Emergency Room Skills Checklist Page 1 of 8
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1 Skills Checklist Page 1 of 8 Print Name: Date: Registered Nurse, NNUL COMPETENCY SSESSMENT TOOL Proficiency Level: Indicated exp. for each task 1-No experience/knowledge 2-Minimal experience, need N: Not pplicable to area or no exp. required 3-Can perform without supervision 4-Perform well and can act as resource person. CRDIOVSCULR. CRDIOVSCULR Continued 1. ssessment d. Cardiac arrest a. uscultation (rate, rhythm) e. Congestive heart failure (CHF) b. Doppler f. Myocarditis c. Heart sounds/murmurs 4. Medications 2. Equipment & procedures a. CLS drugs a. ssist with insertion and set up (1) tropine (1) rterial line (2) Bretylium (Bretylol) (2) Central venous line (3) Epinephrine (drenalin) (3) P catheter/swan-ganz insertion (4) Lidocaine (Xylocaine) (4) Pacemaker (5) Procainamide (Pronestyl) b. Cardioversion (6) Sodium bicarbonate c. Interpretation of waveforms & values b. Other Medications (1) -line (1) denosine (denocard) (2) CVP (2) miodarone (Cordarone) d. Monitoring (3) Digoxin (Lanoxin) (1) Basic 12 lead interpretation (4) Diltiazem (Cardizem) (2) Basic arrhythmia interpretation (5) Dobutamine (Dobutex) 3. Care of the patient with: (6) Dopamine (Intropin) a. cute MI (7) Esmolol (Brevibloc) b. neurysm (8) Lasix (Furosemide) c. ngina (9) Nitroglycerin (Tridil) (10) Nitroprusside (Nipride) (11) Thrombolytic therapy
2 Skills Checklist Page 2 of 8 B. PULMONRY B. PULMONRY Continued 1. ssessment (3) External CPP a. Breath sounds (4) Face masks b. Rate and work of breathing (5) Inhalers 2. Interpretation of lab results (6) Nasal cannula a. rterial blood gases (7) Nebulizer 3. Equipment & procedures (8) Portable O 2 tank a.irway mgt devices/suctioning (9) T-piece (1) Endotracheal tube/suctioning (10) Trach collar (2) Nasal airway/suctioning j. Pulse oximetry (3) Oropharyngeal/suctioning k. Trouble shooting high pressure alarms (4) Sputum specimen collection l. Trouble shooting low pressure alarms (5) Tracheostomy/suctioning 4. Care of the patient with: b. ssist with extubation a. spiration c. ssist with intubation b. COPD d. ssist with thoracentesis c. Hemopneumothorax e. Care of the patient on a ventilator d. Laryngospasm f. Care of the pt with a chest tube e. Pneumonia (1) ssist with set-up & insertion f. Pneumothorax (2) Measuring g. Pulmonary edema (3) Removal h. Pulmonary embolism g. Measure peak flow i. Tension pneumothorax h. Obtaining arterial blood gases j. Tuberculosis (1) rterial line 5. Medications (2) Femoral artery a. minophylline (Theophylline) (3) Radial artery b. Bronkosol (Isoetharine hydrochloride) i. O 2 tx & meds delivery systems c. Epinephrine (drenalin) (1) Bag and mask d. Isuprel (Isoproterenol hydrochloride) (2) ET tube e. Steroids f. Terbutaline
3 Skills Checklist Page 3 of 8 a. Basal skull fracture C. NEUROLOGICL b. Closed head injury 1. ssessment c. CV a. dvanced neuro assessment d. DTs (1) Glasgow coma Scale e. Encephalitis (2) Reflex / motor deficits f. Externalized VP shunts (3) Visual or communication deficts g. Meningitis b. Level of consciousness h. Neuromuscular disease 2. Equipment & procedures i. Overdose a. ssist with lumbar puncture j. Seizures b. Increased ICP management k. Spinal cord injury (1) Medications 4. Medications (2) Positioning a. Decadron (Dexamethasone) (3) Regulation of ICP b. Dilantin (Phenytoin) (4) Temperature control c. Mannitol (Osmitrol) (5) Ventilation d. Phenobarbital c. Intracranial pressure monitoring 3. Care of the patient with: e.solu-medrol (Methylprednisolone sodium succinate)
4 Skills Checklist Page 4 of 8 Skills Skills D. ORTHOPEDICS E. GSTROINTESTINL 1. ssessment 1. ssessment a. Skin & Circulation checks a. bdominal/bowel sounds b. Gait b. Fluid balance c. Range of motion c. Nutritional status 2. Equipment & procedures 2. Interpretation of blood chemistry a. ssist with placement of cast 3. Equipment & procedures b. Support devices a. Placement of nasogastric tube (1) Cane/crutch b. Salem sump to suction (2) Cervical collar c. Saline lavage (3) Sling 4. Care of the patient with: (4) Transfer boards a. bdominal trauma 3. Care of the patient with: b. Bowel obstruction a. nkle brace c. GI bleeding b. nkle splint d. Hepatitis c. Cast 5. Medications d. Knee immobilizer a. ntiemetics e. Pinned fractures b. ntispasmodic f. Wrist splint c. Charcoal d. Ipecac
5 Skills Checklist Page 5 of 8 Skills F. RENL/GENITOURINRY H. WOUND MNGEMENT/SURGICL 1. ssessment - Fluid balance 1. Equipment & procedures 2. Interpretation of lab results a. pplication of Steristrips 3. Equipment & procedures b. ssist with staples a. Insertion & care of straight and Foley c. ssist with sutures catheter (1) Female d. Culdocentesis tray (2) Male e. Set up suture tray b. Urine specimen collection f. Staple removal 4. Care of the patient with: g. Suture removal a. cute renal failure I. EENT b. Peritoneal lavage 1. ssessment c. Renal trauma a. Set up fluorescent/woods lamp exam d. Urinary tract infection b. Visual acuity G. ENDOCRINE/METBOLIC a. pplication of eye patch 1. ssessment b. Ear irrigation a. S/S diabetic coma c. Eye irrigation b. S/S insulin reaction d. Morgan lens irrigation 2. Equipment & procedures e. Nasal packing a. Blood glucose monitoring f. Removal of contact lens 3. Care of the patient with: a. Diabetic ketoacidosis a. Insulin b. Oral hypoglycemics
6 Skills Checklist Page 6 of 8 Skills Skills J. TRUM/SHOCK J. TRUM/SHOCK Continued 1. ssessment k. Hypothermia a. Champion trauma score l. Major trauma b. Poison index m. Minor trauma c. Triage n. Radiation exposure 2. Equipment & procedures (1) naphylactic a. ir transport of trauma patient (2) Cardiogenic b. pplication of mast suit (3) Hypovolemic c. Ground transport (4) Neurogenic 3. Care of the patient with: (5) Septic a. Bites, animal p. Traumatic amputation b. Bites, human K. INFECTIOUS DISESES c. Bites, venomous snake 1. Interpretation of lab values - CBC, SM 7 d. Bites, venomous spider 2. Equipment & procedures e. Burns a. Fever management (1) Rule of nines b. Isolation (2) First degree 3. Care of the patient with IDS (3) Second degree (4) Third degree f. Dehydration g. Electrocution h. Gunshot/stab wound i. Hazardous material exposure j. Heat exhaustion/stroke
7 Skills Checklist Page 7 of 8 Skills Skills L. PHLEBOTOMY/IV THERPY/INVSIVE PROCEDURES 1. Equipment & procedures M. PIN MNGEMENT a. dministration of blood/blood products 1. ssessment of pain level/tolerance (1) utotransfusion 2. Care of the patient with: (2) Cryoprecipitate a. Epidural anesthesia/analgesia (3) Packed red blood cells b. IV conscious sedation (4) Plasma/albumin N. PEDITRICS (5) Whole blood 1. Equipment & procedures b. ssist with cutdown a. Child abuse/recognition/reporting c. Drawing venous blood b. Obtaining consent to treat d. Starting IVs c. Pediatric arrest (1) ngiocath 2. Care of the patient with: (2) Butterfly a. Epiglottitis (3) Heparin lock b. Near drowning 2. Care of the Pt with: c. Overdose/poison ingestion a. ngiography d. Status asthmaticus b. Central line/catheter/ dressing e. Status epilepticus (1) Broviac/Hickman (2) Groshong (3) PICC (4) Portacath c. Pericardiocentesis
8 Skills Checklist Page 8 of 8 O. WOMEN'S HELTH 1. ssessment - ssist with pelvic exam 2. Equipment & procedures P. MISCELLNEOUS a. Pelvic tray 1. M procedures b. Rape kit 2. Suicide precautions c. Reporting acts of violence 3. Care of the patient with: a. bruptio placenta b. DIC c. Hemorrhage d. Placenta previa e. Precipitous delivery f. Preeclampsia/eclampsia g. Spontaneous abortion Signature: Date:
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