TRAVELER SKILLS CHECKLIST PICU. 0 = No Knowledge / 1 = Limited Knowledge / 2 = Proficient. Last Name First Name Social Security Number Discipline
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1 Medication Administration PO Sub q Rectal Topical Drops (i.e. eye, nose, ear) IM Z track IV Push IV Drip Hyperalimentation Lipids Chemotherapy Metered dose inhaler Calculation of Pediatric dosages IV Therapy Start peripheral IV Mixing IV's IV TPA Replace fluids Central Lines PICC lines Broviac lines Portacaths Groshong Hickman Quinton CVP IVAC pumps IMED pumps Syringe pumps PCA pumps Drawing blood from central line Drawing venous blood Cardiovascular Normal hemodynamic values - Neonate Normal hemodynamic values - Infant Page 1 of 10
2 Normal hemodynamic values - Child Normal hemodynamic values - Adolescent Assessment Heart sounds/murmurs Central venous pressure Defibrillation/cardioversion EKG interpretation Invasive hemodynamic monitoring 12 lead EKG interpretation Swan-Ganz Cardiovascular - Patient Care Bacterial endocarditis Assist with pericardial tap Cardiac arrest Cardiac transplant Cardiogenic shock Cardiomyopathy Congenital heart disease/defects Hypovolemic shock Myocarditis Post cardiac surgery Post interventional cardiac cath Pacemaker - Temporary Pacemaker - Permanent Pacemaker - Trans-thoracic IABP Cardiovascular - Medications Dobutamine (Dobutrex) Dopamine (Intropin) Epinephrine (Adrenalin) Nipride (Nitroprusside) Nitroglycerine (Tridil) Sodium bicarbonate Amiodarone Digoxin Bumex Respiratory Page 2 of 10
3 Chest exam and auscultation Crackles Coarseness Diminished Tachypnea Inspiratory/expiratory evaluation Stridor Wheezing Dyspnea/SOB Retractions-Intercostal Retractions-Subcostal Retractions-Supraclavicular Assist with intubation Extubation Respiratory - Patient Care Asthma Assist with bronchoscopy Assist with rapid induction Bronchopulmonary Dysplasia ENT surgery Bronchitis Croup Cystic Fibrosis Epiglottis Flail chest Fresh tracheostomy Hemothorax Near drowning Near SIDS Pneumonia Pulmonary Edema Pneumothorax RDS RSV Thoracentesis Chest tubes-insertion/setup Chest tubes- maintenance care Chest tubes - removal Suction-nasopharyngeal Page 3 of 10
4 Suction-oropharyngeal Suction-tracheostomy Tracheostomy care Collection of sputum specimen CPAP/BiPAP machines High frequency jet ventilator IMV Weaning Home ventilators Apnea monitor Respiratory - Oxygen Therapy Nasal cannula Face mask Nebulizer Oxyhood Non-rebreather mask Ambu bag and mask ECMO (extracorporeal membrane oxygenation) ETCO2 monitoring Respiratory - Blood Gases Obtaining from arterial line Arterial puncture Heelstick Interpretation of gases Pulse oximetry Respiratory - Medications Aminophylline(Theophylline) Prostaglandin Neurological Assessment - Neurological Status Developmental level Glasgow Coma Scale Intracrainial pressure monitoring Hyper/hypo therma blanket Page 4 of 10
5 Bear hugger Warming lights Neurological - Patient Care Brain death/organ procurement Coma Encephalitis Externalized VP shunt/reservoirs Head trauma Meningitis Neuromuscular disease Post neuromuscular disease Spinal Cord injury Status epilepticus CNS infection CVA Hydrocephalus Seizures Crainal tumors Assisting with LP Neurological - Medications Administration of anti-convulsants Gastrointestinal Assessment-abdominal Assessment-nutritional Abdominal decompression devices Gavage Placement of gastrostomy/button tubes Placement of jejunal tubes Placement of nasogastric/orogastric tubes Test for occult blood Gastrointestinal - Patient Care Fresh ostomy Gastroenteritis Severe dehydration Page 5 of 10
6 GE reflux Anorexia/bulimia GI bleeding Hepatic failure Necrotizing enterocolitis (NEC) Pancreatitis Post abdominal surgery Stress ulcer Surgical abdomen Orthopedics Specialized orthopedic bed Traction Orthopedics - Patient Care Pinned fractures Post vertebral surgery Circulation checks for neurovascular assessment Craniofacial reconstruction Multiple fractures Renal/Genitourinary Assessment of fluid balance Interpretation of lab results Specific gravity Collection of urine specimens Insertion and care of foley catheter Insertion and care of supra-pubic catheter Renal/Genitourinary - Patient Care Acute renal failure CAVH Diabetes insipidus (DI) Hemodialysis Hemolytic uremic syndrome (HUS) Nephritis Nephrotic syndrome Peritoneal dialysis Page 6 of 10
7 Post renal transplant Syndrome inappropriate ADH (SIADH) Metabolic/Endocrine Assessment of electrolyte balance Blood glucose testing Metabolic/Endocrine - Patient Care Diabetic ketoacidosis Diabetes Hyperbilirubinemia Acid base imbalance Thyroid dysfunction Insulin pump Oncology/Hemotology Assessment Nutritional status Pain control Reverse isolation Interpretation of blood chemistry and counts Oncology/Hemotology - Patient Care Acute tumor lysis syndrome Bone marrow transplant DIC Fresh oncology surgery Inpatient chemotherapy Inpatient hospice Leukemia Malignant tumors Radiation implants Sickle cell anemia AIDS Anemia Hemophilia Pre/post splenectomy Radiation therapy Page 7 of 10
8 Administration of Chemotherapy Oncology/Hemotology - Administration of blood products RBC Platelets Cryoprecipitate FFP Albumin/Plasma Whole blood Wound and Skin Management Assessment of skin Statis ulcers Surgical wound healing Air fluidized, low airloss beds Sterile dressing changes Wound care/irrigations Wound and Skin Management - Patient Care Burns Pressure sores Staged decubitus ulcers Surgical wounds with drain(s) Traumatic wounds Isolation Standard Contact Enteric Respiratory MRSA VRE Pain Management Assessment of pain level/tolerance IV conscious sedation Epidural anesthesia Page 8 of 10
9 Care of the Dying Child Level of comfort/providing support Knowledge of resources Miscellaneous Knowledge of normal growth and development Recognize/report signs of child abuse Anaphylactic shock Application of restraints Blunt trauma Cardiogenic shock Care of child with cognitive developmental delay Care of child with motor developmental delay Cleft lip and/or palate Gun shot/open chest Hypovolemic shock Septic shock Ingestions/overdose Kawasaki disease Multiple trauma Near drowning Penetrating trauma Suicidal ideation/attempt Pyxis System Able to assure a safe environment for the specific needs of various age groups A.Newborn/Neonate (birth - 30 days) B.Infant (30 days - 1 year) C.Toddler (1-3 years) D.Preschooler (3-5 years) E.School age children (5-12 years) F.Adolescents (12-18 years) G.Young adults (18-39 years) H.Middle adults (39-64 years) I.Older adults (64+) Able to communicate and/or instruct patients according to their age, maturity, comprehension Page 9 of 10
10 A.Newborn/Neonate (birth - 30 days) B.Infant (30 days - 1 year) C.Toddler (1-3 years) D.Preschooler (3-5 years) E.School age children (5-12 years) F.Adolescents (12-18 years) G.Young adults (18-39 years) H.Middle adults (39-64 years) I.Older adults (64+) Evaluate age-appropriate behavior, motor skills and physiological norms A.Newborn/Neonate (birth - 30 days) B.Infant (30 days - 1 year) C.Toddler (1-3 years) D.Preschooler (3-5 years) E.School age children (5-12 years) F.Adolescents (12-18 years) G.Young adults (18-39 years) H.Middle adults (39-64 years) I.Older adults (64+) Page 10 of 10
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