The scope of practice for your lab will depend on several variables, including state law (nurse practice acts and the like), hospital policies, physician expectations and comfort levels, and the experience level of your staff.

In our institution, our techs function at a very high level. We are a mid-sized community hospital and do not have fellows on staff, so our techs perform many duties that fellows usually perform at academic institutions. This includes things like closing pockets, inserting arterial and venous sheaths, inserting diagnostic catheters, watching and calling screens, operating the stimulator box, operating CARTO/ESI (with and without company reps present) and working up data. Of course, not all the techs perform all those functions, and no one does anything without adequate experience and extensive training, and everything is done under the auspices of the physicians. In addition, many staff members have IBHRE certification and/or RCES credentialing (or are planning to) and we are now requiring all new hires to achieve RCES credentialing within 2 years of hire. The majority of our techs have completed our EP Internship (a 6-month didactic and clinical orientation), during which they were trained to perform at the level expected in our lab. Everyone is not an expert at everything, and some have special areas of interest and/or expertise.

If you have fellows on staff, that will most likely limit what your techs can do. Also, some states have regulations allowing only x-ray techs to operate x-ray machinery. Hospital policies may also restrict what techs can do. And if you have a lot of inexperienced people, they are not going to be able to function much above a fairly basic level until they have a year or so of full time employment in the lab, regardless of what the scope of practice says they can do.

So, long story short, the scope of practice for one lab may be very different than the scope of practice in another. It is fine to spell out minimum knowledge/experience requirements, but in reality, there are many variables that impact what EP techs know and how they practice.