ER Skills Checklist This assessment is for determining your experience in the below outlined clinical areas. This checklist will not be used as a determining factor in accepting your application for employment with ADEX Medical Staffing, LLC. Proficency Scale: 1 = No Experience - Theory only 2 = Limited Experience - Infrequent 3 = Moderate Experience - Able to perform independently 4 = Proficient - Able to perform proficiently and instruct Scale: 1 = Never Observed 2 = Less than 6 times a year 3 = 1 or 2 Times a Month 4 = Daily or Weekly Personal Information Name: Email: City: Country: United States State/Region: Send to: None Specified Respiratory 1 2 3 4 1 2 3 4 (High Pressure Alarm.Low Exhale Vol.) Administer O2 (NC, mask) Assessment of Breath Sounds
Assist Needle Thoracostomy Assist with Bronchoscopy Assist with Emergency Trach Assist and care of Intubated Patient Draw Blood from Arterial Line Interpret Arterial Blood Gases Nebulizer Set-up Perform Arterial Puncture Pulse Oximetry Rapid Sequence Induction Re-breather Mask Suctioning Troubleshoot Ventilator Problems Ventilate with Ambu-Bag Venturi Mask Care of Patient with 1 2 3 4 1 2 3 4 Assess Resp. Complications Asthma Chest Injury Chest Tubes/Pleurevac Pulmonary Edema Acute CVA Acute Spinal Cord Injury CNS Infections Halo Traction/Cervical Tongs Increased ICP Open/Closed Head Injury Acute MI
Anaphylactic Shock Aneurysm Angina Automatic Implanted Defibrillation Cardiogenic Shock Congestive Heart Failure Heart Transplant Hypovolemic Shock Permanent or Temporary Pacemaker Septic Shock Abdominal Aortic Aneurysm Acute Pancreatitis Drug Overdose/DT's Gastrostomy/Jejunostomy Tube GI Bleed Open Abd Wound/Incision AIDS Bone Marrow Transplant chemotherapy Ketoacidosis Liver Transplant Oncology Psychiatric Issues Neurology 1 2 3 4 1 2 3 4 Aneurysm Precautions Assist with Lumbar Puncture Glasgow Coma Scale Identify Neuro Complications
Neuro Assessment/Vital Signs Seizure Precautions Emergency Medication Administration 1 2 3 4 1 2 3 4 Atropine Bicarbonate Epinephrine Lidocaine Streptokinase (Indication/Manage) TPA (Indication/Management) Infusion Medication Administration 1 2 3 4 1 2 3 4 Bretylium Dopamine Insulin Pronestyl Infusion Therapy 1 2 3 4 1 2 3 4 Blood/Blood Products Admin. Management and care of Peripheral IV/Heplock Infusion Pump Insert Peripheral IV/Heplock Syringe Pump Access/Care/Blood Draws 1 2 3 4 1 2 3 4 Groshong Hickman/Broviac Implanted Ports
PICC/Midline Venipuncture Assist with Insertion and Setup 1 2 3 4 1 2 3 4 Arterial Lines Autotransfuser Central Venous Catheter Cardiac 1 2 3 4 1 2 3 4 Assessment of Heart Sounds Assist with Arrest/Resuscitation (CPS/ACLS) Automatic External Defib (AED) Basic 12-Lead Interpretation Defibrillation/Cardioversion Identify Lethal Dysrhythmias Perform 12-Lead EKG Place Cardiac Monitor/Telemetry Troubleshoot Monitor/Telemetry Musculoskeletal 1 2 3 4 1 2 3 4 Assist with Cast Application Cutdown 1 2 3 4 1 2 3 4 External Pacemaker Intraosseous Infusions Pericardiocentesis Pulmonary Artery Catheter Temporary Transvenous Pacer
Gastrointestinal 1 2 3 4 1 2 3 4 Assess Abd & Bowel Sounds Gastric Lavage Identification of Abnormalties Insert/Maintain Feeding Tubes Insert/Maintain NG Tubes Integumentary 1 2 3 4 1 2 3 4 Local Anesthetics Suture Setup & Assist Tetanus Prophylactis Venomous Bites Wound Assess & Dressings Wound Cultures Wound Irrigation Assist with External Fixation Pins 1 2 3 4 1 2 3 4 Assist with Nerve Blocks Cast Removal Fit/Instruct Crutch Walking Ice Bag Application Immobilization & Splinting Genito-Urinary 1 2 3 4 1 2 3 4 Assist with Sexual Assault Exam Evidence Collection/Documentation Insertion of Female Catheter Insertion of Male Catheter
Setup/Assist with Vaginal Exam Ear-Nose-Throat (ENT) 1 2 3 4 1 2 3 4 Ear Irrigations Epistaxis Eye Irrigations Visual Acuity Knowledge of Procedure 1 2 3 4 1 2 3 4 Assist with Suction Curettage Care of Newborn Eval of Abd Pain GYN History/Prenatal Assess Precipitous Delivery Spontaneous AB Pediatrics 1 2 3 4 1 2 3 4 Legal Principles re: Child Abuse Principles of Growth & Development Vital Signs/Normal Values for Age Renal-Care of Patient with 1 2 3 4 1 2 3 4 Acute Renal Failure Chronic Renal Failure Hemodialysis Peritoneal Dialysis Renal Transplant
Trauma Care 1 2 3 4 1 2 3 4 Blunt Abdominal Trauma Blunt Chest Trauma Frostbite Gunshot Wound Hypothermia MAST Suit / PASG care Pediatric Trauma Score Principles of C-Spine Immobilization Stab Wound Trauma Assessment Trauma Score Use of Backboard Use of Philadelphia Collar Other 1 2 3 4 1 2 3 4 Assist with Emergency Circumcision Assist with Chemical Burn Assist with Chest Tube Insertion Assist with Diagnostic Peritoneal Lavage Assist with Electrical Burn Assist with Thermal Burn Assist with Thoracotomy Advance Directives Aware of Consent Procedures Crisis Prevention Intervention (CPI) Emergency Pre-Operative Prep Isolation Techniques
Postmortem Care Triage Procedure Age Specific Skills 1 2 3 4 1 2 3 4 Newborn birth-30 days Infant 30 days-1 year Toddler 1-3 years Preschooler 3-5 years School Age 5-12 years Adolescents 12-18 years Young Adults 18-39 years Middle Adults 39-64 years Older Adults 64+ years Signature The information represented above is true and correct to the best of my knowledge. I authorize ADEX Medical Staffing, LLC to share this skills checklist with its clients. Initials: Copyright 2009 ADEX Medical Staffing, LLC Form Reviewed by ADEX Clinician - 11/16/2010