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ULTRASONOGRAPHY ECHOCARDIOGRAPHY VASCULAR TECH SKILLS CHECKLIST
NAME
LAST 4 OF SSN
DATE
I hereby certify that ALL information I have provided to IMCS Group on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.
Instructions:
This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.
Proficiency Scale:
1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently
Rating Stars (Click)
General Ultrasound:
1
2
3
4
Aorta
Appendix
Billiary tract
Gall bladder
Liver
Lung biopsy
Pancreas
Paracentesis
Renal/cyst aspiration
Pelvic male
Spleen
Rating Stars (Click)
Pelvic Transabdominal-Female
1
2
3
4
Adnexa
Endometrial canal
Ovaries
Transvaginal
Uterus
Rating Stars (Click)
Small Part/Specials:
1
2
3
4
Biopsies
Breast/cyst aspiration
Prostate/transrectal probe
Superficial masses
Testicular/scrotum
Thyroid
Rating Stars (Click)
Obstetrics & Gynecology: 1st Trimester
1
2
3
4
Adnexa
Amniotic fluid (Abnormal)
Amniotic fluid (Normal)
Crown rump length 6-14 weeks
Fetal demise
Left Ventricular Outflow Tract (LVOT)
Right Ventricular Outflow Tract (RVOT)
Multiple pregnancy
Spine if visualized
Lower uterine segment
Nuchal translucency
Placenta previa
Rating Stars (Click)
2nd Trimester:
1
2
3
4
Cervical shortening
Insert into placenta & abdomen
3-Vessel cord/ratio/insertion
4-Chamber heart (Abnormal)
4-Chamber heart (Normal)
ABD/HC ratio
Abdominal circumference
Bladder
Cephalic index
Cerebral ventricles
Cerebellum
Cisterna magnum
Cystema magnum
Diaphragm
Feet
Femur length
Gender
Hands
Head circumference
Intraorbital measurements
Interorbital measurements
Kidneys
Nose & lips
Nuchal fold
Placenta location
Stomach
Rating Stars (Click)
3rd Trimester:
1
2
3
4
Amniocentesis (If Applicable)
High risk
Neonatal heads
Transvaginal procedures
Cyst aspiration
Biopsy puncture
Liver/spleen
Aorta
Legs/arterial
Legs/venous
Renal arteries
OPG eye
Segmental pressures
Transcranial
Popliteal
Rating Stars (Click)
Echocardiography:
1
2
3
4
2-dimensional
M-mode
PW doppler
CW doppler
Color doppler
Parasternal long axis view
Parasternal short axis view
Pedoff probe in apical
Pedoff probe in suprasternal
Pedoff probe in parasternal right
Right Ventricular Inflow Tract (RVIT)
Right Ventricular Outflow Tract (RVOT)
4-chamber view
2-chamber view
Subcostal view
Suprasternal View
Cardiac anatomy
Assessment of endocardium
Simpson’s rule
PISA
Diastolic dysfunction evaluation
Continuity equation
Rating Stars (Click)
Special procedures:
1
2
3
4
Bubble study
Transesophageal echocardiogram
Contrast study
Treadmill stress echo
Rating Stars (Click)
Other Cardiology Testing:
1
2
3
4
Holter monitors
EKG
General ultrasound
Doppler studies
Carotid
Venous (arm/leg)
Arterial (arm/leg)
Renal
Abdomen/pelvis
Gall bladder
Testicular
OB/GYN examinations
1st trimester
Transvaginal
Ultrasound assisted procedures
Biopsy
Aspiration
Drainage
Hysterosonography
Amniocentesis
Saline Infused Sonohysterography (SIS)
Rating Stars (Click)
Duplex Scans:
1
2
3
4
Abdominal aorta
Arterial grafts
Dialysis grafts
Extracranial arteries
Lower extremity arteries
Lower extremity veins
Mesenteric arteries
Penile imagina
Renal arteries/kidneys
Upper extremity arteries
Upper extremity veins
Rating Stars (Click)
Diagnostic Abilities:
1
2
3
4
Abdominal aorta/arteries
Bypass grafts-artificial
Bypass grafts-insitu
Common carotid-extracranial
Common carotid-intracranial
Dialysis grafts
Extremity arteries-upper
Extremity arteries-lower
Extremity veins-upper
Extremity veins-lower
Mapping-arterial
Mapping-vein
OPG eye
Penile exams
Renal exams
Stents
Rating Stars (Click)
Indirect Tests:
1
2
3
4
Continuous wave doppler: lower extremity
Continuous wave doppler: upper extremity
Continuous wave doppler: transcranial
Palmer arch
Penise
Plethysmography
Pulse volume recording
Segmental pressures-arterial/non-imaging
Rating Stars (Click)
Equipment
1
2
3
4
GE
HP
Philips
Siemens
Picker
Other
Rating Stars (Click)
Computer Systems
1
2
3
4
AGFA
Fuji
GE
Siemens
Rating Stars (Click)
General Skills
1
2
3
4
Patients in restraints
Lifting/transfer devices
Cardiac arrest/CPR
Use of rapid response teams
Rating Stars (Click)
National Patient Safety Goals
1
2
3
4
Accurate patient identification
Effective communication
Infection control
Universal precautions
Patients in isolation
Minimize risk for fall
Rating Stars (Click)
EMR
1
2
3
4
Epic
Cerner
Eclipsys
McKesson
Meditech
Other Computerized System
Computerized Physician Order Entry
Bar Coding for Medication Administration
MY EXPERIENCE IS PRIMARILY IN:
Unit
No. of Years
Unit
No. of Years
BURN
POST PARTUM
CRITICAL UNIT
LABOR & DELIVERY
PACU
NEWBORN NURSERY
NEUROLOGY
LEVEL II NICU
TELEMETRY
LEVEL III NICU
MEDICAL
PICU
SURGICAL
PEDIATRICS
ONCOLOGY
OB/GYN
ORTHOPEDICS
PSYCHIATRY
OPERATING ROOM
RRT
EMERGENCY ROOM
CRT
TRAUMA CENTER LEV
EL 1
COMMUNITY ER
RURAL ER
Rating Stars (Click)
Age Specific Competencies
1
2
3
4
Newborn/Neonatal (birth – 30 days)
Infant (30 days-1 year)
Toddler (1-3 years)
Preschool (3-5 years)
School Age Children (5-12 years)
Adolescent (12-17 years)
Young Adults (18-44 years)
Middle Adults (45-64 years)
Older Adults (>65 years)
Please list any Additional Skills:
1
2
3
4
Additional training:
1
2
3
4
Additional equipment:
1
2
3
4
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