This profile is for use by healthcare professionals in this discipline and specialty. It will not be a determining factor for the program.
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Please mark your level of experience

1. No theory and/or experience
2. Limited experience/need supervision and/or support
3. Experienced/minimal support needed to perform
4. Proficient/can perform independently

CARDIOVASCULAR

1 / 2 / 3 / 4

Assessment

• Auscultation/Irregular Heart Sounds

• Peripheral Edema

• PQRST Assessment

Interpretation of Labs/Tests

• EKG

• Lab Tests (Cardiac Enzymes, Troponin, BNP)

Equipment & Procedures

• Arrhythmia Interpretation

• 12-Lead Set Up

• 12-Lead Basic Interpretation

• Defibrillation

• External Pacer

Care of the Patient with

• Chest Pain/ACS

• Arrhythmias

• CHF

• AED

• Cardiac Arrest/CPR

Medications

• Nitroglycerin

• Morphine

• Heparin

• ALS (Epinephrine, Atropine, Anti-Arrhythmics)

PULMONARY

1 / 2 / 3 / 4

Assessment

• Abnormal Breath Sounds (Wheezing, Stridor, Crackles)

• Abnormal Breathing Pattern (Rapid, Labored, Slow)

Interpretation of Lab/Tests

• Pulse Oximetry

• ABGs

Equipment & Procedures

• Oxygen Therapy (Nasal Cannula, Face Mask)

• Manual Resuscitation Bag (MRB, Ambu Bag)

• Metered-Dose Inhaler (MDI)

• Nebulizers

Care of the Patient with

• Aspiration

• Asthma/Reactive Airway Disease

• COPD

• Pneumonia

• Pulmonary Edema

• Pulmonary Embolism

Medications

• Bronchodilators

• Steroids

• Diuretics

NEUROLOGICAL

1 / 2 / 3 / 4

Assessment

• Signs & Symptoms of Stroke

• Altered LOC

Equipment & Procedures

• Assist with Lumbar Puncture

• Cervical Collar

• Spinal Immobilization

Care of the Patient with

• Head Injury

• Meningitis

• Migraine

• Seizures

• TIA/Stroke

Medications

• Imitrex (Sumatriptan Succinate)

• Phenobarbitol

• Dilantin (Phenytoin)

• Depakote

• Analgesics

ORTHOPEDICS

1 / 2 / 3 / 4

Assessment

• Range of Motion

• Color, Warmth, Movement, Sensation

• Fracture/Dislocation

Equipment & Procedures

• Apply Splints

• Assist with Casting

• Assist with Reduction of Dislocation

• Spinal Immobilization

• Transfer Boards

Care of the Patient with

• Cast/Splint

• Dislocation

• External Appliance

• Sprain/Fracture

Medications

• Analgesia/Sedation

GASTROINTESTINAL

1 / 2 / 3 / 4

Assessment

• Bowel Sounds

• Distention

• Fluid Balance

• Nutritional Status

Equipment & Procedures

• Enemas

• Gastric Lavage

• G-Tubes

• NG Tubes

Care of the Patient with

• Colostomy

• Constipation/Impaction

• Diarrhea

• G-Tube (Reinsertion/Replacement)

• Nausea/Vomiting

Medications

• Ipecac

• Charcoal

• Antiemetics

• Antispasmodics

RENAL/GENITOURINARY

1 / 2 / 3 / 4

Assessment

• Fluid Status

• Shunt/Fistula (Thrill/Bruit)

Interpretation of Labs

• BUN/Creatinine/Electrolytes

Equipment & Procedures

• Urine Dipstick/C&S

• Placement & Management of Bladder Catheters

Care of the Patient with

• Pyelonephritis/UTI

• Obstruction

• Renal Calculi

• Renal Trauma

• Testicular Torsion

• Priapism

Medications

• Antibiotics

ENDOCRINE/METABOLIC

1 / 2 / 3 / 4

Assessment

• Hypo/Hyperglycemia

Interpretation of Labs

• Blood Glucose

• Urine Ketones

Equipment & Procedures

• Bedside Blood Glucose Monitoring

Care of the Patient with

• Hypoglycemia/Insulin Shock

• Hyperglycemia/DKA

Medications

• Dextrose

• Insulin

• Oral Hypoglycemics

EENT

1 / 2 / 3 / 4

Assessment

• Visual Acuity

• Foreign Body

• Enlarged Tonsils

Equipment & Procedures

• Ear Irrigation/Removal Foreign Body

• Eye Injury/Foreign Body/Detached Retina

• Assist with Removal of Nasal Foreign Body

• Epistaxis

• Set Up/Assist Cautery

• Set Up Slit Lamp

Medications

• Silver Nitrate

• Liquid Cocaine

• Anti-Hypertensives

INFECTIOUS DISEASE

1 / 2 / 3 / 4

Assessment

• Communicable Disease

• Interpret Culture Results

Equipment & Procedures

• Obtain Cultures

• Fever Management

• Isolation

• Reverse Isolation/Hepa Filter

• Use of Personal Protective Equipment

Care of the Patient with

• Communicable Disease

• Infectious Disease

• Immunosuppression/Neutropenia

Medications

• Antibiotics

• Antivirals

WOUND MANAGEMENT

1 / 2 / 3 / 4

Burn Care

Dressing Change

Ostomy Care

Wound Repair (Staples/Sutures, etc.)

PAIN MANAGEMENT

1 / 2 / 3 / 4

Assessment of Pain Level/Use of Pain Scale

Assessment of Response to Pain Management Interventions

Monitoring of Patients after Pain Medication

Comfort Care

Moderate Sedation

PSYCHIATRIC

1 / 2 / 3 / 4

Assessment

• Behavior

• Drug/ETOH

• Risk for Violence

Equipment & Procedures

• Managing Threatening/Violent Behavior

• Psychiatric Hold

Care of the Patient with

• Drug OD

• ETOH OD

• Depression/Anxiety

• Restraints

• Suicide Risk

Medications

• Antipsychotics/Antidepressants

• Reversal Agents

WOMEN'S HEALTH

1 / 2 / 3 / 4

Assessment

• Vaginal Bleeding

• Doppler/Fetal Heart Tones

• Ectopic Pregnancy

Equipment & Procedures

• Obtain Cultures

• Pelvic Tray

Care of the Patient with

• Ectopic Pregnancy

• Hemorrhage

• Pelvic Inflammatory Disease

• Placenta Abruptio/Previa

• Precipitous Delivery

• Pregnancy-Induced Hypertension

• Spontaneous Abortion

PEDIATRICS

1 / 2 / 3 / 4

Child Abuse Recognition/Reporting

Shaken Baby Syndrome

Obtaining Consent to Treat

Assessment

• Normal VS for age groups

• Use of Dynamap/Doppler Leg Cuffs for B/P

• Failure to Thrive

Equipment & Procedures

• Assist with Fracture Stabilization

• Cooling/Warming Measures

• Draw Labs (Venous/Butterfly)

• Ear Care-Assist with Cleaning/Wash, Insert Ear Drops

• IM/SQ Medications in Pediatric Patients

• Obtain RSV Culture

• Obtain Urine Culture (Cath/Bag)

• Lumbar Puncture

• Papoose Board/Therapeutic Hold

• Start IV in Pediatric Patient

Care of the Pediatric Patient with

• Abdominal Pain

• Aspiration

• Asthma/Reactive Airway Disease

• Burns

• Dehydration

• Epiglottitis

• Fever

• Foreign Object

• Fracture

• Head Injury

• Hypo/Hyperglycemia

• Hypo/Hyperthermia

• Lacerations

• Near Drowning

• Nursemaid's Elbow

Medications (Others in System Specific Areas)

• Ipecac/Charcoal

• Bronchodilators/Nebulizers

• Fluid Replacement

MISCELLANEOUS

1 / 2 / 3 / 4

Intake and Triage

National Patient Safety Goals

AMA procedures

Disaster Management

Computerized Charting

Care of the Patient with

• Bites

• Hazardous Materials Exposure

• Victims of Acts of Violence

Age-specific practice criteria

A. Newborn/Neonate (birth - 30 days) / F. Adolescents (12 - 18 years)
B. Infant (30 days - 1 year) / G. Young adults (18 - 39 years)
C. Toddler (1 - 3 years) / H. Middle adults (39 - 64 years)
D. Preschooler (3 - 5 years) / I. Older Adults (64+)
E. School age children (5 - 12 years)

Please check the boxes below for each age group for which you have expertise in providing age-appropriate care

Experience with age groups

A / B / C / D / E / F / G / H / I

Able to adapt care to incorporate normal growth and development.

Able to adapt method and terminology of patient instructions to their age, comprehension, and maturity level.

Can ensure a safe environment reflecting specific needs of various age groups.

My experience is primarily in the following settings

Adults

Yrs.Physician's Office

Yrs.Clinic

Yrs.Urgent Care

Visits/Day:Emergency Dept - Yrs:

Pediatrics

Yrs.Physician's Office

Yrs.Clinic

Yrs.Urgent Care

Visits/Day:Emergency Dept - Yrs:

Certifications/Licensures/Registrations

BLS

Exp. Date:

ACLS

Exp. Date:

PALS

Exp. Date:

Other:

Exp. Date:

Urgent Care/Clinic Skills Checklist, version 2

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* / I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.