Cardiac Catherization Lab Skills Checklist Name* First Last Email* Phone*Proficiency: 1 = Minimal Experience 2 = Limited Experience 3 = Competent 4 = Highly SkilledCardiovascularAngina* 1 2 3 4 Acute MI* 1 2 3 4 Congestive Heart Failure* 1 2 3 4 Cardiac Tamponade* 1 2 3 4 Cardiogenic Shock* 1 2 3 4 Aneurysm* 1 2 3 4 Pulmonary Edema* 1 2 3 4 Pulmonary Embolism* 1 2 3 4 Cerebrovascular Accident (CVA)* 1 2 3 4 Permanent Pacemaker* 1 2 3 4 Temporary Pacemaker* 1 2 3 4 Automatic Implanted Defibrillator* 1 2 3 4 Intra-aortic Balloon Pump (IABP)* 1 2 3 4 Arterial Lines* 1 2 3 4 Central Venous Catheter* 1 2 3 4 Pulmonary Artery Catheter* 1 2 3 4 External Pacemaker* 1 2 3 4 Assessment of Heart Sounds* 1 2 3 4 Assessment of Cardiac Rhythm* 1 2 3 4 Placement / Use of Cardiac Monitor* 1 2 3 4 Identify Life Threatening Dysrhythmias* 1 2 3 4 Perform 12-lead EKG* 1 2 3 4 Basic 12-lead Interpretation* 1 2 3 4 Assist with Code* 1 2 3 4 Defibrillation / Cardioversion* 1 2 3 4 Automatic External Defib (AED)* 1 2 3 4 Cardiac Arrest / CPR* 1 2 3 4 RespiratoryAssessment of Breath Sounds* 1 2 3 4 Administer O2 (NC, Mask)* 1 2 3 4 Ventilate with Ambu-bag* 1 2 3 4 Assist with Intubation* 1 2 3 4 Care of Intubated Patient* 1 2 3 4 Suctioning (NP, OP, ETT, Trach)* 1 2 3 4 Pulse Oximetry (O2 Sat)* 1 2 3 4 Draw Blood From Arterial Line* 1 2 3 4 Interpret Arterial Blood Gases* 1 2 3 4 Assess Resp Complications* 1 2 3 4 IV Therapy / ProceduresStarting PIV's* 1 2 3 4 PICC Lines-Care and Maintenance* 1 2 3 4 Central Venous Lines-Care and Maintenance* 1 2 3 4 Invasive Hemodynamic Monitoring* 1 2 3 4 Blood Draw from PICC / CVL* 1 2 3 4 Administration of Blood / Blood Products* 1 2 3 4 Packed Red Blood Cells* 1 2 3 4 Platelets* 1 2 3 4 IV Infusion Pumps* 1 2 3 4 Blood / Fluid Warmers* 1 2 3 4 Medications & AdministrationInsert Peripheral IV / Heplock* 1 2 3 4 Infusion Pump* 1 2 3 4 Syringe Pump* 1 2 3 4 Blood / Blood Products Admin* 1 2 3 4 Conscious Sedation Medications* 1 2 3 4 Conscious Sedation Reversal Meds* 1 2 3 4 Epinephrine* 1 2 3 4 Atropine* 1 2 3 4 Lidocaine* 1 2 3 4 Bicarbonate* 1 2 3 4 TPA / Thrombolytics* 1 2 3 4 Dopamine* 1 2 3 4 Nipride* 1 2 3 4 Nitroglycerin* 1 2 3 4 Inocor* 1 2 3 4 Dobutamine* 1 2 3 4 Insulin* 1 2 3 4 Pronestyl* 1 2 3 4 Invasive Cardo InterventionsKnowledge of Cardiac System* 1 2 3 4 Setup for Procedure / Aseptic Tech* 1 2 3 4 Indications and Contraindications* 1 2 3 4 Risks and Complications* 1 2 3 4 Preparation and Premedication* 1 2 3 4 Radiation Safety / Environment* 1 2 3 4 Scrubbing for Cardiac Procedures* 1 2 3 4 Circulating Cardiac Procedures* 1 2 3 4 Monitoring Cardiac Procedures* 1 2 3 4 Disposable (Needles, Sheaths...)* 1 2 3 4 Non-disposable (Needles, Sheaths...)* 1 2 3 4 Right Heart Angiography* 1 2 3 4 Left Heart Angiography* 1 2 3 4 Percut TranslumCoronary Angio (PTCA)* 1 2 3 4 TransEsophogeal Echo (TEE)* 1 2 3 4 Electrophysiology Studies (EPS)* 1 2 3 4 Radio Frequency Ablation (RFA)* 1 2 3 4 Implantable Cardioverter Defib (ICD)* 1 2 3 4 Stent Placement* 1 2 3 4 Septal Defects* 1 2 3 4 Balloon Dilatation Valves & Vessel* 1 2 3 4 Post Cath Patient Instruction* 1 2 3 4 Hemodynamic MeasurementsCentral Venous Pressure* 1 2 3 4 Arterial Pressure (MAP)* 1 2 3 4 PA Pressure* 1 2 3 4 This field is hidden when viewing the formPCW Pressure* 1 2 3 4 Cardiac Output* 1 2 3 4 SVO2* 1 2 3 4 Intervene PA Catheter Problems* 1 2 3 4 Obtain ABG* 1 2 3 4 Obtain Mixed Venous Gases* 1 2 3 4 Other Cardiac Cath Data* 1 2 3 4 NeurologyNeuro Assessment / Vital Signs* 1 2 3 4 Glasgow Coma Scale* 1 2 3 4 Identify Neuro Complications* 1 2 3 4 Pain Management* 1 2 3 4 OtherIsolation / Universal Precautions* 1 2 3 4 Advance Directives* 1 2 3 4 Postmortem Care* 1 2 3 4 Pre-operative Care / Preparation* 1 2 3 4 Knowledge of Serum Lab Values* 1 2 3 4 Latex Allergy* 1 2 3 4 Age Specific CompetencyNewborn / Neonate (Birth to 30 days)* 1 2 3 4 Infant (1 month to 1 year)* 1 2 3 4 Toddler (1 year to 3 years)* 1 2 3 4 Preschooler (3 years to 5 years)* 1 2 3 4 School Age Child (5 years to 12 years)* 1 2 3 4 Adolescents (12 years to 18 years)* 1 2 3 4 Young Adults (18 years to 39 years)* 1 2 3 4 Middle Adults (39 years to 64 years)* 1 2 3 4 Older Adults (64 years to 79 years)* 1 2 3 4 Elderly Adults (Over 79+ years)* 1 2 3 4