Skills Checklist – Emergency Room

Skills Checklist – Emergency Room

• Name
  
  First
  
  Last
• Phone
• Email
  
• Cardiovascular*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Assess Heart Sounds
  Acute MI
  Abdominal Aortic Aneurysm
  Angina, unstable
  Cardiac Monitoring
  Congestive Heart Failure (CHF)
  Arrhythmia Intrepretation
  Obtaining 12-Lead EKG
  Cardiopulmonary Arrest/CPR
  Cardioversion
  Defibrillation
  Assist with Insertion of Pacemaker
  Application of External Pacemaker
  Transthoracic Pacemaker
  CVP – set up
  CVP – interpretation of readings
  Swan Ganz – Set up/assist with insert
  Swan Ganz – interpretation of readings
  Thrombolytic Therapy
  Anaphylactic Shock
  Cardiogenic Shock
  Hypovolemic Shock
  Septic Shock

• Respiratory*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Assess Breath Sounds
  Pulmonary Edema
  Pulmonary Emboli
  COPD
  Pneumonia
  Pneumothorax
  Status Asthmaticus
  Chest tube & drainage system
  Intubation – assist with
  Extubation – assist with
  Obtain Arterial Blood Gases
  Oxygen Therapy Administration

• NEUROLOGICAL*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Neuro Assessments
  Glascow Coma Scale
  Neuro Signs
  Acute Head Injuries
  Stroke Protocol
  Acute CVA/TIA
  Seizures
  Seizure precautions
  Increase ICP – monitor/observe for

• GASTROINTESTINAL*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Abdominal Pain
  Appendicitis
  GI Bleed
  Bowel Obstruction
  Acute Pancreatitis
  Diabetic Ketoacidosis (DKA)
  Hernia
  Insertion of NG tube
  Insertion of Ewald tube
  Gastric Lavage

• BURNS*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  First Degree
  Second Degree
  Third Degree
  Hazardous Material Exposure/Reporting

• RENAL*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Acute Renal Failure
  Chronic Renal Failure
  Peritoneal Dialysis
  Renal Calculi/Kidney Stones
  EENT

• ORTHOPEDIC*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Assess Extremity Circulation
  Set up/assist cast application
  Set up/assist OCL Splinting
  Closed Fracture Reductions – assist with
  Dislocation Reductions – assist with

• OBSTETRICS/GYNECOLOGY*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Doppler Fetal Heart Tones (FHT)
  Emergency Delivery
  Hemorrhage
  Ectopic Pregnancy

• OBSTETRICS/GYNECOLOGY*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Spontaneous Abortion
  Placentia Previa
  Aburptio Placenta
  Communicable Diseases

• PEDIATRICS*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Pediatric Assessments/VS
  Medication Dosage Calculation
  Lab Value Interpretation
  Overdose/Poison ingestion
  Pediatric Arrest/Resuscitation
  Near Drowning
  Child Abuse/Reporting

• PYSCHIATRIC*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Overdose
  ETOH Withdrawl/Delirium Tremens
  Suicidal Patients
  Crisis Intervention
  Restraints
  Maintaining Patient Rights
  Emergency 72 Hour Hold

• TRAUMA*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Level 1 Trauma experience
  Level 2 Trauma experience
  Open Chest Massage
  Hypovolemic Shock
  AutoTransfuser
  MAST Suit

• ENVIRONMENTAL*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Hypothermia
  Heat Stroke/Exhaustion
  Heat Exhaustion
  Snake Bite

• MISCELLANEOUS*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Triage Procedures
  Isolation Procedures
  Intrepretation of Critical Lab Values
  Insertion of Adult IV’s
  Insertion of Pediatric IV’s
  Wound Management
  Setup/Assist with Central Line Insertion
  Blood Product Administration
  Procedure for Patient Signing AMA
  Consent for Treatment of a Minor
  Conscious Sedation
  Computer Charting Systems

• SEXUAL ASSULT*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Rape Kit
  Reporting Procedure for Violent Acts
  Lacerations

• MEDICATIONS*
  

  	Rarely	Some Experience	Proficient	Trainer / Preceptor	N/A
  Antiarrhythmias
  Anticoagulants
  Antihypertensives
  Antiseizures
  Antipsychotics
  Benzodiazepines
  Continuous IV Paralytics
  Reversal Agents
  IV Vasopressors
  Emergency Medications
  Insulin
  Steroids
  Narcotics
  Automated Medication Dispensing
  Interpretation of Lab Values
  Thrombolytics

• Do you speak any languages other than English?*
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• Confirmation*
  • 
    I attest that the information I have given is both true and, to the best of my knowledge, represents an accurate self assessment of my professional skills and/or education.
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• Date
  
  Date Format: MM slash DD slash YYYY