Telemetry

    Instruction

    Please rate your experience / frequency (within the last year) using the scale (check the appropriate boxes below)

  • 0 = No theory and/or experience
  • 1 = Limited experience/need supervision and/or support
  • 2 = Experienced/minimal support needed to perform)
  • 3 = Proficient/can perform independently
  • 4 = Expert/very experienced in the field

Recruiter Information

Recruiter TEEMA email

Personal Information

Full Name

Email

Phone number

Last 4 of Social Security Number

Date

PULMONARY

Pneumonia

Respiratory Distress

COPD

Breath Sounds

Post Thoracic Surgery

Chest Tube Placement & Management

Trach Management

Modes of Ventilation (AC/PC/SIMV/CPAP)

Intubation/Extubation

External CPAP/BiPAP

Interpretation of Arterial Blood Gases

GASTROINTESTINAL

GI Bleeding

GI Surgery

Liver Failure

Pancreatitis

Liver Transplant

Pancreas Transplant

NEUROLOGIC & PSYCHIATRIC

Stroke Scale Assessment

CVA

Brain Injury

Post Craniotomy

Spinal Cord Injury

Seizure Disorders

ETOH/Drug Withdrawal

RENAL/GENITOURINARY

Renal Failure

Renal Surgery

Renal Transplant

Arteriovenous Fistula/Shunt

Nephrostomy Tubes

Peritoneal Dialysis

ENDOCRINE METABOLIC

Diabetes - Hypo/Hyperglycemic Crisis

Pituitary Disorders

IV Insulin Protocols

Indwelling Insulin Pumps

MEDICATIONS

Anti-Arrhythmics

Anticoagulants (IV, oral, & injection)

Anti-Hypertensives

Anti-Psychotics

Anti-Seizure Medications

Benzodiazepines

Procedural Sedation

Diuretics

Emergency Medications

Inhaled Medications

Insulin

Titrate Vasoactive Drips

Manage Vasoactive Drips - No Titration

Narcotics/Opioid Analgesics (IV, oral, & injection)

Nitrates (Oral & Topical)

Non-Opioid Analgesics (IV, Oral, & Injection)

Reversal Agents

Steroids (IV, Oral, Inhaled)

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

CARDIAC MONITORING & EMERG. RESPONSE

Dysrhythmia Interpretation

Dysrhythmia Management

Obtain 12 Lead EKG

Interpret 12 Lead EKG

Cardioversion

Defibrillation

Malignant Hyperthermia

IV THERAPY

Starting Ivs

Central Line Blood Draws

Central Line/Implanted Line Care

Arterial Line Management

TPN & Lipids

Blood Product Administration

Administration of Chemotherapy

PROFESSIONAL KNOWLEDGE AND SKILLS

National Patient Safety Goals/Core Measures

Fall Risk Assessment/Prevention

Pressure Ulcer Risk Assessment/Prevention

Patient/Family Teaching

Age Specific/Population-Based Care

Isolation Precautions

Infection Prevention

Pain Assessment & Management

Charge Experience

Interpretation and Communication of Lab Values

Specialty Beds

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