Emergency Room Skills Checklist

Personal Information
Name
E-Mail address

Please indicate your overall practical experience level with each skill using the key below. All fields are required.

Key
None	No experience
Limited	Requires additional training
Moderate	Have performed and able to do without supervision
Well Skilled	Very experienced and able to perform independently
Proficient	Able to teach and supervise

Trauma	None	Limited	Moderate	Well Skilled	Proficient
Air Transport of Trauma Patient
Care of a patient with:
Major Trauma
Minor Trauma
M.A.S.T. Suit
Burns - Care of a patient with:	None	Limited	Moderate	Well Skilled	Proficient
First Degree
Second Degree
Third Degree
Electrocution
Dressing Procedure
Hazardous Materials Exposure
Radiation Exposure
Respiratory	None	Limited	Moderate	Well Skilled	Proficient
Assisting with Intubation
Assisting with Extubation
Tracheotomy
Trach Tube
T-Piece
Setting Up of Arterial Line
Ventilator
O2 Mask
O2 Cannula
Venturi Mask
Ambu Bags
O2 Cylinders
Nebulizer Set Up
Oropharyngeal Suction
Nasotracheal Suction
Endotracheal Suction
Assisting with Chest Tube Insertion
Use of Pleuravac Drainage System
Use of Emerson Drainage System
Obtaining Arterial Blood Gases:
From Radial Artery
From Femoral Artery
From Arterial Line
Care of a patient with:
Pulmonary Edema
C.O.P.D.
Pneumothorax
Gastrointestinal - Care of a patient with:	None	Limited	Moderate	Well Skilled	Proficient
G.I. Bleed
Abdominal Wounds
G.I. Tubes
Acute Abdominal Disorders
Insertion of Nasogastric Tube
Gastric Lavage
Renal - Care of a patient with:	None	Limited	Moderate	Well Skilled	Proficient
Acute Renal Failure
Chronic Renal Failure
Peritoncal Dialysis
Orthopedic - Care of a patient with:	None	Limited	Moderate	Well Skilled	Proficient
Set Up for Cast Application
Checking C.M.S.
Set Up for OCL Splinting
Set Up for Insertion of Steinman Pin/K-wires Insertion
Assist with Closed Fracture/Dislocation Reduction
Sedation Monitoring
Application of Orthopedic Appliances
EENT - Care of a patient with:	None	Limited	Moderate	Well Skilled	Proficient
Set Up for Fluorscein/Woods Lamp Exam
Use of Morgan Lens Irrigation
Ear Irrigation
Eye Patch Application
Nasal Packing
Remove Contact Lens
Visual Acuity
Lacerations	None	Limited	Moderate	Well Skilled	Proficient
Setting Up Suture Tray
Assist with Sutures
Assist with Staples
Suture Removal
Staple Removal
Steri Strips
Pediatric	None	Limited	Moderate	Well Skilled	Proficient
Calculating Emergency Medication Dosages
Knowledge of Normal Serum Lab Values
Care of a patient with:
Pediatric Arrest/Resuscitation
Epiglottitis
Overdose/Poison Ingestion
Near Downing
Child Abuse
Obstetrics/Gynecology - Care of a patient with:	None	Limited	Moderate	Well Skilled	Proficient
Spontaneous Abortion
Hemorrhage
Placenta Previa
Abruptio Placenta
Preeclampsia/Eclampsia
Emergency Delivery
Communicable Disease
Psychiatric	None	Limited	Moderate	Well Skilled	Proficient
Crisis Intervention
Upholding Patient's Rights
Care of:
Suicidal Patient
Patient with Overdose
Patient in Restraints
Neurological:	None	Limited	Moderate	Well Skilled	Proficient
Neuro Assessment
Monitoring Neuro Signs
Use of Glascow Coma Scale
Acute Head Injury
Acute T.I.A./C.V.A.
Acute Spinal Cord Injury
Seizure Precautions
Observing for Increased Intracranial Pressure
Application of Orthopedic Appliances
Transport of Patient with Spinal Cord Injuries
Assist with Lumbar Puncture
Neurological - Knowledge and Use of:	None	Limited	Moderate	Well Skilled	Proficient
Dilantin
Phenobarbital
Decadron
Mannitol
Solu-Medrol
Cardiovascular:	None	Limited	Moderate	Well Skilled	Proficient
Open Chest Heart Massage
Assist with Insertion of Permanent Pacemaker
Assist with Insertion of Temporary Pacemaker
Trans-thoracic Pacemaker
Prevenous Pacemaker
Set Up and Use of CVP
Interpretation of CVP Readings
Interpretation of Swan Ganz Readings
Thrombolytic Therapy
Anaphalactic Shock
Cardiogenic Shock
Septic Shock
Hypovolemic Shock
Administration of Blood and Blood Products
Cardiovascular - Care of Patient with:	None	Limited	Moderate	Well Skilled	Proficient
Acute MI, CHF, Angina
Abdominal Aortic Aneurysm
Cardiac Monitoring
Recognizing Arrhythmias
Obtaining 12 Lead EKGs
Cardiopulmonary Arrest
Cardioversion
Defibrillation
Cardiovascular - Preparation/Calculation of the Following Drugs:	None	Limited	Moderate	Well Skilled	Proficient
Lidocaine
Bretylium
Nipride
Dopamine
Isuprel
Digitalis
Sodium Bicabonate
Atropine
Epinephrine
Dobutrex
Tridil/Nitroglycerine
Sexual Assult/Child Abuse	None	Limited	Moderate	Well Skilled	Proficient
Rape Kit
Reporting Procedures for Acts of Violence
Environmental - Care of a patient with:	None	Limited	Moderate	Well Skilled	Proficient
Hypothermia
Heat Stroke
Heat Exhaustion
Snake Bite
Administration of Antivenin
Animal Bite
Poison Index
Additional Emergency Room Skills	None	Limited	Moderate	Well Skilled	Proficient
Isolation Procedures
Triage Procedures
Care of Patient with AIDS
Lab Values
Procedure for Patient Signing AMA
Consent for Treatment of Minor
Disaster Protocols
Heparin/Saline Lock
Universal Precautions
Assist with Peritoneal Lavage
Post-Mortem Care
PICC Insertion
Starting IVs
Adult
Pediatric
Miscellaneous Instruments/Trays	None	Limited	Moderate	Well Skilled	Proficient
Pelvic Tray
Cut Down Tray
Procto Tray
CVP Tray
Trach Tray
Culdocentesis Tray
Thoracentesis Tray
Age-Specific Competence	None	Limited	Moderate	Well Skilled	Proficient
Neonates/Newborns (birth - 30 days)
Infants (30 days - 1 year)
Toddler (1-3 years)
Preschooler (3 - 5- years)
Older Children (5 - 12 years)
Adolescents (12 - 18 years)
Young Adults (18 - 39 years)
Middle Adults (39 - 64 years)
Older Adults/Geriatrics (64+ years of age)

Preserving Higher Standards of Patient Care