Cardiac Echocardiography Checklist


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.

Total Stars:

Obtained Stars:

Ranking: 0%

Proficiency Scale:

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

  ULTRASOUND-ECHOCARDIOGRAPHY         Rating Stars (Click) 1 2 3 4
  Adult Echocardiography  
  Pediatric Echocardiography  
  Fetal Echocardiography  
  Trauma Echocardiography  
  Stress Echocardiography  
  Treadmill Testing  
  Dobutamine  
  Pharmacologic Stress Echo  
  Transesophageal Echocardiography (TEE)  
  Intraoperative Echocardiography  
  Contrast Echocardiography  
  Myocardial Contrast  
  Echo-Guided Procedures  
  Plethysmography  
  Doppler Vascular Procedures  
  Pressure Measurements  
  Two-Dimensional Mode  
  Three-Dimensional Mode  
  M-Mode  
  Ped Off Probe  
  Pulsed Wave Doppler  
  Continuous Wave Doppler  
  Color Doppler Mapping  
  Portable Studies  
  Invasive Procedure Guidance  
  EKG/ECG  
  Parasternal Long Axis View  
  RVIT  
  RVOT  
  Parasternal Short Axis View  
  4 Chamber View  
  2 Chamber View  
  Apical Long  
  Subcostal View  
  Subcostal Short Axis of RV Inflow and Outflow  
  IVC  
  Hepatic Veins  
  Abdominal Aorta  
  Suprasternal Notch  
  Simpson�s Rule  
  Proximal Isovelocity Surface Area  
  Diastolgy with TDI  
  Continuity Equation  
  PEDIATRIC ECHO         Rating Stars (Click) 1 2 3 4
  Two-Dimensional Mode  
  Three-Dimensional Mode  
  M-Mode  
  Ped Off Probe  
  Pulsed Wave Doppler  
  Continuous Wave Doppler  
  Color Doppler Mapping  
  Portable Studies  
  Invasive Procedure Guidance  
  EKG/ECG  
  Parasternal Long Axis View  
  RVIT  
  RVOT  
  Parasternal Short Axis View  
  4 Chamber View  
  2 Chamber View  
  Inverted Apical 4 Chamber View  
  Inverterd Apical 5 Chamber View  
  Subcostal Long View  
  Subcostal Long with Sweep  
  Subcostal Short with Sweep (Bi Caval View)  
  Subcostal Aortic Arch  
  Subcostal Abdominal Aorta  
  Subcostal Situs View  
  Suprasternal Notch View- Long  
  Suprasternal Notch View- Short  
  Left Atrium with Pulmonary Veins with Suprasternal Notch  
  Pulmonary Artery Branches  
  Ductal View  
  Arch Sidedness  
  Scanning Complex Anomolies  
  Scanning Post-Surgical Repairs  
  Simpson�s Rule  
  Proximal Isovelocity Surface Area  
  Diastology  
  Stress Echo  
  Continuity Equation  
  EQUIPMENT         Rating Stars (Click) 1 2 3 4
  Phillips  
  Siemens  
  Toshiba  
  Hitachi  
  General Electric  
  HP  
  Other  
  AGE SPECIFIC EXPERIENCE         Rating Stars (Click) 1 2 3 4
  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)  
  Middle Adults (39 to 64 years)  
  Geriatric Adults (65+ years)