Cath Lab Technologist Skills Checklist

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Requested by email:

Today's Date: * +

First Name: *

Last Name: *

Mobile Phone Number: *

Email Address: *

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GENERAL SKILLS:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Patients in Restraints	123
Proper Abbreviations	123
Supervisor or Charge Experience	123
Lifting and Transferring Patinets	123
Patients in Isolution (Infection Prevention)	123
Universal Precautions	123
CPR/BLS	123

EQUIPMENT:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Computerized Charting: Epic	123
Computerized Charting: Meditech	123
Computerized Charting: McKesson	123
Computerized Charting: EClinicalWorks	123
Computerized Charting: AllScripts	123
Computerized Charting: Cerner	123
Lift/Transferring Devices	123
IV Pumps	123
Automated Medication Dispensing Machines	123
Cardioversion	123
EKG/Lead Placement	123
Intra Aortic Balloon Pump	123
Defibrillator	123
ACT Machine	123
Hemochron	123
Femostop	123
Power Injector	123
Vasoseal	123
Angioseal	123
PerClose	123
Manual Pressure Hold	123
Suction Equipment	123
Oxygen Administration Equipment	123

PRE-PROCEDURE:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Doppler Studies	123
EKG	123
Vital Signs	123
Allen Test	123

HEMODYNAMIC MONITORING:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

PAP	123
PCW	123
CVP	123
SVR	123
PVR	123
CO2	123
CO	123
Cl	123
Waveform Assessment	123
Ejection Fractions	123
Arterial Pressure	123

CARDIOVASCULAR MONITORING:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

ABG interpretation	123
Pulse Checks (Radial, Femoral, Brachial, Pedal, Post Tibial)	123
Lab work Interpretation	123
Hematoma Recognition	123

CATH PROCEDURES AND INTERVENTIONS:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Adult Cardiac Catheterization	123
Pediatric Cardiac Catheterization	123
Shunt Detection	123
Ventricular Assistive Devices	123
Angioplasty	123
Stent Placement	123
Pericardiocentesis	123
Ablations	123

OTHER EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Pacemaker Placement: Permanent	123
Pacemaker Placement: Temporary Epicardial	123
Pacemaker Placement: Temporary External	123
Automatic Defibrillator Implantation	123
Thrombolysis and Thrombectomy	123
Assist with Line Insertions (A-line, central Lines, PA lines)	123
Biological	123
Angiography	123
Arteriograms	123
Valvuplasty	123
Cardiac Biopsy	123
Venogram	123
Embolization	123
Pericardial Tap	123
Intra-Aortic Balloon Pump Placement and Setup	123
AV Fistulas	123
Endografts	123
IVC Filters	123
TIPPS Procedure	123
Continuous Arteriovenous Hemofiltration (CAVH)	123
FFR Radiwire	123
Embolic Protection Devices	123
AngioJet	123

EMERGENCY PROCEDURES:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Emergency Defibrillation	123
Vasovagal Response	123
Pneumothorax	123
Myocardial Infarction (MI)	123
Embolism	123
Cardiogenic Shock	123
Anaphylaxis	123
IABP Insertion	123

AGE OF PATIENTS CARED FOR:

Rank each of the following sections on a scale of 1 to 3:
1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *

Newborn/Neonate (birth to 30 days)	123
Infant (31 days to 12 months)	123
Toddler/Preschool (13 months to 5 years)	123
School Age Child/ Adolescent	123
Young Adults/Middle Adult (19 years to 64 years)	123
Older Adults/Elderly (65+ years)	123

Attestation

ATTESTATION: *

I certify that the information provide above accurately reflects my experience in each of the clinical areas identified within the past three years.

If you agree with the Attestation above, please electronically sign your name. *