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Pediatric Emergency Department

Information

Name *

Last 4 digits of SSN *

Phone *

Email *

Proficiency Scale

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

Cardiovascular

Cardiac Anomalies *

CHF/Pulmonary Edema *

Cardiogenic Shock *

Cardioversion *

Heart Sounds *

Pulmonary

Reactive Airway Disease *

Croup *

Pneumonia *

Epiglottitis *

Aspiration *

Airway Obstruction *

Hemo/Pneumothorax *

Chest Tube Placement/Management *

ABG Interpretation *

Neurological

Meningitis/Encephalitis *

Seizures - Febrile/Epileptic *

Lumbar Puncture *

Migraine *

Orthopedic

Fractures/Casting *

Open/Complex Fractures *

Nursemaid's Elbow *

Apply/Manage Splints *

Circulation Checks *

Crutch Walking *

Car Seat Instruction for Casted Patient *

Gastrointestinal

Abdominal Trauma/Peritoneal Lavage *

Abdominal Pain *

Constipation *

GI Bleeding *

Hepatitis/Liver Failure *

Poison Ingestion *

Endocrine/Metabolic

Hypoglycemia *

Hyperglycemia *

DKA *

Genitourinary

Acute Renal Failure *

UTI/Pyelonephritis *

Renal Trauma *

Testicular Torsion *

OB/GYN

Menstrual Pain *

Ovarian Cyst *

Ectopic Pregnancy *

Pelvic Inflammatory Disease/STD *

Sexual Assault *

Reporting Acts of Violence *

EENT

Foreign Body - Eye *

Foreign Body - Ear *

Foreign Body - Nose *

Epistaxis *

Trauma

Glasgow Coma/Pediatric Trauma Scale *

Trauma Code *

Trauma Team Member *

Brain Injury *

Spinal Cord Injury *

Spinal Precautions *

Facial/Dental Trauma *

Penetrating Trauma *

Blunt Trauma *

Traumatic Amputation *

Hypovolemic Shock *

Neurogenic Shock *

Anaphylactic Shock *

Septic Shock *

Burns - 2nd Degree *

Burns - 3rd Degree *

Infectious Disease/Immunosuppression

Contagious/Infectious Patients *

Isolation *

Reporting Communicable Disease *

Neutropenia/Reverse Isolation *

Psychiatric

Drug /ETOH Overdose/Withdrawal *

Psychiatric Hold *

Suicidal Patient *

Medications

Pediatric Dosage Calculations *

Anti-Arrhythmics *

Anticoagulants (IV, Oral & Injection) *

Anti-Hypertensives *

Anti-Psychotics *

Anti-Seizure Medications *

Benzodiazepines *

Continuous IV Paralytics *

Continuous IV Sedation *

Procedural Sedation - Administration *

Ketamine *

Emergency Medications *

Inhaled Medications *

Insulin *

IV Vasopressors *

Narcotics/Opioid Analgesics (IV, Oral & Injection) *

Reversal Agents *

Steroids (IV, Oral & Inhaled) *

Automated Medication Dispensing (i.e. Pyxis, Omnicell) *

Professional Knowledge and Skills

Recognizing/Reporting Abuse *

Triage *

Ambulance/Paramedic Radio *

Charge Experience *

EMTALA *

National Patient Safety Goals/Core Measures *

Fall Risk Assessment/Prevention *

Pressure Ulcer Risk Assessment/Prevention *

Restraints/Use of Least Restrictive Device *

Patient Family Teaching *

Car Seat Specific Standards/Teaching *

Age/Developmentally Specific/Population Based Care *

Pain Assessment and Management - Verbal/Non-Verbal *

Interpretation and Communication of Lab Values *

EMR

Epic *

Cerner *

Eclipsys *

McKesson *

Meditech *

Allscripts *

Other Computerized System *

Computerized Physician Order Entry *

Bar Coding for Medication Administration *

Age Specific Competencies

Infant (Birth - 1 year) *

Preschooler (ages 2-5 years) *

Childhood (ages 6-12 years) *

Adolescents (ages 13-21 years) *

Young Adults (ages 22-39 years) *

Adults (ages 40-64 years) *

Older Adults (ages 65-79 years) *

Elderly (ages 80+ years) *

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