Critical Care Skills Checklist
0= No Experience
1= Limited Experience
2= One to Three Years Experience
3= Able to Function Independently
4= Expert (Able to Teach and Supervise)
Your Name *
Last name, First name
Your answer
BCLS
Expiration Date
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ACLS
Expiration Date
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If you have any other applicable certifications, please list them and their expiration dates here:
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Cardiovascular System Review:
Placement of Cardiac Monitor
Arrhythmia interpretation
12 Lead EKG Interpretation
Defibrillation/Cardioversion
CPR
Care of patients with Pacemakers: Permanent
Care of patients with Pacemakers: Transthoracic
Care of patients with Pacemakers: Transvenous
Care of patients with Pacemakers: Placement (External)
Care of patients with Pacemakers: Pacemaker
Assist with insertion/setup
Central venous catheter
Arterial line
Pulmonary artery catheter
Temporary pacemaker
Obtain and Interpret hemodynamic measurements: CVP
Obtain and Interpret hemodynamic measurements: Arterial Pressure (MAP)
Obtain and Interpret hemodynamic measurements: PA pressure
Obtain and Interpret hemodynamic measurements: PCW pressure
Obtain and Interpret hemodynamic measurements: Cardiac Output
Obtain and Interpret hemodynamic measurements: SVR
Identify and intervene PA catheter complications (e.g. balloon rupture over wedge) Obtain samples and interpret blood values for: ABG
Identify and intervene PA catheter complications (e.g. balloon rupture over wedge) Obtain samples and interpret blood values for: Mixed Venous ABG
Identify and intervene PA catheter complications (e.g. balloon rupture over wedge) Obtain samples and interpret blood values for: Electrolyte imbalances
Emergency Medication Administration: Dopamine
Emergency Medication Administration: Licocaine
Emergency Medication Administration: Bretylium
Emergency Medication Administration: Epinephrine
Emergency Medication Administration: Atrophine
Emergency Medication Administration: Bicarbonate
Managemet of pt. on multiple vasoactive drips: Nipride
Managemet of pt. on multiple vasoactive drips: Nitroglycerine
Managemet of pt. on multiple vasoactive drips: Inocor
Managemet of pt. on multiple vasoactive drips: Dopamine
Managemet of pt. on multiple vasoactive drips: Dobutamine
Care of pt. with acute M.I.
TPA Administration
Care of pre/post PTCA
Management of Cardiogenic shock
Septic shock
Hypovolemic shock
Care of pt. on intra aortic balloon pump
Care of pt. on ventricle assist device (RVAD or LVAD) Care of open heart surgery pt: Immediate
Care of pt. on ventricle assist device (RVAD or LVAD) Care of open heart surgery pt: 24-48 hours post-op
Care of heart transplant pt.
Assist with open chest procedure
Care of pt. with MAST suit/rotating tourniquets
Care of patient with abdominal aortic aneurysm
Assist with pericardiocentesis
NEUROLOGICAL SYSTEM REVIEW:
Perform basic neuro/assess/ vitals
Perform advanced neuro assess. (e.g. cranial nerves, reflexes, visual or communication deficits)
Increased pressure monitoring
Increased ICP management (e.g. positioning temp. regulation, meds.)
Recognition and intervention of complications (e.g. CSF leak, clot, hemiation)
Use of rotating bed
Stryker frame
Care of patient with halo traction/cervical tongs
Care of patient with barbiturate induced coma
Epicural med. Administration
Care of patient with ventriculostomy
Care of patient with: Craniotomy
Care of patient with: Acute CVA
Care of patient with: Head Injury
Care of patient with: Spinal Cord Injury
Care of patient with: Cerebral aneurysm
Care of patient with: Seizures
PULMONARY SYSTEM REVIEW
Identify and intervene respiratory complications (e.g. tension pneumo thorax aspiration, pulmonary edema, laryngospasm)
Assist with Intubation
Intubate
Extubate
Assist with chest tube insertion/ set up/ removal
Assist with thoracentesis
Assist with bronchoscopy
Care of patient with tracheostomy
Care of intubated patient
Continuous O2 and CO2 monitoring equipment
Troubleshoot ventilator complications
Weaning patient from vent
Modes of ventilation: IMV
Modes of ventilation: CPAP
Modes of ventilation: PEEP
Modes of ventilation: Assist/ Control
Modes of ventilation:
Modes of ventilation: Pressure Support
Modes of ventilation: High frequency jet vent.
Perform arterial puncture
Interpret ABG's
Care of patient with ECMO
Care of patient with ARDS
Care of patient with pulmonary edema
Care of patient with lung transplant
Administration of nebulizer meds.
MISCELLANEOUS
Care of patient with: GI Bleed
Care of patient with: Abdominal Surgery
Care of patient with: Burns
Care of patient with: AIDS
Care of patient with: Septic Shock
Care of patient with: Renal Failure
Care of patient with: Hemodialysis
Care of patient with: Peritoneal Dialysis
Care of patient with: Multiple Trauma
Care of patient with: Isolation
Care of patient with: Organ and tissue donation
UNIT EXPERIENCE
Please indicate years of experience in each area:
Medical
Your answer
Surgical
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Trauma
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Cardiothoracic
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Cardiovascular
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Coronary Care
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Burn
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Neuro
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Stepdown
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ER
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PACU
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I certify that this is my skills checklist. *
Please type your full name in lieu of a signature.
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Date *
Please list today's date.
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