Key Responsibilities and Required Skills for Catheterization Lab Technician

🎯 Role Definition

The Catheterization Lab Technician (Cath Lab Tech) is a clinical technologist who supports invasive cardiovascular procedures including coronary angiography, percutaneous coronary intervention (PCI), structural heart interventions, and peripheral vascular procedures. Responsible for preparing the sterile field and equipment, operating imaging and hemodynamic monitoring systems, assisting the clinical team during procedures, ensuring patient safety (including radiation and contrast safety), and maintaining accurate documentation. This role requires strong technical skills, adherence to sterile technique, familiarity with fluoroscopy and digital imaging, and the ability to respond quickly in high-acuity situations.

📈 Career Progression

Typical Career Path

Entry Point From:

Radiologic Technologist (X‑ray/Fluoroscopy)
Cardiovascular Technologist (non-invasive)
Surgical Technologist or OR Technician
Registered Nurse (transitioning into cath lab roles)

Advancement To:

Lead/Senior Cath Lab Technician
Cath Lab Supervisor or Manager
Clinical Educator / Training Specialist (Cardiology)
Interventional Radiology Technologist
Clinical Systems Specialist (imaging/hemodynamics)

Lateral Moves:

Electrophysiology (EP) Lab Technician
Vascular Access or Interventional Radiology
Sterile Processing Supervisor (with additional training)
Cardiac Device Representative / Clinical Specialist

Core Responsibilities

Primary Functions

Prepare the catheterization laboratory before each case by verifying sterile supplies, inventorying procedure trays, setting up angiographic catheters, sheaths, guidewires, balloons, stents, and contrast media according to case type and operator preference.
Maintain strict sterile technique during setup and throughout invasive procedures; perform sterile draping of the patient, instrument tables, and imaging catheter mounts to prevent infection.
Operate fluoroscopy systems, digital angiography equipment, and imaging workstations to capture appropriate angiographic sequences; adjust imaging parameters and document exposure settings to optimize visualization while minimizing radiation dose.
Monitor and record invasive hemodynamic data (arterial pressures, central venous pressure, pulmonary artery pressures) and continuously observe ECG monitoring for arrhythmias; communicate changes promptly to the physician and nursing staff.
Assist operators with arterial and venous access by preparing and organizing access kits, holding introducers or catheters as instructed, and providing wire/catheter exchanges during coronary and peripheral procedures.
Manage contrast media preparation and injection protocols, including power injector setup, contrast warming, correct contrast selection, and documentation of contrast volumes to mitigate nephrotoxicity risk.
Administer or assist with medication delivery during procedures under appropriate licensure or per institutional policy (e.g., sedation agents, heparin, vasodilators) and monitor patient response.
Apply external radiation protection principles: position shielding, use collimation, monitor cumulative dose reports, and participate in the facility’s radiation safety program to ensure compliance with ALARA standards.
Troubleshoot and perform routine checks on cath lab equipment: imaging consoles, hemodynamic monitors, power injectors, suction, and electrosurgical units; escalate technical issues to biomedical engineering when necessary.
Prepare and manage specialized interventional devices (stents, balloons, embolic materials, closure devices) including device loading, flushing, priming, and device-specific preparation according to manufacturer instructions for use (IFU).
Assist during complex interventions (PCI, transcatheter valve repair/replacement, peripheral interventions, thrombectomy) by anticipating operator needs, passing devices, and maintaining clear sterile technique throughout multi-device exchanges.
Facilitate emergency procedures: rapidly assemble resuscitation equipment, assist with temporary pacing, deliver defibrillation support, prepare transfer plans for emergent surgical interventions, and follow hospital ACLS protocols during code situations.
Manage specimen handling and documentation (e.g., hemodynamic tracings, biopsies, explanted devices) and ensure proper labeling, chain of custody, and delivery to the lab or pathology as required.
Provide detailed procedural documentation in the electronic health record (EHR) and cath lab information system (CLIS): case start/stop times, devices used (lot numbers), contrast volume, fluoroscopy time, hemodynamic measurements, complications, and post-procedure disposition.
Conduct pre-procedure equipment and safety time-outs in coordination with the procedural team; confirm patient identity, procedure site, allergies (contrast/medication), and anticoagulation status.
Assist with vascular closure device deployment and post-procedural hemostasis measures, including pressure application, site monitoring, and instructions for nursing and recovery staff.
Maintain inventory control and ensure appropriate stocking of implants, disposables, and emergency supplies; coordinate with supply chain and vendors to reorder specialized items and manage consignment or consignment implant logs.
Participate in infection control and quality improvement initiatives: report incidents, support root cause analyses for adverse events, and implement corrective actions to improve procedural safety and outcomes.
Educate patients and families on pre- and post-procedure expectations including vascular access care, activity restrictions, medication instructions, and follow-up scheduling when within scope of role and institution policy.
Support training and orientation of new cath lab staff and students by demonstrating sterile technique, equipment setup, troubleshooting workflows, radiation safety, and documentation standards.
Ensure regulatory and accreditation compliance by maintaining accurate records of device lot numbers, personnel competencies, radiation exposure logs, and participating in periodic audits and mock surveys.

Secondary Functions

Participate in performance improvement projects, data collection for registry reporting (e.g., NCDR CathPCI), and initiatives to reduce contrast use and radiation exposure.
Support case scheduling and coordinate pre-procedural testing logistics with nursing, anesthesia, and imaging departments to optimize throughput.
Act as a liaison with vendors and device representatives for device education, technical support, and inventory reconciliation during cases.
Assist in maintaining cath lab policies, protocols, and procedure manuals; recommend updates based on latest clinical guidelines and technology advances.
Engage in community outreach or in-service education for referring departments to improve referral appropriateness and pre-procedure preparation.
Help plan and execute cath lab training simulation drills for emergency response scenarios and new device implementation.
Coordinate maintenance and preventive service schedules with biomedical engineering to minimize downtime and ensure equipment reliability.
Support research and clinical trials by ensuring protocol adherence for device handling, labeling, and documentation when participating in investigational device studies.

Required Skills & Competencies

Hard Skills (Technical)

Proficiency with fluoroscopy systems and digital angiography suites (Siemens, Philips, GE) including image acquisition, archival, and dose management.
Competent in invasive hemodynamic monitoring, interpretation of waveforms, and basic troubleshooting of pressure transducer systems.
Sterile technique mastery for vascular access procedures, catheter exchanges, and multi-device manipulations.
Familiarity with coronary and peripheral catheter types, guidewires, stents, balloons, angioplasty technique basics, and vascular closure devices.
Experience using power injectors for contrast administration and knowledge of contrast safety, renal protection strategies, and documentation of contrast volume.
Skilled in ECG rhythm monitoring, recognition of common arrhythmias (VF, VT, bradycardia, SVT) and immediate intervention steps per protocol.
Hands-on experience with cath lab information systems (CLIS), EPIC/Meditech integration, and procedural documentation workflows.
Competence in radiation safety practices: lead shielding placement, collimation, dosimeter use, and knowledge of ALARA principles.
Ability to operate and troubleshoot ancillary equipment: suction, electrosurgical units, temporary pacing generators, hemodynamic monitors, and transducers.
Inventory management and sterile supply handling including tracking lot numbers, expiration dates, and consignment inventory.
Basic pharmacology relevant to cath lab practice (anticoagulants, vasodilators, sedatives) and adherence to institution medication administration policies.
Familiar with infection control policies, sterilization protocols, and post-procedure cleaning procedures for interventional suites.

Soft Skills

Calm, decisive performance under pressure in high-acuity interventional environments.
Strong situational awareness and anticipation of operator needs to improve procedural efficiency.
Clear, concise communication and teamwork with physicians, nurses, anesthesia, and device reps.
Attention to detail for documentation, device tracking, and compliance tasks.
Adaptability to changing case mixes, emergent procedures, and new technologies.
Teaching and mentoring aptitude for onboarding new staff and cross-training team members.
Problem-solving orientation for equipment issues, workflow bottlenecks, or supply disruptions.
Commitment to continuous learning and following evolving clinical guidelines and device IFUs.

Education & Experience

Educational Background

Minimum Education:

High school diploma or GED plus completion of an accredited cardiovascular technology, radiologic technology, or surgical technologist program (or equivalent military training). Many employers also accept Registered Nurses (ADN/BSN) with cath lab experience.

Preferred Education:

Associate degree in Cardiovascular Technology (Invasive Cardiology), Radiologic Technology (ARRT), or an Associate/Bachelor of Science in Nursing (for RN cath tech roles).
Additional coursework or certificate in interventional cardiology, vascular technology, or cath lab operations is a plus.

Relevant Fields of Study:

Cardiovascular Technology (Invasive)
Radiologic Technology / Interventional Radiography
Nursing (ADN/BSN)
Surgical Technology
Biomedical or Clinical Engineering (for equipment-focused roles)

Experience Requirements

Typical Experience Range: 1–5 years of clinical experience, with at least 1 year of hands-on experience in a catheterization lab, interventional radiology, or cardiac operating room preferred.

Preferred:

2–4 years of direct cath lab experience supporting coronary and peripheral interventions.
Prior experience with PCI, structural heart procedures, or electrophysiology is highly desirable.
Demonstrated competence in sterile technique, fluoroscopy operation, hemodynamic monitoring, and high-acuity patient care.

Certifications commonly required or strongly preferred: BLS (Basic Life Support), ACLS (Advanced Cardiac Life Support), certification in Cardiovascular Technology (RCIS or RCES), ARRT (for radiologic technologists), and state licensure where applicable.