condition. Using sound waves I am able to perform cardiac ultrasounds to visualize the heart, which provides the cardiologist with valuable information regarding the heart’s structure and motion. Standing side by side with an invasive cardiologist, I am able to assist with invasive diagnostic cardiac catheterization procedures that look for blockages in the coronary arteries, and if found, I play an integral part in the interventional procedure using balloons and stents to reopen the vessel. Through mapping of the heart’s electrical conduction system, the electrophysiology study will find rhythm abnormalities and correct them with specialized cardiac ablation procedures including implanting pacemakers where applicable. This specialty requires me to have a cool head and the ability to think and act quickly in critical situations.

Along with the five months of didactic training, CVT students are exposed to some of the most technologically advanced equipment in the cardiovascular field. The program employs two state-of-the- art Laerdal SimMan 3G Advanced Cardiac Life Support (ACLS) simulators that are utilized during the ACLS and patient assessment portion of the curriculum. The two simulators provide a tangible hands-on link between didactic lessons learned in pharmacology and patient assessment. It allows students to effectively practice CVT skills in a training environment. Having this level of simulator technology allows students to learn all the different modalities of cardiovascular training that they experience throughout the course and will be exposed to upon graduation. In previous years there was no way to illustrate some of the things that a CVT will see out in the real world, like patient reaction in real time and how to treat and anticipate possible complications.

The most impressive simulation capability is during the cardiac catheterization rotation. There is a fully functional cardiac catheterization suite that allows students to practice positioning the x-ray equipment, safe patient transfer procedures, and setting up and maintaining a sterile field. It is fully stocked with the same diagnostic and interventional equipment that is used during real clinical rotations.

Petty Officer 1st Class (FMF/CAC) Aldrin Augustus, instructor and Navy service lead for the cardiovascular technician program at the Medical Education and Training Campus, instructs Army Spc. Victoria Belbusti and Navy Petty Officer 3rd Class Chessa Sheppard on the intricacies of performing a cardiac echocardiogram on Petty Officer 2nd Class Florentino Ramirez. (Photo by Lisa Braun)

In addition to the cardiac catheterization laboratory, the program utilizes a Simbionix Angio-Mentor to teach invasive skills. Students use the simulator to combine all the didactic and clinical hands on invasive techniques learned throughout the curriculum. The ANGIO Mentor provides experience with basic and advanced guide wire and catheter skills, familiarity with endovascular procedures, and cath lab team experience. Students learn how to manipulate catheters, inflate balloons and stents, and respond to complications associated with all the respective procedures. The simulator tracks x-ray exposure, contrast administration and reacts to the procedure in real time. Other skills learned include how to operate the C-arm, patient’s table, and fluoroscopic screen, as well as how to read the hemodynamic monitoring and administer medications. The simulator offers hands-on training that is designed to enhance manual dexterity and improve appropriate instrument decision making. I was able to feel the high-end sensation that provides realistic simulation of guide wire, balloon, stent and other interventional devices.

The program also conducts team training exercises to build confidence and help students understand the requirements of all the catheter lab team members. Patient safety is the primary focus of the vast curricula, and validation studies have reinforced the value of simulators in professional development.

Recently, our program director underwent one of the procedures the students learn about in the program. He had an atrial fibrillation ablation, where the cardiologist mapped the electrical conduction system of the heart to see where the abnormal impulses were coming from. Once the doctor knew the location he used a catheter to deliver extremely cold energy to that area, destroying the tissue to restore normal heart rhythm. However, seeing this as an opportunity for more learning, the program director invited his students to observe the procedure so they could see firsthand what they will be expected to do after they graduate. In addition, the staff where the procedure was conducted included two cardiovascular technicians who were trained at METC by him!

Stories like these are the reason we take great pride in our field and why we are so dedicated to providing the highest quality training using the most advanced, cutting edge technology to produce the world’s finest cardiovascular technicians!