Pediatric Intensive Care Unit (PICU) SKILLS CHECKLIST

Please rate your experience / frequency within the last year
0 = No Experience / Observed Only
1 = Limited Experience / Rarely Done (<6 times/year)
2 = May Need Some Review / Occasionally Done (1-2 times/month)
3 = Experienced / Frequently Done (daily or weekly)

Please rate your experience / frequency within the last year

0 = No Experience / Observed Only

1 = Limited Experience / Rarely Done (<6 times/year)

2 = May Need Some Review / Occasionally Done (1-2 times/month)

3 = Experienced / Frequently Done (daily or weekly)

Please rate your experience / frequency within the last year
0 = No Experience / Observed Only
1 = Limited Experience / Rarely Done (<6 times/year)
2 = May Need Some Review / Occasionally Done (1-2 times/month)
3 = Experienced / Frequently Done (daily or weekly)

MM slash DD slash YYYY

Age Of Patients Cared For

Newborn/Neonate (birth to 30 days)
Infant 31 days to 12 months)
Toddler/Preschool (13 months to 5 years)
School Age Child/adolescent (6 years to 18 years)
Young Adults/ Middle Adult (19 years to 64 years)
Older Adults/Elderly (65+ years)

General Skills

Care of Patient in Restraints
Automated Med Dispensing Systems
Electronic Documentation
IV Pumps
Peripheral IV Insertion, Care and Maintenance
Access/Management of Implanted Ports
Access/Management of Central Lines (CVL, Hickman, Broviac, Groshong, etc.)
Cardiac Monitoring/Interpretation
PCA/Epidural pumps
Titration of drips
Administration of Blood/Blood Products
Knowledge of "Do Not Use Abbreviations"

Medication Administration

Moderate/Conscious Sedation
Sedation Reversal Agents

Cardiovascular General Skills

Blood pressure/invasive (arterial line)
Heart Sounds/Murmurs
Central venous pressure

Invasive Hemodynamic Monitoring Pa/swan Ganz

Defibrillation/Cardioversion
EKG Interpretation (Basic and Advanced)

Cardiovascular-care Of The Child With:

Anaphylactic Shock
Bacterial Endocarditis
Coarctation of the Aorta
Cardiac Arrest
Cardiac Transplant
Cardiogenic shock
Cardiomyopathy
Fresh Open Heart Surgery
Hypoplastic Heart
Hypovolemic Shock
Myocarditis
Open Heart Surgery, more than 6 hours
Post Interventional Cardiac Cath
Septal Defect
Septic Shock
Tetrology of Fallot
Transposition of the Great Vessels

Respiratory General Skills

Obtaining Blood Gases
Pulse Oximeter

Airway Management

Assist with Intubation
Assist with Extubation

Suctioning

Bulb Syringe
Nasal airway/suctioning
Oral airway/suctioning
Apnea/Apnea Monitoring

Chest Tube (Assist With)

Insertion
Removal
ECMO (Extracorporeal Membrane Oxygenation)
End Tidal CO2

O2 Therapy

Bag & mask
Isolette
Oxyhood
Tent
Trach collar
Thoracentesis

Ventilators

CPAP/PEEP/BIPAP
High frequency jet ventilator
Oscillating ventilator
Pressure ventilator
Volume ventilator
Weaning

Respiratory-care Of Child With:

Asthma
Asphyxiation
Bronchiolitis(RSV)
Bronchopulmonary Dysplasia
Pneumonia
Croup
Chronic respiratory disease
Cystic Fibrosis
Lung Transplant
Epiglottitis
Fresh tracheostomy
Foreign body aspiration
Flail Chest
Hemothorax
Near Drowning
Tonsillitis
Pertussis
Pneumothorax
Respiratory distress syndrome (RDS)
Respiratory Arrest
Respiratory failure

Neuro General Skills

Glasgow Coma Scale
Assist with lumbar puncture
Seizure Precautions
Intracranial pressure monitoring

Neuro-care Of Child With:

Epilepsy
Febrile Seizure
Head Trauma
Post Neurosurgery
Spinal Cord Injury
Status epilepticus
Coma
Brain death/organ procurement
Encephalitis
Meningitis
Externalized VP shunt/reservoirs
Neuromuscular disease
Anticonvulsants

Gastrointestinal General Skills

Abdominal Assessment
Interpretation of Lab Results - Serum Electrolytes
Feedings (Storage and Prep of)
Bottle
Breast
Gavage
TPN
PPN
Gastrostomy/Button
J-Tubes
NG to Suction
Gastric Lavage
Placement of Naso/Orogastric Tube

Gastrointestinal-care Of Child With:

Anal Fissure
Anorexia/Bulimia
Cleft Lip/Palate
Colostomy
Ileostomy
Fresh Ostomy
Diaphragmatic Hernia
Severe Failure to Thrive (FTT)
Pancreatitis
Pyloric Stenosis Repair
GE Reflux
GI Bleeding
Crohn's Disease
Ulcerative Colitis
Severe Gastroenteritis/Dehydration
Intestinal Parasites
Necrotizing Enterocolitis (NEC)
Surgical Abdomen
Liver Transplant
Small Bowel Transplant
Poison Ingestion/Overdose

Renal/genitourinary General Skills

Assessment of fluid balance
Interpretation of Lab Results (UA/BUN/Creatinine)
Test urine and interpret
Collection of urine specimens
Assist with suprapubic tap
Insertion & Care of Straight and Foley Catheter
Suprapubic

Renal/genitourinary-care Of Child With:

Acute renal failure
CAVH
Peritoneal dialysis
Hemodialysis
Hemolytic uremic syndrome (HUS)
Nephritis
Nephrotic syndrome
Renal transplant
Syndrome of inappropriate ADH (SIADH)

Endocrine/metabolic General Skills

Diabetes mellitus
Diabetic ketoacidosis
Diabetic coma
Hyper/hypocalcemia
Hyperbilirubinemia
Kawasaki's Disease
Thyroid dysfunction

Orthopedics General Skills

Specialized orthopedic bed

Orthopedics-care Of Child With:

Cervical traction
Fracture/Cast Care
Splints
Open Fracture
Closed Fracture
Pinned fractures
Post vertebral surgery

Wound Management

Assessment of skin status
Stasis ulcers
Multiple abdominal wounds and drains
Gunshot Wounds
Stab Wounds
Hazardous Material Exposure
Surgical wound healing
Lacerations
Sterile dressing changes
Wound care/irrigations
Drains
JP
Penrose
Hemovac

Wounds-care Of Child With:

Burns
Rule of Nines
First Degree
Second Degree
Third Degree
Fluid Resuscitation Burn Formulas
Radiation Exposure
Pressure sores
Electrical Burns
Traumatic wounds

Oncology/blood Dyscrasias

Reverse isolation
Interpretation of Lab Result

Oncology-care Of Child With:

Malignant tumors
Hodgkins Disease
Fresh oncologic surgery
Acute tumor lysis syndrome
Leukemia
Wilm's Tumor
Bone Marrow transplant
Disseminated intravascular coagulation
Sickle Cell Anemia
Chemotherapy
Radiation implant

Infectious Diseases General Skills

Cultures (Including sensitivities)
CBC/differential (shift)

Infectious Diseases-care Of Child With:

Isolation Precautions/Procedures
Cytomegalovirus (CMV)
HIV/AIDS
MRSA
VRE
CRE
Tuberculosis
C- Difficile
Hepatitis
Common childhood communicable diseases

Phlebotomy/iv Therapy

Peripheral IV Insertion, Care and Maintenance
Intraosseous Line
Hickman
Groshong
Saline Lock
Aortocath
Broviac
Quinton Catheter
Central Line Care and Maintenance
PICC Line Care and Maintenance
Peripheral Line
Arterial Line
Drawing Blood from Central Line/PICC Line
Drawing Venous Blood

Administration Of Blood/blood Products

Cryoprecipitate
Packed Red Blood Cells
Whole Blood

Pain Management General Skills

Assessment - Pain Level Using Age Appropriate Scales

Miscellaneous

Normal Growth & Development
Normal Laboratory Values
Recognize Signs of Abuse or Neglect
Immunization Schedule

Miscellaneous-care Of Child With:

Anorexia/Bulimia
Craniofacial Reconstruction
Depression
HEENT Surgery
Suicide attempt

Medication Administration For Children

Calculation of Pediatric Doses
Titration of IV drips
Eye/Ear Installations
Metered Dose Inhaler
Intravenous medications (IV)
Subcutaneous (SQ) injections
Z Trach
Knowledge of emergency drug action and reaction
Pediatric drug actions & reactions
Antipyretics
Adenosine
Aminophylline
Atropine
Anticoagulants
Anticonvulsants
Antibiotics
Antihypertensives
Charcoal
Cardizem
Decadron
Dilantin
Dopamine
Diuretics
Digoxin
Epinephrine
Growth Hormone
Heparin
Hyperalimentation
Immunizations
Inotropes ( Dobutamine, Primacor)
Intrathecal Medications
Inocor
Insulin
Insulin Drips
Isuprel
Kayexalate
Lidocaine
Mannitol
Narcotic Analgesics
Narcan
Nitroglycerin
Nipride
Steroids
Sodium Bicarbonate
TPA
Vasopressin
Ventolin (albuterol)