Name*
First
Last
Age Specific Care
Proficiency Rating
Frequency Rating
Newborn/Neonate (birth - 30 days) *
Newborn/Neonate (birth - 30 days) proficiency* Newborn/Neonate (birth - 30 days) frequency* Infant (30 days - 1 year) *
Infant (30 days - 1 year) proficiency* Infant (30 days - 1 year) frequency* Toddler (1 - 3 years) *
Toddler (1 - 3 years) proficiency* Toddler (1 - 3 years) frequency* Preschooler (3 - 5 years) *
Preschooler (3 - 5 years) proficiency* Preschooler (3 - 5 years) frequency* School Age Child (5 - 12 years) *
School Age Child (5 - 12 years) proficiency* School Age Child (5 - 12 years) frequency* Adolescents (12 - 18 years) *
Adolescents (12 - 18 years) proficiency* Adolescents (12 - 18 years) frequency* Young Adults (18 - 39 years) *
Young Adults (18 - 39 years) proficiency* Young Adults (18 - 39 years) frequency*
General Skills
Proficiency Rating
Frequency Rating
Standard Precautions *
Standard Precautions proficiency* Standard Precautions frequency* Isolation Precautions *
Isolation Precautions proficiency* Isolation Precautions frequency* Pediatric Respiratory / Cardiac Arrest *
Pediatric Respiratory / Cardiac Arrest proficiency* Pediatric Respiratory / Cardiac Arrest frequency* Adult Respiratory / Cardiac Arrest *
Adult Respiratory / Cardiac Arrest proficiency* Adult Respiratory / Cardiac Arrest frequency* Crash Carts *
Crash Carts proficiency* Crash Carts frequency* Defibrillators *
Defibrillators proficiency* Defibrillators frequency* Care of Patient in Restraints *
Care of Patient in Restraints proficiency* Care of Patient in Restraints frequency* Pain Management *
Pain Management proficiency* Pain Management frequency* Automated Med Dispensing Systems *
Automated Med Dispensing Systems proficiency* Automated Med Dispensing Systems frequency* Care Planning & Discharge Planning *
Care Planning & Discharge Planning proficiency* Care Planning & Discharge Planning frequency* Patient / Family Education *
Patient / Family Education proficiency* Patient / Family Education frequency* Electronic Documentation *
Electronic Documentation proficiency* Electronic Documentation frequency* Patient Head to Toe Assessment *
Patient Head to Toe Assessment proficiency* Patient Head to Toe Assessment frequency*
Cardiovascular
Proficiency Rating
Frequency Rating
Cardiac Anomalies *
Cardiac Anomalies proficiency* Cardiac Anomalies frequency* CHF / Pulmonary Edema *
CHF / Pulmonary Edema proficiency* CHF / Pulmonary Edema frequency* Cardiogenic Shock *
Cardiogenic Shock proficiency* Cardiogenic Shock frequency* Cardioversion *
Cardioversion proficiency* Cardioversion frequency* Heart Sounds *
Heart Sounds proficiency* Heart Sounds frequency*
Pulmonary
Proficiency Rating
Frequency Rating
Reactive Airway Disease *
Reactive Airway Disease proficiency* Reactive Airway Disease frequency* Croup *
Croup proficiency* Croup frequency* Pneumonia *
Pneumonia proficiency* Pneumonia frequency* Epiglottitis *
Epiglottitis proficiency* Epiglottitis frequency* Aspiration *
Aspiration proficiency* Aspiration frequency* Airway Obstruction *
Airway Obstruction proficiency* Airway Obstruction frequency* Hemo / Pneumothorax *
Hemo / Pneumothorax proficiency* Hemo / Pneumothorax frequency* Chest Tube Placement / Management *
Chest Tube Placement / Management proficiency* Chest Tube Placement / Management frequency* ABG Interpretation *
ABG Interpretation proficiency* ABG Interpretation frequency*
Neurological
Proficiency Rating
Frequency Rating
Meningitis / Encephalitis *
Meningitis / Encephalitis proficiency* Meningitis / Encephalitis frequency* Seizures - Febrile / Epileptic *
Seizures - Febrile / Epileptic proficiency* Seizures - Febrile / Epileptic frequency* Lumbar Puncture *
Lumbar Puncture proficiency* Lumbar Puncture frequency* Migraine *
Migraine proficiency* Migraine frequency*
Orthopedic
Proficiency Rating
Frequency Rating
Fractures / Casting *
Fractures / Casting proficiency* Fractures / Casting frequency* Open / Complex Factures *
Open / Complex Factures proficiency* Open / Complex Factures frequency* Nursemaid's Elbow *
Nursemaid's Elbow proficiency* Nursemaid's Elbow frequency* Apply / Manage Splints *
Apply / Manage Splints proficiency* Apply / Manage Splints frequency* Circulation Checks *
Circulation Checks proficiency* Circulation Checks frequency* Crutch Walking *
Crutch Walking proficiency* Crutch Walking frequency* Car Seat Instruction for Casted Patient *
Car Seat Instruction for Casted Patient proficiency* Car Seat Instruction for Casted Patient frequency*
Gastrointestinal
Proficiency Rating
Frequency Rating
Abdominal Trauma / Peritoneal Lavage *
Abdominal Trauma / Peritoneal Lavage proficiency* Abdominal Trauma / Peritoneal Lavage frequency* Abdominal Pain *
Abdominal Pain proficiency* Abdominal Pain frequency* Constipation *
Constipation proficiency* Constipation frequency* GI Bleeding *
GI Bleeding proficiency* GI Bleeding frequency* Hepatitis / Liver Failure *
Hepatitis / Liver Failure proficiency* Hepatitis / Liver Failure frequency* Poison Ingestion *
Poison Ingestion proficiency* Poison Ingestion frequency*
Endocrine / Metabolic
Proficiency Rating
Frequency Rating
Hypoglycemia *
Hypoglycemia proficiency* Hypoglycemia frequency* Hyperglycemia *
Hyperglycemia proficiency* Hyperglycemia frequency* DKA *
DKA proficiency* DKA frequency*
Genitourinary
Proficiency Rating
Frequency Rating
Acute Renal Failure *
Acute Renal Failure proficiency* Acute Renal Failure frequency* UTI / Pyelonephritis *
UTI / Pyelonephritis proficiency* UTI / Pyelonephritis frequency* Renal Trauma *
Renal Trauma proficiency* Renal Trauma frequency* Testicular Torsion *
Testicular Torsion proficiency* Testicular Torsion frequency*
Ob / Gyn
Proficiency Rating
Frequency Rating
Menstrual Pain *
Menstrual Pain proficiency* Menstrual Pain frequency* Ovarian Cyst *
Ovarian Cyst proficiency* Ovarian Cyst frequency* Ectopic Pregnancy *
Ectopic Pregnancy proficiency* Ectopic Pregnancy frequency* Pelvic Inflammatory Disease / STD *
Pelvic Inflammatory Disease / STD proficiency* Pelvic Inflammatory Disease / STD frequency* Sexual Assault *
Sexual Assault proficiency* Sexual Assault frequency* Reporting Acts of Violence *
Reporting Acts of Violence proficiency* Reporting Acts of Violence frequency*
EENT
Proficiency Rating
Frequency Rating
Foreign Body - Eye *
Foreign Body - Eye proficiency* Foreign Body - Eye frequency* Foreign Body - Ear *
Foreign Body - Ear proficiency* Foreign Body - Ear frequency* Foreign Body - Nose *
Foreign Body - Nose proficiency* Foreign Body - Nose frequency* Epistaxis *
Epistaxis proficiency* Epistaxis frequency*
Trauma
Proficiency Rating
Frequency Rating
Glasgow Coma Scale *
Glasgow Coma Scale proficiency* Glasgow Coma Scale frequency* Trauma Code *
Trauma CodePASTE proficiency* Trauma Code frequency* Trauma Team Member *
Trauma Team Member proficiency* Trauma Team Member frequency* Brain Injury *
Brain Injury proficiency* Brain Injury frequency* Spinal Cord Injury *
Spinal Cord Injury proficiency* Spinal Cord Injury frequency* Spinal Precautions *
Spinal Precautions proficiency* Spinal Precautions frequency* Facial / Dental Trauma *
Facial / Dental Trauma proficiency* Facial / Dental Trauma frequency* Penetrating Trauma *
Penetrating Trauma proficiency* Penetrating Trauma frequency* Blunt Trauma *
Blunt Trauma proficiency* Blunt Trauma frequency* Traumatic Amputation *
Traumatic Amputation proficiency* Traumatic Amputation frequency* Hypovolemic Shock *
Hypovolemic Shock proficiency* Hypovolemic Shock frequency* Neurogenic Shock *
Neurogenic Shock proficiency* Neurogenic Shock frequency* Anaphylactic Shock *
Anaphylactic Shock proficiency* Anaphylactic Shock frequency* Septic Shock *
Septic Shock proficiency* Septic Shock frequency* Burns - 2nd Degree *
Burns - 2nd Degree proficiency* Burns - 2nd Degree frequency* Burns - 3rd Degree *
Burns - 3rd Degree proficiency* Burns - 3rd Degree frequency*
Infectious Disease / Immunosuppression
Proficiency Rating
Frequency Rating
Contagious / Infectious Patients *
Contagious / Infectious Patients proficiency* Contagious / Infectious Patients frequency* Isolation *
Isolation proficiency* Isolation frequency* Reporting Communicable Disease *
Reporting Communicable Disease proficiency* Reporting Communicable Disease frequency* Neutropenia / Reverse Isolation *
Neutropenia / Reverse Isolation proficiency* Neutropenia / Reverse Isolation frequency* Pediatric Dose Calculations *
Pediatric Dose Calculations proficiency* Pediatric Dose Calculations frequency* Anti - Arrhythmias *
Anti - Arrhythmias proficiency* Anti - Arrhythmias frequency* Anticoagulants (IV, Oral, and Injection) *
Anticoagulants (IV, Oral, and Injection) proficiency* Anticoagulants (IV, Oral, and Injection) frequency* Anti - Hypertensives *
Anti - Hypertensives proficiency* Anti - Hypertensives frequency* Anti - Psychotics *
Anti - Psychotics proficiency* Anti - Psychotics frequency* Anti - Seizure Medications *
Anti - Seizure Medications proficiency* Anti - Seizure Medications frequency* Benzodiazepines *
Benzodiazepines proficiency* Benzodiazepines frequency* Continuous IV Paralytics *
Continuous IV Paralytics proficiency* Continuous IV Paralytics frequency* Continuous IV Sedation *
Continuous IV Sedation proficiency* Continuous IV Sedation frequency* Procedural Sedation - Administration *
Procedural Sedation - Administration proficiency* Procedural Sedation - Administration frequency* Ketamine *
Ketamine proficiency* Ketamine frequency* Emergency Medications *
Emergency Medications proficiency* Emergency Medications frequency* Inhaled Medications *
Inhaled Medications proficiency* Inhaled Medications frequency* Insulin *
Insulin proficiency* Insulin frequency* IV Vasopressors *
IV Vasopressors proficiency* IV Vasopressors frequency* Narcotics / Opioid Analgesics (IV, Oral, and Injection) *
Narcotics / Opioid Analgesics (IV, Oral, and Injection) proficiency* Narcotics / Opioid Analgesics (IV, Oral, and Injection) frequency* Reversal Agents *
Reversal Agents proficiency* Reversal Agents frequency* Steroids (IV, Oral, and Inhaled) *
Steroids (IV, Oral, and Inhaled) proficiency* Steroids (IV, Oral, and Inhaled) frequency*
Professional Knowledge and Skills
Proficiency Rating
Frequency Rating
Recognizing / Reporting Abuse *
Recognizing / Reporting Abuse proficiency* Recognizing / Reporting Abuse frequency* Triage *
Triage proficiency* Triage frequency* Ambulance / Paramedic Radio *
Ambulance / Paramedic Radio proficiency* Ambulance / Paramedic Radio frequency* Charge Experience *
Charge Experience proficiency* Charge Experience frequency* EMTALA *
EMTALA proficiency* EMTALA frequency* NATIONAL PATIENT SAFETY GOALS / CORE MEASURES
Fall Risk Assessment / Prevention *
Fall Risk Assessment / Prevention proficiency* Fall Risk Assessment / Prevention frequency* Restraints / Use of Least Restrictive Device *
Restraints / Use of Least Restrictive Device proficiency* Restraints / Use of Least Restrictive Device frequency* Patient / Family Teaching *
Patient / Family Teaching proficiency* Patient / Family Teaching frequency* Car Seat Specific Standards / Teaching *
Car Seat Specific Standards / Teaching proficiency* Car Seat Specific Standards / Teaching frequency* Age / Developmentally Specific / Population Based Care *
Age / Developmentally Specific / Population Based Care proficiency* Age / Developmentally Specific / Population Based Care frequency* Pain Assessment and Management - Verbal / Non - Verbal *
Pain Assessment and Management - Verbal / Non - Verbal proficiency* Pain Assessment and Management - Verbal / Non - Verbal frequency* Interpretation and Communication of Lab Values *
Interpretation and Communication of Lab Values proficiency* Interpretation and Communication of Lab Values frequency*
EMR
Proficiency Rating
Frequency Rating
Epic *
Epic proficiency* Epic frequency* Cerner *
Cerner proficiency* Cerner frequency* Eclipsys *
Eclipsys proficiency* Eclipsys frequency* McKesson *
McKesson proficiency* McKesson frequency* Meditech *
Meditech proficiency* Meditech frequency* Allscripts *
Allscripts proficiency* Allscripts frequency* Other Computerized System *
Other Computerized System proficiency* Other Computerized System frequency* Computer Physician Order Entry *
Computer Physician Order Entry proficiency* Computer Physician Order Entry frequency* Bar Coding for Medication Administration *
Bar Coding for Medication Administration proficiency* Bar Coding for Medication Administration frequency* Certify your information* I certify that I have provided true and accurate information about my skills and experience to the best of my ability
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