CATH LAB SKILLS CHECKLIST
Name:
When completing this ckecklist, please indicate your level of proficiency in each area according to the scale below. Place a check mark in box which best describes your expertiese with each skill.

The scale is as follows:
1. Not performed   2. Intermitten experience   3. Very experienced.
CARDIOVASCULAR ANATOMY & PHYSIOLOGY:
  1. Heart Sounds   1 2 3
  2. Coronary Circulation   1 2 3
  3. Vascular System   1 2 3
  4. Hemodynamics   1 2 3
  5. Conduction System   1 2 3
  6. Pathophysiologic Conditions   1 2 3
  7. CHF (Congestive Heart Failure)   1 2 3
  8. Ischemia   1 2 3
  9. Pulmonary Hypertension   1 2 3
  10. Systemic Hypertension   1 2 3
  11. Diseases of the Aorta   1 2 3
CERTIFICATIONS:
  1. BLS   1 2 3
  2. ACLS   1 2 3
  3. PALS   1 2 3
  4. Fluoroscopy   1 2 3
ELECTROCARDIOGRAM:
  1. Application of leads   1 2 3
  2. Interpretation   1 2 3
  3. Monitoring   1 2 3
  4. Arrythmias   1 2 3
EQUIPMENT AND INSTRUMENTATION :
  1. Pacemakers   1 2 3
    1.    1 2 3
    2.    1 2 3
    3.    1 2 3
  2. Defribrillators   1 2 3
  3. Radiography Equipment (cameras,etc.)   1 2 3
  4. Film Processing   1 2 3
  5. Automatic Pressure Injectors   1 2 3
  6. Catheters, guidewires, needles   1 2 3
  7. Cardiacouput Equipment   1 2 3
  8. Transducers   1 2 3
  9. Oxygen Delivery   1 2 3
    1.    1 2 3
    2.    1 2 3
    3.    1 2 3
  10. Ergometers   1 2 3
  11. Angio-Jet Machine   1 2 3
  12. Power Injector   1 2 3
  13. Stents   1 2 3
  14. Intra-aortic balloon pumps   1 2 3
  15. ACT Machine   1 2 3
  16. Co-ox Machine   1 2 3
HOLTER MONITORING:
  1. Preparation of Equipment   1 2 3
  2. Application of leads   1 2 3
  3. Monitoring   1 2 3
INVASIVE PROCEDURES:
  1. Cardiac catheterization   1 2 3
  2. Right-sided Procedure   1 2 3
  3. Left-sided Procedure   1 2 3
  4. Preparation and Pre-Medication   1 2 3
  5. Complications   1 2 3
    1. Angiography   1 2 3
    2. Imaging Systems   1 2 3
    3. Left Ventriculography   1 2 3
    4. Coronary Ateriography   1 2 3
    5. Aortaography   1 2 3
    6. Complications   1 2 3
      PATIENT CARE:
      1. Preparation of procedures   1 2 3
      2. Catheterization Protocols   1 2 3
      3. Arterial & Venous Line Management   1 2 3
      4. Patient Education   1 2 3
      5. Emergency Procedures   1 2 3
      6. Radiation Protections   1 2 3
      7. Vital Signs   1 2 3
      8. Normal Lab Values   1 2 3
        1.    1 2 3
        2.    1 2 3
        3.    1 2 3
        4.    1 2 3
      ROLES-CIRCULATING :
      1. Pulse Oximetry   1 2 3
      2. Calibration of Equipment   1 2 3
      3. Documentation   1 2 3
      ROLES-S CRUBBING:
      1. Sterile Technique   1 2 3
      STRESS TESTING:
      1. Preparation of Equipment   1 2 3
      2. Monitoring   1 2 3
      3. Complications   1 2 3
      4. Bicycle Procedures   1 2 3
      5. Thallium/Muga Strest Test   1 2 3
      TREATMENTS:
      1. Defibrillation and Cardioversion   1 2 3
      2. Percutaneous Translumal Angioplasty   1 2 3
      3. Implants   1 2 3
      4. Stents   1 2 3
      5. Central Venous Line Catether   1 2 3
      6. Filters   1 2 3
      7. Arthrectomy   1 2 3
      8. Thrombolytic Therapy   1 2 3
      9. Rotoblator   1 2 3
      10. Bracy Therapy   1 2 3
      The information I have given is true and accurate to the best of my knowledge. Please sign and date below.
      SIGNATURE: (Last 4 digits of your SSN)    Reenter your last 4 digits of your SSN:   DATE:

        
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