Medical Tech Skills Checklist Name First Middle Last Date MM slash DD slash YYYY 1 = No Experience 2 = Need Supervision 3 = Able to perform without Supervision 4 = Able to perform Independently 5 = Able to Supervise or Teach I hereby certify that the information provided in this checklist is true, to the best of my knowledge, and authorize the release of this document.Blood BankComponent Preparation 1 2 3 4 5 Special Blood Typing 1 2 3 4 5 Procedures 1 2 3 4 5 Patient Identification 1 2 3 4 5 Emergency Release 1 2 3 4 5 Freezing Blood 1 2 3 4 5 Antibody Identification 1 2 3 4 5 Antibody Titer 1 2 3 4 5 Blood Irradiation 1 2 3 4 5 Cold Agglutinins 1 2 3 4 5 Direct Coombs Test 1 2 3 4 5 Indirect Coombs Test 1 2 3 4 5 Cross Match 1 2 3 4 5 Donor Unit Collections 1 2 3 4 5 Immediate Spin Cross Match 1 2 3 4 5 Plasmapheresis 1 2 3 4 5 Plateletpheresis 1 2 3 4 5 Rhogam 1 2 3 4 5 Kell, Kidd, Duffy, RH HR, MNS, Lewis, P 1 2 3 4 5 Type RH 1 2 3 4 5 UrinalysisAutomated Instrumentation 1 2 3 4 5 Crystal Identification 1 2 3 4 5 Semen Analysis 1 2 3 4 5 Macroscopic U.A. 1 2 3 4 5 Microscopic U.A. 1 2 3 4 5 HematologyBody Fluid Count 1 2 3 4 5 Bleeding Time 1 2 3 4 5 Lee-White Clotting Time 1 2 3 4 5 Differential 1 2 3 4 5 Eosinophil Count 1 2 3 4 5 Factor Assays 1 2 3 4 5 Fibrinogen 1 2 3 4 5 Fibrin Split Products / FDP 1 2 3 4 5 Platelet Aggregation 1 2 3 4 5 Platelet Count 1 2 3 4 5 PT and PTT 1 2 3 4 5 Reticulocyte 1 2 3 4 5 Sedimentation Rate 1 2 3 4 5 Sickle Cell Prep 1 2 3 4 5 PAS, Peroxidase, Leukocyte, Aldaline Phosphatase 1 2 3 4 5 Thrombin Time 1 2 3 4 5 Fetal Hemoglobin 1 2 3 4 5 ChemistryAcetone Analysis 1 2 3 4 5 Atomic Absorption 1 2 3 4 5 Thin Layer Chromatography 1 2 3 4 5 Gas Chromatography 1 2 3 4 5 CSF / Body Fluid Drug Monitoring 1 2 3 4 5 CSF / Body Fluid Electrolytes 1 2 3 4 5 Electrophoresis 1 2 3 4 5 Immunoelectrophoresis 1 2 3 4 5 Osmolality 1 2 3 4 5 Stool Analysis 1 2 3 4 5 Instrumentation Used - Blood Gas 1 2 3 4 5 Instrumentation Used - Main Chemistry Unit 1 2 3 4 5 Serology / ImmunologyHemagglutination Inhibition 1 2 3 4 5 Pregnancy Testing 1 2 3 4 5 Meningitis Screen 1 2 3 4 5 Body Fluids 1 2 3 4 5 Rubella Serology 1 2 3 4 5 ANA 1 2 3 4 5 ASO Titer 1 2 3 4 5 C3. C4, Total Complement 1 2 3 4 5 Febrile Agglutinations 1 2 3 4 5 FTA - ABS 1 2 3 4 5 LE Cell Prep 1 2 3 4 5 Monospot 1 2 3 4 5 Radial Immuno Diffusion 1 2 3 4 5 Rheumatoid Factor 1 2 3 4 5 RPR 1 2 3 4 5 TORCH Studies 1 2 3 4 5 PhlebotomyBasic Safety Guidelines: Gloves, Goggles 1 2 3 4 5 Communication Skills 1 2 3 4 5 Ability to Write Procedures 1 2 3 4 5 Masks 1 2 3 4 5 Use of Balance (Weighing) 1 2 3 4 5 Anticoagulants - Knowledge of Tube Types and Uses 1 2 3 4 5 Calculation for Solution Prep: Molarity, Molality 1 2 3 4 5 Finger Stick 1 2 3 4 5 Heel Stick 1 2 3 4 5 M.L.A. 1 2 3 4 5 Operation of Centrifuge 1 2 3 4 5 Pediatric 1 2 3 4 5 Pipetting 1 2 3 4 5 To Contain 1 2 3 4 5 To Deliver 1 2 3 4 5 Venipuncture 1 2 3 4 5 Volumetric 1 2 3 4 5 Microbiology / VirologyBlood Culture 1 2 3 4 5 Cell Culture 1 2 3 4 5 Aerobic Culture 1 2 3 4 5 Anaerobic Culture 1 2 3 4 5 Anaerobic Identification 1 2 3 4 5 Mycobacteria: Culture 1 2 3 4 5 Sensitivities 1 2 3 4 5 Virus Identification 1 2 3 4 5 Virus Isolation 1 2 3 4 5 Acid Fast Stain (Fluorescent) 1 2 3 4 5 Acid Fast Stain (Kinyoun) 1 2 3 4 5 C Difficili Assay 1 2 3 4 5 Concentration Techniques 1 2 3 4 5 Culture Plating 1 2 3 4 5 Darkfield 1 2 3 4 5 Gram Stain 1 2 3 4 5 Identification 1 2 3 4 5 India Ink 1 2 3 4 5 KOH Prep 1 2 3 4 5 M.I.C. 1 2 3 4 5 Chlamydia Culture 1 2 3 4 5 Chlamydia Smear 1 2 3 4 5 Malarial Examination 1 2 3 4 5 Occult Blood 1 2 3 4 5 Organism Identification (Aerobic) 1 2 3 4 5 Ova and Parasite Concentration 1 2 3 4 5 Ova and Parasite Identification: Trichcone 1 2 3 4 5 West Mount-Mobility 1 2 3 4 5 Wet Mount 1 2 3 4 5 RIAData Reduction 1 2 3 4 5 Curves / Regression 1 2 3 4 5 Counters 1 2 3 4 5 Background Counts 1 2 3 4 5 Scintillation Counter 1 2 3 4 5 Hormone Testing 1 2 3 4 5 Radiation Safety Techniques 1 2 3 4 5 Instrumentation / Gamma Counters 1 2 3 4 5 B12 / Folates 1 2 3 4 5 Hepatitis 1 2 3 4 5 Thyroid Testing 1 2 3 4 5 Tumor Markers 1 2 3 4 5
