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.
| ULTRASOUND-ECHOCARDIOGRAPHY | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Adult Echocardiography |
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| Pediatric Echocardiography |
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| Fetal Echocardiography |
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| Trauma Echocardiography |
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| Stress Echocardiography |
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| Treadmill Testing |
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| Dobutamine |
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| Pharmacologic Stress Echo |
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| Transesophageal Echocardiography (TEE) |
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| Intraoperative Echocardiography |
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| Contrast Echocardiography |
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| Myocardial Contrast |
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| Echo-Guided Procedures |
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| Plethysmography |
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| Doppler Vascular Procedures |
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| Pressure Measurements |
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| Two-Dimensional Mode |
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| Three-Dimensional Mode |
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| M-Mode |
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| Ped Off Probe |
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| Pulsed Wave Doppler |
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| Continuous Wave Doppler |
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| Color Doppler Mapping |
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| Portable Studies |
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| Invasive Procedure Guidance |
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| EKG/ECG |
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| Parasternal Long Axis View |
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| RVIT |
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| RVOT |
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| Parasternal Short Axis View |
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| 4 Chamber View |
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| 2 Chamber View |
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| Apical Long |
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| Subcostal View |
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| Subcostal Short Axis of RV Inflow and Outflow |
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| IVC |
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| Hepatic Veins |
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| Abdominal Aorta |
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| Suprasternal Notch |
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| Simpson’s Rule |
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| Proximal Isovelocity Surface Area |
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| Diastolgy with TDI |
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| Continuity Equation |
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| PEDIATRIC ECHO | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Two-Dimensional Mode |
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| Three-Dimensional Mode |
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| M-Mode |
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| Ped Off Probe |
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| Pulsed Wave Doppler |
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| Continuous Wave Doppler |
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| Color Doppler Mapping |
|
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| Portable Studies |
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| Invasive Procedure Guidance |
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| EKG/ECG |
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| Parasternal Long Axis View |
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| RVIT |
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| RVOT |
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| Parasternal Short Axis View |
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| 4 Chamber View |
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| 2 Chamber View |
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| Inverted Apical 4 Chamber View |
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| Inverterd Apical 5 Chamber View |
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| Subcostal Long View |
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| Subcostal Long with Sweep |
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| Subcostal Short with Sweep (Bi Caval View) |
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| Subcostal Aortic Arch |
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| Subcostal Abdominal Aorta |
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| Subcostal Situs View |
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| Suprasternal Notch View- Long |
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| Suprasternal Notch View- Short |
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| Left Atrium with Pulmonary Veins with Suprasternal Notch |
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| Pulmonary Artery Branches |
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| Ductal View |
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| Arch Sidedness |
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| Scanning Complex Anomolies |
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| Scanning Post-Surgical Repairs |
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| Simpson’s Rule |
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| Proximal Isovelocity Surface Area |
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| Diastology |
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| Stress Echo |
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| Continuity Equation |
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| EQUIPMENT | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Phillips |
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| Siemens |
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| Toshiba |
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| Hitachi |
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| General Electric |
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| HP |
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| Other |
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| AGE SPECIFIC EXPERIENCE | Rating Stars (Click) | 1 | 2 | 3 | 4 | ||
| Newborn/Neonate (birth to 30 days) |
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| Infant (1 month to 1 year) |
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| Toddler (1 year to 3 years) |
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| Preschooler (3 years to 5 years) |
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| School Age Child (5 years to 12 years) |
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| Adolescents (12 years to 18 years) |
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| Young Adults (18 years to 39 years) |
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| Middle Adults (39 to 64 years) |
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| Geriatric Adults (65+ years) |
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