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Pediatric Emergency Room

This self evaluation is for assessing your experience in specific clinical areas. This self evaluation will not be a determining factor in accepting your application to become an employee of Fusion Medical Staffing.

  • 0 = Not Applicable
  • 1 = No Experience
  • 2 = Some Experience
  • 3 = Intermittent Experience
  • 4 = Experienced
  • 5 = Very Experienced
*Required
n/a
1
2
3
4
5

* Required

Age of Patients Cared For

Newborn/Neonate (birth to 30 days)*

Infant (1 month to 1 year)*

Toddler (1 year to 3 years)*

Preschooler (3 years to 5 years)*

School Age Child (5 years to 12 years)*

Adolescents (12 years to 18 years)*

Young Adults (18 years to 39 years)*

General Skills

Standard Precautions*

Isolation Precautions*

Pediatric Respiratory/ Cardiac Arrest*

Adult Respiratory/ Cardiac Arrest*

Crash Carts*

Defibrillators*

Care of Patient in Restraints*

Automated Med Dispensing Systems*

Care Planning & Discharge Planning*

Patient/Family Education*

Electronic Documentation*

Patient Head to Toe Assessment*

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 Factures*

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 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 Schock*

Anaphylactic Shock*

Septic Shock*

Burns - 2nd Degree*

Burns - 3rd Degree*

Infectious Disease/Immunosuppression

Contagious/ Infectious Patients*

Isolation*

Reporting Communicable Disease*

Neutropenia/ Reverse Isolation*

Psychiatric

Pediatric Dose Calculations*

Anti-Arrhythmias*

Anticoagulants (IV, Oral, and 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, and Injection)*

Reversal Agents*

Steroids (IV, Oral, and Inhaled)*

Professional Knowledge and Skills

Recognizing/ Reporting Abuse*

Triage*

Ambulance/ Paramedic Radio*

Charge Experience*

EMTALA*

National Patient Safety Goals/ Core Measures*

Fall 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*

Computer Physician Order Entry*

Bar Coding for Medication Administration*

Application Agreement

The information I have given is true and accurate to the best of my knowledge, and I hereby authorize Fusion Medical Staffing to release this Skills Checklist to staffing clients of Fusion Medical Staffing. Submit this skills evaluation with your initial application. To be updated annually.

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