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Perfusionist Checklist

EQUIPMENT AND TECHNIQUES * SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Extracorporeal Circuit Components for Cardiopulmonary Bypass
Myocardial Preservation
Blood Conservation Techniques
Adequacy of Perfusion
Systemic Hypothermia
Organ Transplantation
Adjunctive Techniques
Heart-lung machine
Cell saver
Hemoconcentrator
Ventricular Assist Device (VAD)
Intra-Aortic Balloon Pump (IABP)
ExtraCorporeal Membrane Oxygenation (ECMO)
ExtraCorporeal Life Support (ECLS)
EQUIPMENT AND TECHNIQUES * FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Extracorporeal Circuit Components for Cardiopulmonary Bypass
Myocardial Preservation
Blood Conservation Techniques
Adequacy of Perfusion
Systemic Hypothermia
Organ Transplantation
Adjunctive Techniques
Heart-lung machine
Cell saver
Hemoconcentrator
Ventricular Assist Device (VAD)
Intra-Aortic Balloon Pump (IABP)
ExtraCorporeal Membrane Oxygenation (ECMO)
ExtraCorporeal Life Support (ECLS)
GENERAL SKILLS * SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Pediatric Respiratory/Cardiac Arrest
Adult Respiratory/Cardiac Arrest
Standard Precautions
Isolation Precautions
Administers blood products, parenteral fluids, and drugs under order from the physician
Monitors and calculates physiologic lab values
Provides complete pacemaker analysis
Autologous Blood Salvage
Left Heart Bypass
Minimally Invasive (Percutaneous) Bypass
Liver Perfusion
Retrograde Cerebral Perfusion
Selective Antegrade Cerebral Perfusion
GENERAL SKILLS * FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Pediatric Respiratory/Cardiac Arrest
Adult Respiratory/Cardiac Arrest
Standard Precautions
Isolation Precautions
Administers blood products, parenteral fluids, and drugs under order from the physician
Monitors and calculates physiologic lab values
Provides complete pacemaker analysis
Autologous Blood Salvage
Left Heart Bypass
Minimally Invasive (Percutaneous) Bypass
Liver Perfusion
Retrograde Cerebral Perfusion
Selective Antegrade Cerebral Perfusion
CARDIOPULMONARY BYPASS * SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Priming of Equipment
Initiation of cardiopulmonary bypass
Administration of Prescribed Fluids/Medications
Temperature Management
Anticoagulation
Acid-Base Management
Ultrafiltration
Flow Rates
Cardioplegia
Weaning/Resumption of Natural Circulation
Massive Air Embolus
Pump Failure
CARDIOPULMONARY BYPASS * FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Priming of Equipment
Initiation of cardiopulmonary bypass
Administration of Prescribed Fluids/Medications
Temperature Management
Anticoagulation
Acid-Base Management
Ultrafiltration
Flow Rates
Cardioplegia
Weaning/Resumption of Natural Circulation
Massive Air Embolus
Pump Failure
AGE SPECIFIC COMPETENCIES * SKILL

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Newborn/Neonate (birth to 30 days)
Infant (31 days to 12 months)
Toddler (1-3 years)
Preschooler (3-5 years)
School age children (5-12 years)
Adolescents (12-18 years)
Young adults (18-39 years)
Middle adults (39-64 years)
Older adults (64-79 years)
Elderly adults (80+ years)
AGE SPECIFIC COMPETENCIES * FREQUENCY

PLEASE RATE YOUR LEVEL OF SKILLS & FREQUENCY OF PERFORMANCE FOR THE FOLLOWING PROCEDURES/SKILLS: Proficiency I have never done the stated task. I have performed the task/skill infrequently; I require more experience/practic
Newborn/Neonate (birth to 30 days)
Infant (31 days to 12 months)
Toddler (1-3 years)
Preschooler (3-5 years)
School age children (5-12 years)
Adolescents (12-18 years)
Young adults (18-39 years)
Middle adults (39-64 years)
Older adults (64-79 years)
Elderly adults (80+ years)