CYNET_SYSTEMS_MAIN_LOGO.gif   EKG TECHNICIAN SKILLS CHECKLIST
   NAME    
   LAST 4 OF SSN      
   EMAIL      
   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) Cardiovascular Electrophysiology  1 2 3 4  
Cardiac cycle   
Electrical conduction system   
Refractory   
Transmembrane potential   
Polarization   
Depolarization  
Repolarization  
Action potential  
Phase 0 – Phase 4   
Rating Stars (Click) EKG interpretation 1 2 3 4  
Ventricular tachycardia  
Ventricular fibrillation  
Atrial tachycardia  
Atrial fibrillation  
Atrial flutter  
Junctional escape rhythms   
Asystole  
PEA (pulseless electrical activity)  
Normal sinus rhythm   
Sinus Tachycardia  
Sinus Bradycardia   
Acute myocardial infarction patterns   
Cardiac pacemakers   
Wolff-Parkinson-White  
Heart blocks  
First degree heart block   
Second degree heart block  
Type I   
Type II  
Third degree heart block   
Rating Stars (Click) ECG Techniques and Recognition  1 2 3 4  
P, Q, R, S, and T waves  
Baseline values  
ECG measurement   
Time  
Heart rate  
Voltage  
Axis/ hexaxial system  
Intervals  
Segments   
Complexes  
Normal and abnormal ST segment   
Rating Stars (Click) Recognition of Recording Errors/ Artifacts  1 2 3 4  
Incorrect standardization   
Incorrect paper speed  
Lead reversals   
Incorrect lead placement   
Electrical interference  
Somatic tremor   
Wandering baseline  
Rating Stars (Click) ECG, Holter, and Stress Testing
Instrumentation 		1 2 3 4  
ECG calibration methods   
Single channel   
Three channel  
Rating Stars (Click) Stress Test Techniques and Contraindications  1 2 3 4  
Protocols   
Bruce   
Modified Bruce  
Naught on   
Prep techniques   
Test interpretation  
Calculation   
Double product  
Bicycle procedure   
Ergometers   
Arms  
Leg  
Treadmill   
Pharmacologic   
Dipryridamole  
Dobutamine  
Thallium  
Cardiolyte  
Holter Monitoring  
Preparation techniques   
Lead placement   
Interpretation  
Recognition of artifact  
Cardiac Medications   
Antihypertensives  
Nitrates  
Calcium channel blockers  
Beta blockers  
Cardiac Glycosides   
Antiarrhythmics  
Emergency medications   
Epinephrine  
Atropine   
Verapamil   
Lidocaine   
Oxygen  
Isuprel   
Rating Stars (Click) ECG Leads  1 2 3 4  
Bipolar leads  
Unipolar leads   
Precordial leads   
Einthoven’s triangle and law  
Rating Stars (Click) Skin preparation 1 2 3 4  
Shaving  
Alcohol prep   
Diaphoretic patients  
Rating Stars (Click) Phlebotomy  1 2 3 4  
Butterfly ‘stick  
Vacutainer method   
Rating Stars (Click) Vital Signs  1 2 3 4  
Temperature   
Oral   
Tympanic  
Axillary  
Rectal   
SpO2 (Pulse oximeter)   
Pulse   
Auscultation  
Apical pulse  
Palpation   
Carotid pulse   
Brachial pulse   
Radial pulse   
Femoral pulse   
Blood pressure  
Automatic  
Manual   
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  
Rating Stars (Click) Age Specific Competencies 1 2 3 4  
Infant (Birth - 1 year)  
Preschooler (ages 2-5 years)  
Childhood (ages 6-12 years)  
Adolescents (ages 13-21 years)  
Young Adults (ages 22-39 years)  
Adults (ages 40-64 years)  
Older Adults (ages 65-79 years)  
Elderly (ages 80+ years)  
CERTIFICATIONS     Expiry Date :   
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