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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