Key Responsibilities and Required Skills for Upper GI Technician

🎯 Role Definition

The Upper GI Technician is a specialized radiologic technologist who performs and assists in fluoroscopic imaging of the upper gastrointestinal tract (esophagus, stomach, proximal small bowel) including barium swallows, esophagrams, upper GI series, and related contrast studies. This role requires expert patient preparation, safe operation of fluoroscopy equipment, contrast administration, image acquisition and processing, radiation safety compliance (ALARA), and close collaboration with radiologists, gastroenterologists, nursing staff, and front-office teams. Ideal candidates demonstrate strong technical ability with PACS/DICOM, excellent patient communication, and a focus on procedural quality and safety.

📈 Career Progression

Typical Career Path

Entry Point From:

Radiologic Technologist (General Radiography) transitioning into fluoroscopy/GI imaging
GI Tech or Endoscopy Tech with radiology cross-training
New graduate RT with fluoroscopy clinical rotation experience

Advancement To:

Lead Upper GI / Fluoroscopy Technologist
Fluoroscopy or GI Imaging Supervisor
Radiology Clinical Educator or Preceptor
Interventional Radiology Technologist or Procedural Imaging Specialist

Lateral Moves:

CT Technologist
MRI Technologist with additional training
Endoscopy/GI Lab Tech (if cross-trained)
PACS Administrator / Imaging Informatics Specialist

Core Responsibilities

Primary Functions

Review physician orders, imaging histories, and clinical notes to verify indications for upper GI fluoroscopic studies, ensure appropriate contrast selection, and confirm any fasting or pre-procedure requirements prior to patient arrival.
Prepare, measure, mix, and document contrast media (barium sulfate, gastrografin) and oral contrast regimens in accordance with facility protocols and manufacturer instructions while verifying patient allergies and renal status when applicable.
Escort and verbally prepare patients for upper GI procedures, clearly explaining step-by-step instructions, positioning requirements, expected sensations, and safety precautions to reduce anxiety and improve study quality.
Position patients accurately on the fluoroscopy table and assist with dynamic positioning techniques (upright, oblique, lateral, decubitus) to obtain diagnostic views of the esophagus, stomach, and proximal small bowel.
Operate fluoroscopy and radiographic equipment to acquire high-quality dynamic and static images, optimizing exposure parameters and collimation while minimizing radiation dose to the patient and staff (ALARA principles).
Assist the radiologist or gastroenterologist during procedures by coordinating table movements, adjusting image capture settings, acquiring spot images, and providing real-time contrast administration as directed.
Monitor patients continuously during procedures for signs of distress, aspiration, contrast reaction, or other adverse events; initiate emergency protocols and basic life support (BLS) if indicated until advanced care arrives.
Accurately label, process and archive images to PACS using DICOM standards and facility naming conventions; ensure complete procedural documentation, exam codes, and charge capture for billing integrity.
Perform fluoroscopic spot and digital acquisitions, measure anatomical landmarks when requested, and annotate images according to radiologist specifications to enable timely and precise reporting.
Maintain radiation safety protocols: use lead aprons, thyroid shields, gonadal shielding, dosimeters, and time/distance/shielding techniques; document dosimetry and escalate anomalous exposures for review.
Conduct routine quality control checks and daily/weekly preventive maintenance tasks on fluoroscopic units, image intensifiers, monitors, and contrast delivery equipment; log and report equipment anomalies to biomedical engineering.
Sterilize, disinfect, and prepare procedural rooms and ancillary equipment according to infection control and hospital clean-room standards, ensuring readiness between cases and reducing cross-contamination risk.
Triage and schedule inpatient and outpatient upper GI appointments in coordination with nursing and administrative staff to optimize throughput and patient flow while maintaining accurate scheduling records.
Reconcile contrast inventory, order supplies, manage expiration tracking, and maintain a clean and organized procedure area to support uninterrupted clinical operations.
Educate patients and caregivers on pre- and post-procedure instructions including fasting, medication modifications, hydration after contrast administration, and signs/symptoms to report post-discharge.
Verify patient identity, obtain informed consent documentation when required, and ensure adherence to HIPAA and patient privacy policies throughout the imaging process.
Cross-train with endoscopy teams when applicable to assist with hybrid GI procedures, coordinate fluoroscopic/endoscopic imaging workflows, and support sedation monitoring in collaboration with nursing staff.
Assist with provider communication by escalating critical findings to the interpreting physician, relaying procedural concerns, and ensuring immediate clinician awareness of acute complications.
Participate in peer review, case audits, and continuous quality improvement initiatives to optimize imaging protocols, reduce repeat exams, and improve diagnostic yield for upper GI studies.
Maintain competency records, complete required continuing education (fluoroscopy safety, contrast reactions, infection control), and pursue ARRT/State re-licensure and facility credentialing as required.
Train, mentor, and evaluate junior techs, student radiographers, and cross-trained staff on upper GI imaging protocols, patient handling, and equipment operation to build team capability.
Support multidisciplinary rounds, case conferences, and image review sessions by preparing and presenting key studies and technical insights related to upper GI imaging.
Ensure accurate documentation of procedural complications, contrast reactions, and safety incidents in the electronic medical record and incident reporting systems for follow-up and compliance.
Adapt procedure technique and patient handling for pediatric, geriatric, bariatric, and mobility-limited patients, ensuring diagnostic image quality while maintaining patient dignity and safety.

Secondary Functions

Assist with outpatient triage phone calls, pre-procedure screening (including medication reconciliation), and patient scheduling logistics to minimize no-shows and cancellations.
Collaborate with radiology leadership to develop and refine upper GI imaging protocols, standardized positioning guides, and dose-reduction strategies.
Participate in periodic audits of exam appropriateness, radiation dose metrics, and image quality benchmarks to support departmental accreditation and regulatory compliance.
Contribute to the development of training materials, procedural checklists, and e-learning modules for staff onboarding and ongoing competency maintenance.
Support the radiology department’s safety initiatives, including fire safety drills, emergency equipment checks, and maintenance of resuscitation cart supplies.

Required Skills & Competencies

Hard Skills (Technical)

Fluoroscopy equipment operation and dynamic imaging technique for upper GI studies (barium swallow, esophagram, upper GI series, small bowel follow-through).
Contrast media preparation, oral contrast administration, and knowledge of indications/contraindications (barium, water-soluble contrast).
Strong understanding of radiation safety principles (ALARA), use of dosimeters, and compliance with state and federal fluoroscopy regulations.
Proficiency with PACS, DICOM standards, image routing, archiving, and basic image post-processing and annotation.
Electronic Health Record (EHR) navigation for orders, procedure documentation, and integration (examples: Epic, Cerner).
Radiographic positioning and anatomy specific to esophagus, stomach, and proximal small bowel imaging.
Basic life support (BLS) / CPR certification and capability to assist in medical emergencies during procedures.
Infection control practices, room turnover, and sterile technique applicable to procedural imaging environments.
Quality assurance and preventive maintenance routines for fluoroscopy and radiography equipment.
Patient monitoring fundamentals (vital signs), recognition of contrast reactions, and initial emergency response protocols.
Familiarity with billing and coding concepts for radiology procedures, CPT code capture, and charge reconciliation.
Venipuncture and peripheral IV assistance (if cross-trained or required by facility).
Ability to measure and document radiation dose indicators (dose area product, fluoroscopy time) and assist in dose reporting.

Soft Skills

Clear, compassionate patient communication and the ability to instruct patients of diverse backgrounds and clinical needs.
Calm decision-making and situational awareness under pressure, especially when managing adverse reactions or difficult procedures.
Team collaboration and coordination with radiologists, nurses, schedulers, and biomedical engineering to ensure safe, efficient care.
Strong attention to detail for documentation, image labeling, and quality control to reduce repeat exams and diagnostic errors.
Time management and prioritization to balance high-volume schedules while maintaining procedural quality.
Problem-solving mindset to troubleshoot equipment or procedural issues and escalate when indicated.
Professionalism, empathy, and respect for patient privacy and dignity at all times.
Adaptability and willingness to learn new imaging modalities, protocols, and software updates.
Teaching and mentorship aptitude for training students and new staff in procedural techniques.
Continuous improvement orientation and proactive contribution to quality initiatives and protocol optimization.

Education & Experience

Educational Background

Minimum Education:

High school diploma or equivalent with completion of an accredited Radiologic Technology program and active RT certification/registration (ARRT or equivalent).

Preferred Education:

Associate degree in Radiologic Technology, Medical Imaging, or related allied health field.
Additional certificate or training in fluoroscopy or GI imaging is a plus.

Relevant Fields of Study:

Radiologic Technology / Diagnostic Medical Sonography / Medical Imaging
Allied Health Sciences
Nursing background with radiology cross-training (for hybrid GI lab roles)

Experience Requirements

Typical Experience Range:

1–5 years as a Registered Radiologic Technologist; 1–3 years of focused fluoroscopy or upper GI experience preferred.

Preferred:

2+ years performing upper GI fluoroscopic studies, documented competency with barium/contrast procedures, and experience operating modern fluoroscopy units and PACS.
Current BLS/CPR certification, state licensure for radiologic technologists, and facility-specific fluoroscopy privileges or credentialing.
Prior experience in a hospital-based radiology or GI lab environment, with demonstrated ability to manage complex patients and coordinate multidisciplinary care.