Emergency Room Skills Checklist

Name*
First Last
Email*
Phone*
Proficiency:
1 = Minimal Experience
2 = Limited Experience
3 = Competent
4 = Highly Skilled
Trauma
Air Transport of Trauma Patient*
- 1
- 2
- 3
- 4
Major Trauma*
- 1
- 2
- 3
- 4
Minor Trauma*
- 1
- 2
- 3
- 4
M.A.S.T. Suit*
- 1
- 2
- 3
- 4
Burns
First Degree*
- 1
- 2
- 3
- 4
Second Degree*
- 1
- 2
- 3
- 4
Third Degree*
- 1
- 2
- 3
- 4
Electrocution*
- 1
- 2
- 3
- 4
Dressing Procedure*
- 1
- 2
- 3
- 4
Hazardous Materials Exposure*
- 1
- 2
- 3
- 4
Radiation Exposure*
- 1
- 2
- 3
- 4
Respiratory
Pulmonary Edema*
- 1
- 2
- 3
- 4
C.O.P.D.*
- 1
- 2
- 3
- 4
Pneumothorax*
- 1
- 2
- 3
- 4
Assisting with Intubation*
- 1
- 2
- 3
- 4
Assisting with Extubation*
- 1
- 2
- 3
- 4
T-Piece*
- 1
- 2
- 3
- 4
Obtaining Arterial Blood Gases*
- 1
- 2
- 3
- 4
From Radial Artery*
- 1
- 2
- 3
- 4
From Femoral Artery*
- 1
- 2
- 3
- 4
From Arterial Line*
- 1
- 2
- 3
- 4
Setting Up of Arterial Line*
- 1
- 2
- 3
- 4
Ventilator*
- 1
- 2
- 3
- 4
O2 Mask*
- 1
- 2
- 3
- 4
O2 Cannula*
- 1
- 2
- 3
- 4
Venturi Mask*
- 1
- 2
- 3
- 4
Ambu Bags*
- 1
- 2
- 3
- 4
O2 Cylinders*
- 1
- 2
- 3
- 4
Nebulizer Set-Up*
- 1
- 2
- 3
- 4
Oropharyngeal Suction*
- 1
- 2
- 3
- 4
Nasotracheal Suction*
- 1
- 2
- 3
- 4
Endotracheal Suction*
- 1
- 2
- 3
- 4
Assisting with Chest Tube Insertion*
- 1
- 2
- 3
- 4
Use of Pleuravac Drainage System*
- 1
- 2
- 3
- 4
Use of Emerson Drainage System*
- 1
- 2
- 3
- 4
Gastrointestinal
G.I. Bleed*
- 1
- 2
- 3
- 4
Abdominal Wounds*
- 1
- 2
- 3
- 4
G.I. Tubes*
- 1
- 2
- 3
- 4
Acute Abdominal Disorders*
- 1
- 2
- 3
- 4
Insertion of Nasogastric Tube*
- 1
- 2
- 3
- 4
Gastric Lavage*
- 1
- 2
- 3
- 4
Renal
Acute Renal Failure*
- 1
- 2
- 3
- 4
Chronic Renal Failure*
- 1
- 2
- 3
- 4
Peritoneal Dialysis*
- 1
- 2
- 3
- 4
Orthopedic
Set-up for Cast Application*
- 1
- 2
- 3
- 4
Checking C.M.S.*
- 1
- 2
- 3
- 4
Set-up for OCL Splinting*
- 1
- 2
- 3
- 4
Set-up for Insertion of Steinman Pin / K-Wires Insertion*
- 1
- 2
- 3
- 4
Assist with Closed Fracture / Dislocation Reduction*
- 1
- 2
- 3
- 4
Sedation Monitoring*
- 1
- 2
- 3
- 4
Application of Orthopedic Appliances*
- 1
- 2
- 3
- 4
EENT Disorders
Set-up for Fluorescein / Woods Lamp Exam*
- 1
- 2
- 3
- 4
Use of Morgan Lens Irrigation*
- 1
- 2
- 3
- 4
Ear Irrigations*
- 1
- 2
- 3
- 4
Eye Irrigations*
- 1
- 2
- 3
- 4
Eye Patch Application*
- 1
- 2
- 3
- 4
Nasal Packing*
- 1
- 2
- 3
- 4
Remove Contact Lens*
- 1
- 2
- 3
- 4
Visual Acuity*
- 1
- 2
- 3
- 4
Lacerations
Setting up Suture Tray*
- 1
- 2
- 3
- 4
Assist with Sutures*
- 1
- 2
- 3
- 4
Assist with Staples*
- 1
- 2
- 3
- 4
Suture Removal*
- 1
- 2
- 3
- 4
Staple Removal*
- 1
- 2
- 3
- 4
Steri Strips*
- 1
- 2
- 3
- 4
Pediatric
Calculating Emergency Medication Dosages*
- 1
- 2
- 3
- 4
Knowledge of Normal Serum Lab Values*
- 1
- 2
- 3
- 4
Pediatric Arrest / Resuscitation*
- 1
- 2
- 3
- 4
Epiglottitis*
- 1
- 2
- 3
- 4
Overdose / Poison Ingestion*
- 1
- 2
- 3
- 4
Near Drowning*
- 1
- 2
- 3
- 4
Child Abuse*
- 1
- 2
- 3
- 4
Miscellaneous Instruments / Trays
Pelvic Tray*
- 1
- 2
- 3
- 4
Cut Down Tray*
- 1
- 2
- 3
- 4
Procto Tray*
- 1
- 2
- 3
- 4
CVP Tray*
- 1
- 2
- 3
- 4
Trach Tray*
- 1
- 2
- 3
- 4
Culdocentesis Tray*
- 1
- 2
- 3
- 4
Thoracentesis Tray*
- 1
- 2
- 3
- 4
Obstetrics / Gynecology
Spontaneous Abortion*
- 1
- 2
- 3
- 4
Hemorrhage*
- 1
- 2
- 3
- 4
Placenta Previa*
- 1
- 2
- 3
- 4
Abruptio Placenta*
- 1
- 2
- 3
- 4
Pre-eclampsia / Eclampsia*
- 1
- 2
- 3
- 4
Emergency Delivery*
- 1
- 2
- 3
- 4
Communicable Diseases*
- 1
- 2
- 3
- 4
Psychiatric
Crisis Intervention*
- 1
- 2
- 3
- 4
Upholding Patient's Rights*
- 1
- 2
- 3
- 4
Suicidal Patient*
- 1
- 2
- 3
- 4
Patient with Overdose*
- 1
- 2
- 3
- 4
Patient in Restraints*
- 1
- 2
- 3
- 4
Neurological
Neuro Assessment*
- 1
- 2
- 3
- 4
Monitoring Neuro Signs*
- 1
- 2
- 3
- 4
Use of Glasgow Coma Scale*
- 1
- 2
- 3
- 4
Acute Head Injury*
- 1
- 2
- 3
- 4
Acute T.I.A. / C.V.A.*
- 1
- 2
- 3
- 4
Acute Spinal Cord Injury*
- 1
- 2
- 3
- 4
Seizure Precautions*
- 1
- 2
- 3
- 4
Observing for Increased Intracranial Pressure*
- 1
- 2
- 3
- 4
Application for Orthopedic Appliances*
- 1
- 2
- 3
- 4
Transport of Patient with Spinal Cord Injuries*
- 1
- 2
- 3
- 4
Assist with Lumbar Puncture*
- 1
- 2
- 3
- 4
Dilantin*
- 1
- 2
- 3
- 4
Phenobarbital*
- 1
- 2
- 3
- 4
Decadron*
- 1
- 2
- 3
- 4
Mannitol*
- 1
- 2
- 3
- 4
Solu-Medrol*
- 1
- 2
- 3
- 4
Cardiovascular
Acute MI, CHF, Angina*
- 1
- 2
- 3
- 4
Abdominal Aortic Aneurysm*
- 1
- 2
- 3
- 4
Cardiac Monitoring*
- 1
- 2
- 3
- 4
Recognizing Arrhythmias*
- 1
- 2
- 3
- 4
Obtaining 12 Lead EKG's*
- 1
- 2
- 3
- 4
Cardiopulmonary Arrest*
- 1
- 2
- 3
- 4
Cardioversion*
- 1
- 2
- 3
- 4
Defibrillation*
- 1
- 2
- 3
- 4
Open Chest Heart Massage*
- 1
- 2
- 3
- 4
Permanent Pacemakers*
- 1
- 2
- 3
- 4
Temporary Pacemakers*
- 1
- 2
- 3
- 4
Trans-thoracic Pacemakers*
- 1
- 2
- 3
- 4
Pervenous Pacemakers*
- 1
- 2
- 3
- 4
Set-up & Use of CVP*
- 1
- 2
- 3
- 4
Interpretation of CVP Readings*
- 1
- 2
- 3
- 4
Interpretation of Swan-Ganz Readings*
- 1
- 2
- 3
- 4
Thrombolytic Therapy*
- 1
- 2
- 3
- 4
Anaphylactic Shock*
- 1
- 2
- 3
- 4
Cardiogenic Shock*
- 1
- 2
- 3
- 4
Septic Shock*
- 1
- 2
- 3
- 4
Hypovolemic Shock*
- 1
- 2
- 3
- 4
Administration of Blood & Blood Products*
- 1
- 2
- 3
- 4
Lidocaine*
- 1
- 2
- 3
- 4
Bretylium*
- 1
- 2
- 3
- 4
Nipride*
- 1
- 2
- 3
- 4
Dopamine*
- 1
- 2
- 3
- 4
Isuprel*
- 1
- 2
- 3
- 4
Digitalis*
- 1
- 2
- 3
- 4
Sodium Bicarbonate*
- 1
- 2
- 3
- 4
Atropine*
- 1
- 2
- 3
- 4
Epinephrine*
- 1
- 2
- 3
- 4
Dobutrex*
- 1
- 2
- 3
- 4
Tridil / Nitroglycerine*
- 1
- 2
- 3
- 4
Sexual Assault / Child Abuse
Sexual Assault Kit*
- 1
- 2
- 3
- 4
Reporting Procedures for Acts of Violence*
- 1
- 2
- 3
- 4
Environmental
Hypothermia*
- 1
- 2
- 3
- 4
Heat Stroke*
- 1
- 2
- 3
- 4
Heat Exhaustion*
- 1
- 2
- 3
- 4
Snake Bite*
- 1
- 2
- 3
- 4
Administration of Antivenom*
- 1
- 2
- 3
- 4
Animal Bite*
- 1
- 2
- 3
- 4
Poison Index*
- 1
- 2
- 3
- 4
Additional E.R. Skills
Isolation Procedures*
- 1
- 2
- 3
- 4
Triage Procedures*
- 1
- 2
- 3
- 4
Care of Patient with AIDS*
- 1
- 2
- 3
- 4
Lab Values*
- 1
- 2
- 3
- 4
Procedure for Patient Signing AMA*
- 1
- 2
- 3
- 4
Consent for Treatment of Minor*
- 1
- 2
- 3
- 4
Disaster Protocols*
- 1
- 2
- 3
- 4
Heparin / Saline Lock*
- 1
- 2
- 3
- 4
Starting IV's*
- 1
- 2
- 3
- 4
Adult IV's*
- 1
- 2
- 3
- 4
Pediatric IV's*
- 1
- 2
- 3
- 4
Universal Precautions*
- 1
- 2
- 3
- 4
Assist with Peritoneal Lavage*
- 1
- 2
- 3
- 4
Age Specific Competency
Newborn / Neonate (Birth - 30 days)*
- 1
- 2
- 3
- 4
Infant (30 days - 1 year)*
- 1
- 2
- 3
- 4
Toddler (1 - 3 years)*
- 1
- 2
- 3
- 4
Preschooler (3 - 5 years)*
- 1
- 2
- 3
- 4
School Age Children (5 - 12 years)*
- 1
- 2
- 3
- 4
Adolescents (12 - 18 years)*
- 1
- 2
- 3
- 4
Young Adults (18 - 39 years)*
- 1
- 2
- 3
- 4
Middle Adults (39 - 64 years)*
- 1
- 2
- 3
- 4
Older Adults (64 - 79 years)*
- 1
- 2
- 3
- 4
Elderly Adults (Over 79+ years)*
- 1
- 2
- 3
- 4

Proficiency:

Trauma

Burns

Respiratory

Gastrointestinal

Renal

Orthopedic

EENT Disorders

Lacerations

Pediatric

Miscellaneous Instruments / Trays

Obstetrics / Gynecology

Psychiatric

Neurological

Cardiovascular

Sexual Assault / Child Abuse

Environmental

Additional E.R. Skills

Age Specific Competency