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Skills Checklists

Congratulations on your decision to apply for an allied position with ClubStaffing! Before we can offer you an allied employment opportunity, an electronic skills assessment must be completed. From the skills checklist below, please locate the list that matches your specialty and complete the online form. Be sure to review your information thoroughly before clicking the submit button. Thank you!

ClubStaffing
5901 Broken Sound Pkwy.
Suite 450
Boca Raton, Florida 33487
Fax: (561) 367-0884


Anesthesia Technician Skills Checklist

*
Denotes required field

This profile is for use by healthcare professionals in this discipline and specialty.  It will not be a determining factor for the program.
Please enter your full legal name as it appears on your Social Security Card.
First Name* Middle Name Last Name*
E-Mail Address* Phone Number*
 
1. No experience; requires education, training and supervision 2. Intermittent experience; may need support or supervision
3. Proficient; consistent experience, independent 4. Expert level; can teach/supervise others
 
WORK SETTING
1 2 3 4
 
Inpatient
 
Outpatient
 
EQUIPMENT
1 2 3 4
 
Active warming devices
 
Anesthesia machine
 
Blood Warmer
 
Capnography/capnometry
 
Defibrillator/Crash Cart
 
Electrocardiograms
 
Fluid warmers
 
Intra -Aortic Balloon Pump
 
Invasive Pressure Monitor
 
Neuromuscular blockade monitors
 
Precordial/esophageal stethoscopes
 
Pulse oximeters
 
Rapid infusers
 
Perform anesthesia machine checkouts
 
IV PUMPS
1 2 3 4
 
IV Pumps: Alaris
 
IV Pumps: Alibaba
 
IV Pumps: Bard
 
IV Pumps: Baxter
 
IV Pumps: Braun
 
IV Pumps: Other (Specify)
 
VENTILATOR SET UP
1 2 3 4
 
Adult
 
Neonatal
 
Pediatric
 
EMERGENCIES
1 2 3 4
 
Accidental extubation
 
Anesthesia machine malfunction
 
Endotracheal tube migration
 
Hypercarbia/ hypocarbia
 
Hypoxia
 
Increased peak airway pressures
 
KNOWLEDGE OF GENERAL ANESTHESIA/ANALGESIA
1 2 3 4
 
Inhalation Agents
 
Intramuscular Agents
 
Intravenous Agents
 
Pre-Peri-Post Operative Prep & Medication
 
KNOWLEDGE OF REGIONAL ANESTHESIA/BLOCKS
1 2 3 4
 
Epidural and Caudal
 
Field Blocks
 
Infiltration
 
Intravenous
 
Lower Extremity
 
Spinal
 
Sympathetic Blocks
 
Topical
 
Upper Extremity
 
KNOWLEDGE OF FLUID/MEDICATION SIDE EFFECTS
1 2 3 4
 
Benzodiazepines
 
H2 blockers
 
Induction agents
 
Inhalation agents
 
Blood/Plasma
 
Intravenous Fluids
 
Muscle Relaxants
 
Plasma Expanders
 
Vasoactive Drugs
 
Local anesthetics
 
Narcotic antagonists
 
Narcotics
 
Neuromuscular blocking agents
 
SURGERIES
1 2 3 4
 
Cardiovascular
 
ENT
 
Eye
 
Gastrointestinal
 
Genitourinary
 
GYN/OB
 
Hematologic
 
Hepatic
 
Musculoskeletal
 
Neurologic
 
Renal
 
Respiratory
 
SUPPORT CARE OF PATIENTS WITH:
1 2 3 4
 
Arterial Line
 
Central Line
 
PROCEDURES
1 2 3 4
 
Assist with Basic airway setup
 
Assist with intubation/extubation
 
Assist with extubation
 
Assist with patient denitrogenation prior to the induction of anesthesia
 
Assist with rapid sequence intubations
 
Assist with treatment of a partial or complete laryngospasm
 
Assist with treatment of airway obstructions
 
Confirmation of correct tube placement following intubation
 
Support Intravenous Catheter Placement
 
Support Invasive Line Placement
 
MONITORING SYSTEMS USED
1 2 3 4
 
GE
 
Philips
 
Spacelabs
 
Other (Specify)
 
PROFESSIONAL KNOWLEDGE AND SKILLS
1 2 3 4
 
Fall Risk Assessment/Prevention
 
Infection Prevention
 
Isolation Precautions
 
Universal Protocol Procedures (Time Out)
 
AGE SPECIFIC/POPULATION-BASED CARE
1 2 3 4
 
Neonate/Infant
 
Toddler/Preschool
 
School Age Children
 
Adolescents
 
Young/Middle Adults
 
Older Adults/ Geriatrics
 
EMR
1 2 3 4
 
Allscripts
 
GE
 
Bar Coding for Medication Administration
 
Cerner
 
Computer Physician Order Entry
 
Eclipsys
 
Epic
 
Meditech
 
Other: Specify
 
Other: Specify
 
EMR Conversion
 
CERTIFICATIONS * (Current at time of completing this form)
 
BLS or CPR
 
Certified Anesthesia Technician (Cer.A.T.)
 
Certified Anesthesia Technologist (Cer.A.T.T.)
 
PALS
 
ACLS
 
Other: Specify
 
Other: Specify
Anesthesia Technician Skills Checklist, version 2

I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. Falsification of any information provided, will result in being ineligible to travel with AMN. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.

© 2021 AMN Healthcare, Inc. All rights reserved. Reproduction and distribution of these materials is prohibited without the expressed written authorization of AMN Healthcare, Inc.