Cath Lab Tech Skills Checklist
   NAME  
   Email-Id
   DATE    
I hereby certify that ALL information I have provided 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)
AGE OF PATIENTS CARED FOR 1
2
3
4
Peds
Adults
Rating Stars (Click)
CIRCULATING ROLE (PAV) 1
2
3
4
Airway Maintenance
Arm Cases
Biopsy
Co-Ox Setup Q.C., Run Sample
Defibrillator Setup/Use
IABP
Power Injector Setup/Use
Left Heart Catheterization
Right Heart Catheterization
PTCA/ Stents/ Balloons
Radiation Protection
Atherectomy
Permanent Pacemaker
Temporary Pacemaker
Setting Threshold of Pacemakers
Rotablator
Sphygmomanometer Monitoring
Transducer Setup/Calibration
Run Angiojet Machine
IVUS
Rating Stars (Click)
HEMODYNAMIC MONITORING 1
2
3
4
Biopsy
Handoff Reports
Left Heart Caths
Right Heart Caths
Coronary Intervention
Hematoma Recognition & Mgt
Coronary Atherectomy
IVUS
Intra Aortic Balloon Pump
EP Study
Ablation
Rotablator
FFR
Rating Stars (Click)
SCRUB POSITION 1
2
3
4
Left Heart Catheterization
Right Heart Catheterization
Coronary Intervention
Stent Implantation
Rotational Coronary Atherectomy
IVUS
Intra Aortic Balloon Pump
Biopsy
Closure Device
Temporary Pacemakers
Angiojet
Radial
Brachial
Peripherals
IVUS
FFR
Impella
PPM
ICD
BiV
Loop Recorder
Structural Heart
Manifold
ACIST/Medrad
Hybrid OR
Atherectomy
Simultaneously Scrub & Pan Xray
Rating Stars (Click)
CATH LAB/ANGIO/SPECIALS:EQUIPMENT 1
2
3
4
Phillips
Siemens
Toshiba
GE
Siemens Artis Zeego
Shimadzu
Cannon Alphenix
Electronic Documentation
Rating Stars (Click)
HEMODYNAMIC MONITORING EQUIP 1
2
3
4
GE MacLab Marquette
Mennen
Merge Cardio/ Camtronics VERICIS
McKesson
Philips Xper IM/ WITT
Siemens Sensis
Position