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Electrical Therapy Competency Checklist:
ACLS provider course
Electrical Therapy Competency Checklist: - ACLS provider course
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*
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Participant Name:
*
Date
*
MM slash DD slash YYYY
Competences
Cardioversion
Attach the cardiac monitor by applying 3 or 5 leads ECG
*
Check it if Completed correctly
Not Done Correctly
Turn on the monitor and Identify the rhythm correctly.
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Check it if Completed correctly
Not Done Correctly
States the indications for synchronized cardioversion.
*
Check it if Completed correctly
Not Done Correctly
Ensures that the “SYNC” button is activated and the indicators are on the QRS complex.
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Check it if Completed correctly
Not Done Correctly
Select the appropriate cardioversion energy level by the manufacturer’s recommendation.
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Check it if Completed correctly
Not DonaNot Done Correctlye
Apply the pads or paddles properly.
*
Check it if Completed correctly
Not Done Correctly
Press the charge button.
*
Check it if Completed correctly
Not Done Correctly
Says “CLEAR” and visually checks the other rescuers are clear of patients.
*
Check it if Completed correctly
Not Done Correctly
Ensures that Oxygen is away from the patient.
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Check it if Completed correctly
Not Done Correctly
Delivers cardioversion by holding down the shock button until the defibrillator discharges.
*
Check it if Completed correctly
Not Done Correctly
Reassess and properly identify the rhythm on the monitor
*
Check it if Completed correctly
Not Done Correctly
Repeat steps and increase the energy dose in a stepwise fashion if the rhythm does not convert
*
Check it if Completed correctly
Not Done Correctly
Defibrillation
Recognizes the rhythm on the monitor (PVT or VF )
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Check it if Completed correctly
Not Done Correctly
Assess the patient to confirm the absence of spontaneous pulse.
*
Check it if Completed correctly
Not Done Correctly
Select the appropriate defibrillation energy level by using the manufacturer's recommended energy dose for the initial dose
*
Check it if Completed correctly
Not Done Correctly
Properly apply pads or paddles.
*
Check it if Completed correctly
Not Done Correctly
Charges defibrillator.: Says “CLEAR” and visually checks that other rescuers are clear of the patient. Ensures that oxygen is away from the patient Delivers defibrillation shock
*
Check it if Completed correctly
Not Done Correctly
Percutaneous Pacemaker
Recognizes bradycardia on the monitor and states that the patient is unstable.
*
Check it if Completed correctly
Not Done Correctly
Connect the pacing pads to the patient
*
Check it if Completed correctly
Not Done Correctly
Set the pacemaker rate (the pacemaker may have a default setting (e.g., 80 bpm) that can be adjusted as needed).
*
Check it if Completed correctly
Not Done Correctly
Select demand or non-demand pacing mode (if available)
*
Check it if Completed correctly
Not Done Correctly
Set current at a minimum if not automatically done by pacemaker
*
Check it if Completed correctly
Not Done Correctly
Activate the pacemaker and adjust current upward until electrical and mechanical capture are identified
*
Check it if Completed correctly
Not Done Correctly
Evaluator Name
*
Evaluator ID#
*
Result
*
Pass
Need Remediation
Phone
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Our Story
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Membership
Account
SHA Services
CPR Guidlines
Guidelines in English
Guidelines in Arabic
Performance Sheet
Memo For CPR Centers
Education
Cardiac Awareness Program
SHA Events
SHA2024 | 35th Annual Conference of the Saudi Heart Association
SHA2023 | 34th Annual Conference of the Saudi Heart Association
SHA2022 | 33rd Annual Conference
SHA2021 | 32nd Annual Conference
Upcoming Events
Previous Events
WebCast
SHA Journals
Official Website JSHA
JSHA PubMed
Scientific Program 2024
Virtual Research Academy
35th SHA Conference Gallery
SHA Guidelines & Statements
SHA Guidelines
SHA Position Statements
SHA Statements
Life Support Courses
Account
Contact Us
SHA Journal
Official Website of JSHA
JSHA in PubMed
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