EKG Technician Skills Checklist One program to handle all talent management needs from acquisition to development Personal Information HiddenOverall ScoreOut of 4Name(Required) First Middle Last Last 4 Digits of Social Security Number Email(Required) HiddenDate MM slash DD slash YYYY Proficiency Scale1 – No Experience 2 – Need Training 3 – Able to perform with supervision 4 – Able to perform independentlyAGE OF PATIENTS CARED FORNewborn/Neonate (birth to 30 days)(Required) 1 2 3 4 Infant (1 month to 1 year)(Required) 1 2 3 4 Toddler (1 year to 3 years)(Required) 1 2 3 4 Preschooler (3 years to 5 years)(Required) 1 2 3 4 School Age Child (5 years to 12 years)(Required) 1 2 3 4 Adolescents (12 years to 18 years)(Required) 1 2 3 4 Young Adults (18 years to 39 years)(Required) 1 2 3 4 Middle Age(40 years to 63 years)(Required) 1 2 3 4 Older Adults (64 years to 79 years)(Required) 1 2 3 4 GENERAL SKILLSStandard Precautions(Required) 1 2 3 4 Isolation Precautions(Required) 1 2 3 4 Pediatric Respiratory/Cardiac Arrest(Required) 1 2 3 4 Adult Respiratory/Cardiac Arrest(Required) 1 2 3 4 Crash Carts(Required) 1 2 3 4 Defibrillators(Required) 1 2 3 4 Electronic Documentation(Required) 1 2 3 4 CARDIOVASCULARHeart Sounds(Required) 1 2 3 4 Coronary Circulation(Required) 1 2 3 4 Vascular System(Required) 1 2 3 4 Conduction System(Required) 1 2 3 4 Congestive Heart Failure(Required) 1 2 3 4 Ischemia(Required) 1 2 3 4 Pulmonary Hypertension(Required) 1 2 3 4 Systemic Hypertension(Required) 1 2 3 4 Diseases of the Aorta(Required) 1 2 3 4 CARDIOVASCULAR ELECTROPHYSIOLOGYCardiac Cycle(Required) 1 2 3 4 Electrical Conduction System(Required) 1 2 3 4 Refractory(Required) 1 2 3 4 Transmembrane Potential(Required) 1 2 3 4 Polarization(Required) 1 2 3 4 Depolarization(Required) 1 2 3 4 Repolarization(Required) 1 2 3 4 Action Potential(Required) 1 2 3 4 Phase 0 - Phase 4(Required) 1 2 3 4 EKG INTERPRETATIONVentricular Tachycardia(Required) 1 2 3 4 Ventricular Fibrillation(Required) 1 2 3 4 Atrial Tachycardia(Required) 1 2 3 4 Atrial Fibrillation(Required) 1 2 3 4 Atrial Flutter(Required) 1 2 3 4 Junctional Escape Rhythms(Required) 1 2 3 4 Asystole(Required) 1 2 3 4 Pulseless Electrical Activity (PEA)(Required) 1 2 3 4 Normal Sinus Rhythm(Required) 1 2 3 4 Sinus Tachycardia(Required) 1 2 3 4 Sinus Bradycardia(Required) 1 2 3 4 Acute Myocardial Infarction Patterns(Required) 1 2 3 4 Cardiac Pacemakers(Required) 1 2 3 4 Wolff-Parkinson-White(Required) 1 2 3 4 Ventricular Fibrillation(Required) 1 2 3 4 First Degree Heart Block(Required) 1 2 3 4 Second Degree Heart Block(Required) 1 2 3 4 Second Degree Heart Block Type I (Wenckebach)(Required) 1 2 3 4 Second Degree Heart Block Type II(Required) 1 2 3 4 Third Degree Heart Block(Required) 1 2 3 4 EKG TECHNIQUES AND RECOGNITIONP, Q, R, S, and T Waves(Required) 1 2 3 4 Baseline Values(Required) 1 2 3 4 Incorrect Standardization(Required) 1 2 3 4 Incorrect Paper Speed(Required) 1 2 3 4 Lead Reversals(Required) 1 2 3 4 Incorrect Lead Placement(Required) 1 2 3 4 Electrical Interference(Required) 1 2 3 4 Somatic Tremor(Required) 1 2 3 4 Wandering Baseline(Required) 1 2 3 4 EKG MEASUREMENTTime(Required) 1 2 3 4 Heart Rate(Required) 1 2 3 4 Voltage(Required) 1 2 3 4 Axis/Hexaxial System(Required) 1 2 3 4 Intervals(Required) 1 2 3 4 Segments(Required) 1 2 3 4 Complexes(Required) 1 2 3 4 Normal and Abnormal ST Segment(Required) 1 2 3 4 INSTRUMENTATIONEKG Calibration Methods(Required) 1 2 3 4 Single Channel(Required) 1 2 3 4 Three Channel(Required) 1 2 3 4 PROTOCOLS/PROCEDURESBruce(Required) 1 2 3 4 Modified Bruce(Required) 1 2 3 4 Naughton(Required) 1 2 3 4 Bicycle Procedure(Required) 1 2 3 4 Ergometers(Required) 1 2 3 4 Treadmill(Required) 1 2 3 4 Prep Techniques(Required) 1 2 3 4 Test Interpretation(Required) 1 2 3 4 Calculation(Required) 1 2 3 4 Double Product(Required) 1 2 3 4 PHARMOCOLOGICALDipyridamole(Required) 1 2 3 4 Dobutamine(Required) 1 2 3 4 Thallium(Required) 1 2 3 4 Cardiolyte(Required) 1 2 3 4 HOLTER MONITORINGPreparation Techniques(Required) 1 2 3 4 Lead Placement(Required) 1 2 3 4 Interpretation(Required) 1 2 3 4 Recognition of Artifact(Required) 1 2 3 4 CARDIAC MEDICATIONSAntihypertensives(Required) 1 2 3 4 Nitrates(Required) 1 2 3 4 Calcium Channel Blockers(Required) 1 2 3 4 Cardiac Glycosides(Required) 1 2 3 4 Antiarrhythmics(Required) 1 2 3 4 EMERGENCY MEDICATIONSEpinephrine(Required) 1 2 3 4 Atropine(Required) 1 2 3 4 Verapamil(Required) 1 2 3 4 Lidocaine(Required) 1 2 3 4 Oxygen(Required) 1 2 3 4 Isuprel(Required) 1 2 3 4 EKG LEADSBipolar Leads(Required) 1 2 3 4 Unipolar Leads(Required) 1 2 3 4 Precordial Leads(Required) 1 2 3 4 Einthoven’s Triangle and Law(Required) 1 2 3 4 SKIN PREPARATIONShaving(Required) 1 2 3 4 Alcohol Prep(Required) 1 2 3 4 Diaphoretic Patients(Required) 1 2 3 4 PHLEBOTOMYButterfly Stick(Required) 1 2 3 4 Vacutainer Method(Required) 1 2 3 4 VITAL SIGNSTemperature(Required) 1 2 3 4 SpO2 (Pulse Oximeter)(Required) 1 2 3 4 Pulse(Required) 1 2 3 4 Auscultation(Required) 1 2 3 4 Apical Pulse(Required) 1 2 3 4 Palpation(Required) 1 2 3 4 Carotid Pulse(Required) 1 2 3 4 Brachial Pulse(Required) 1 2 3 4 Radial Pulse(Required) 1 2 3 4 Femoral Pulse(Required) 1 2 3 4 Automatic Blood Pressure(Required) 1 2 3 4 Manual Blood Pressure(Required) 1 2 3 4 CERTIFICATIONSETC(Required) Yes No ETC Expiry date: MM slash DD slash YYYY CCT(Required) Yes No CCT Expiry date: MM slash DD slash YYYY CET(Required) Yes No CET Expiry date: MM slash DD slash YYYY AuthorizationsLegal Consent(Required) I agree to the terms and conditions.Consumer Disclosure Regarding Conducting Business Electronically, Signing Documents Electronically, and Receiving Electronic Notices and Disclosures Please read the information below, carefully, as it concerns your rights. eSignatures are an efficient way to execute an agreement with the same legal force and effect of a handwritten or “wet ink” signature. 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