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Ultrasound Skills Checklist

 

My responses in this checklist represent a true reflection of my experience and comfort level.

 

Please self-rate your comfort level in performing tasks in connection with the below checklist.  Rate your level of comfort for each line item by following the below ranking system.  Simply fill in the appropriate option immediately following the rating number.

 

Typed Name (Typing your name below serves as an electronic signature) *      Date*

                                                         

 

Phone*

             

 

Recruiter

 

Level of Comfort/Experience

N/A=Non-applicable

1=Inexperienced in this area

2=Limited comfort/experience in this area

3=Comfortable/experienced in this area

4=Very comfortable/highly experienced in this area

 

Area

Not Applicable

 Yes

 No

 

 

CERTIFICATION

ARDMS Certified

N/A  

Yes

No

 

 

 

 

 

ARDMS Eligible

N/A  

Yes

No

RVT Certified

N/A  

Yes

No

RVT Eligible

N/A  

Yes

No

RDCS Certified

N/A  

Yes

No

RDCS Eligible

N/A  

Yes

No

 

Area

Not Applicable

Inexperienced

Limited

Experienced

Highly Experienced

GENERAL ULTRASOUND

Appendix

N/A  

1

2

3

4

Biopsies

N/A  

1

2

3

4

Breasts

N/A  

1

2

3

4

Color or Doppler

N/A  

1

2

3

4

Color or Doppler

N/A  

1

2

3

4

Eye

N/A  

1

2

3

4

Gallbladder, CBD

N/A  

1

2

3

4

Intra Operative

N/A  

1

2

3

4

Kidneys, Spleen, Adrenals

N/A  

1

2

3

4

Liver, Pancreas

N/A  

1

2

3

4

Paracentesis

N/A  

1

2

3

4

Superficial masses

N/A  

1

2

3

4

Testicles

N/A  

1

2

3

4

Thhorocentesis

N/A  

1

2

3

4

Thyroids

N/A  

1

2

3

4

 

VASCULAR TECHNOLOGY

Upper extremity venous

N/A  

1

2

3

4

Upper extremity arterials

N/A  

1

2

3

4

Lower extremity venous

N/A  

1

2

3

4

Lower extremity arterials

N/A  

1

2

3

4

Carotoids

N/A  

1

2

3

4

Abdominal Aorta, IVC

N/A  

1

2

3

4

SMA, Celiac, Renals

N/A  

1

2

3

4

Hepatic, Splenic

N/A  

1

2

3

4

Resistive index

N/A  

1

2

3

4

Pulsatility index

N/A  

1

2

3

4

Color or Doppler

N/A  

1

2

3

4

Area for % Stenosis

N/A  

1

2

3

4

Diameter for % Stenosis

N/A  

1

2

3

4

PW/CW for % Stenois

N/A  

1

2

3

4

PVR (arms and legs)

N/A  

1

2

3

4

IPG (arms and legs)

N/A  

1

2

3

4

Plethysmography for fingers and toes

N/A  

1

2

3

4

Penile doppler

N/A  

1

2

3

4

ICD

N/A  

1

2

3

4

 

OB/GYN

Level I

N/A  

1

2

3

4

BPD, HC, AC, F1

N/A  

1

2

3

4

Stomach, heart, kidneys

N/A  

1

2

3

4

Diaphragm bladder

N/A