ICU Skills Checklist

First name:	Last name:
Phone:	Email:
SSN (last 4 only):	Date: (MM/DD/YYYY)

Key - for each box mark:

Limited or no experience
Somewhat experienced but may need review
Can function independently
Competent to supervise

	1	2	3	4
RESPIRATORY
Assessment of Breath Sounds
Administer O2 (NC, Mask)
Assist with Intubation
Ventilate with Ambu-bag
Suctioning
Use of ETT CO2 detectors
Assist with Extubation
Use of Pressure Ventilators
Use of Volume Ventilators
Weaning Patient from Ventilator
Use of IMV
Use of CPAP
Use of PEEP
Use of Assist-control
Use of Blow-by
Use of Pressure Support
Use of Hi-freq Jet Ventilation
Troubleshoot Ventilator Problems
Pulse Oximetry
Perform Arterial Puncture
Draw Blood from Arterial Line
Interpret Arterial Blood Gases
Assist with Chest Tube Insertion
Assist with Chest Tube Removal
Assist with Thoracentesis
Assist with Bronchoscopy
Assist with Cricothyroid Airway
Assess Resp Complications
Care of Patient With:
Chest Injury
Hemo / Pneumo
Tracheostomy
ECMO
ARDS
Pulmonary Edema
Lung Transplant
RENAL
Care of Patient With:
Acute Renal Failure
Chronic Renal Failure
Hemodialysis
Peritoneal Dialysis
Renal Transplant
CARDIAC
Assist With Insertion and Setup:
Arterial Lines
Central Venous Catheter
Pulmonary Artery Catheter
Pericardiocentesis
Placement of External Pacemaker
Intra-aortic Balloon (IABP)
Obtain/Interpret Hemodynamic Measurements:
Central Venous Pressure
Arterial Pressure (MAP)
PA Pressure
PCW Pressure
Cardiac Output (thermodilution)
SVO2
Intervene PA Catheter Problems
Obtain ABG
Obtain Mixed Venous Gases
OTHER
Isolation Techniques
Advance Directives
Postmortem Care
Pre-operative Care / Preparation
Post-anesthesia Care
Care of Patient With:
Multiple Trauma
Burns
Oncology
Chemotherapy
AIDS
Ketoacidosis
Bone Marrow Transplant
Liver Transplant

	1	2	3	4
CARDIAC
Assessment of Heart Sounds
Use of Cardiac Monitors
Identify Lethal Dysrhythmias
Telemetry
Perform 12-lead EKG
Basic 12-Lead Interpretation
Assist with Code
Defibrillation / Cardioversion
Cardiac Arrest / CPR
Assist with Open Chest Procedure
Emergency Medication Administration:
Epinephrine
Atropine
Lidocaine
Bretylium
Bicarbonate
TPA
Vaso-active Drips:
Dopamine
Nipride
Nitroglycerin
Inocor
Dobutamine
Care of Patient With:
Acute MI
Congestive Heart Failure
Pre / post Cardiac Cath
Pre / post Cardiac Surgery
Cardiac Tamponade
Aneurysm
Permanent Pacemaker
Temporary Pacemaker
Intra-aortic Balloon Pump (IABP)
Automatic Implanted Defibrillator
Heart Transplant
Cardiogenic Shock
Septic Shock
Hypovolemic Shock
DIC
Ventricular Assist Device
NEUROLOGY
Neuro Assessment / Vital Signs
Glasgow Coma Scale
Assist with Lumbar Puncture
Intracranial Pressure Monitoring
Seizure Precautions
Aneurysm Precautions
Use of Rotating Bed
Use of Stryker Frame
Epidural Medication Admin
Care of Patient With:
Open / Closed Head Injury
Acute CVA
Spinal Cord Injury
Craniotomy
Increased ICP
Cerebral Aneurysm
Halo Traction / Cervical Tongs
Degenerative Diseases of CNS
CNS Infections
Drug Overdose / DTs
GASTROINTESTINAL
Assessment of Bowel Sounds
Identification of Abnormalities
Insert / Maintain Feeding Tubes
Insert / Maintain NG tubes
Care of Patient With:
GI Bleed
Esophageal Hemorrhage
Acute Pancreatitis
Open Abd Wound / Incision
Peritoneal Lavage
Abdominal Aortic Aneurysm

The information I have provided in this skills checklist is true and accurate to the best of my knowledge. I hereby authorize Fortus Group to release this information to client facilities in relation to consideration of my employment.