Skill Sheet 1: Adult CPR and AED Use Student Name
Date
Instructor Name
Instructor #
Review the Skill Sheet with students and explain the required steps. During the skill check give assessment information, but not actions to take. Check off each step as it is performed successfully. If the student fails any portion, practice, provide feedback, and retest the entire skill. Use as many skill sheets as required until proficient. Test students in pairs. Rescuer 1 will assess the victim and provide 1-rescuer adult CPR. Rescuer 2 will bring an AED and bag mask to the scene. Test each student on their individual roles, then switch roles and retest. Mark a or the time in the Rescuer 1 & 2 columns. Adult CPR: Required Actions Rescuer 1 Rescuer 2 1.
Scene Size-Up: Look around, state, “Checking for safety.” State, “I am putting on gloves.”
2.
Check Response & Breathing at the same time: Tap on shoulder, shout. Scan the chest for 5-10 seconds. (The victim is unresponsive and not breathing)
3.
Activate EMS: Send someone to activate EMS and get an AED.
4.
Time: ___ sec.
Time: ___ sec.
Check Pulse: Check carotid pulse for 5-10 seconds. (There is no pulse)
Time: ___ sec.
Time: ___ sec.
5.
30 Compressions: 2 hands in the center of the chest between the nipples. 30 compressions in < 18 seconds.
Time: ___ sec.
Time: ___ sec.
6.
2 Breaths: Open airway using head tilt/chin lift. Use a barrier to give 2 breaths w/ visible chest rise for at least 1 breath. < 10 seconds to give 2 breaths and resume compressions.
7.
30 Compressions: At least 2” deep and with full recoil.
8.
Rescuer 2 Arrives: Rescuer 1 continues CPR while Rescuer 2 prepares AED. Rescuer 1
Rescuer 2
Rescuer 1
Rescuer 2
AED Use: Required Actions 9.
Power on AED: Rescuer 2 places AED near victim’s head & powers it on. Encourages Rescuer 1 to continue CPR until AED is ready.
10.
Apply Pads to Bare Skin: Right upper chest below collarbone; left lower chest
11.
Switch Positions: When AED states ‘Stop CPR,’ switch positions. Rescuer 1 is now at the head. Rescuer 2 is at the chest ready to take over compressions after the shock.
12.
Clear Victim: Rescuer 2 states, “Clear!” or “Everybody clear!” Looks up and down to ensure no one is touching the victim or clothes.
13.
AED Shock: Rescuer 2 presses shock button when victim is clear. 2-Rescuer Adult CPR: Required Actions
14.
Immediately Resume CPR: Rescuer 2 starts w/ chest compressions.
15.
Bag Mask Use: Rescuer 1 selects proper mask and bag size. Uses C/E position to create seal and open airway. Provides 2 rescue breaths w/ visual chest rise for at least 1 breath.
16.
Continue Compressions: Resume compressions immediately after breaths. Provide 30 compressions in < 18 seconds
Time: ___ sec.
Time: ___ sec.
17.
Rescue Breaths: Provide 2 rescue breaths w/ bag mask in < 10 seconds
Time: ___ sec.
Time: ___ sec.
©EMS Safety 2011
CPR & AED for Professional Rescuers
Version A
Skill Sheet 2: Child and Infant CPR Student Name
Date
Instructor Name
Instructor #
Review the Skill Sheet with students and explain the required steps. During the skill check give assessment information, but not actions to take. Check off each step as it is performed successfully. If the student fails any portion, practice, provide feedback, and retest the entire skill. Use as many skill sheets as required until proficient. Test students in pairs. Rescuer 1 will assess the victim and provide 1-rescuer CPR. Rescuer 2 will bring a bag mask to the scene. Test each student on their individual roles, then switch roles and retest. Mark a or the time in the Rescuer 1 & 2 columns.
1 & 2-Rescuer Child CPR: Required Actions 1.
2.
Scene Size-Up: Look around, state, “Checking for safety.” State, “I am putting on gloves.” Check Response & Breathing at the same time: Tap on shoulder, shout. Scan the chest for 5-10 seconds. (The victim is unresponsive and not breathing)
3.
Activate EMS: Send someone to activate EMS and get an AED.
4.
Check Pulse: Check carotid pulse for 5-10 seconds. (There is no pulse) 30 Compressions: 1 or 2 hands in center of chest between the nipples. 30 compressions in < 18 seconds.
5. 6.
2 Breaths: Open airway using head tilt/chin lift. Use a barrier to give 2 breaths w/ visible chest rise for at least 1 breath. < 10 seconds to give 2 breaths and resume compressions.
7.
30 Compressions: About 2” deep and with full recoil.
8. 9.
2.
Rescuer 2
Time: ___ sec.
Time: ___ sec.
Time: ___ sec.
Time: ___ sec.
Time: ___ sec.
Time: ___ sec.
Time: ___ sec.
Time: ___ sec.
Rescuer 1
Rescuer 2
Time: ___ sec.
Time: ___ sec.
Rescuer 2 Arrives: Prepares bag mask. Rescuers switch positions. Rescuer 2 provides 15 compressions. Bag mask Use: Rescuer 1 uses bag mask to give 2 breaths w/ visible chest rise for at least 1 breath. 1 & 2-Rescuer Infant CPR: Required Actions
1.
Rescuer 1
Scene Size-Up: Look around, state, “Checking for safety.” State, “I am putting on gloves.” Check Response & Breathing at the same time: Flick soles of feet, shout. Scan the chest for 5-10 seconds. (The victim is unresponsive and not breathing)
3.
Activate EMS: Send someone to activate EMS and get an AED.
4.
Check Pulse: Check brachial pulse for 5-10 seconds. (There is no pulse)
Time: ___ sec.
Time: ___ sec.
5.
30 Compressions: 2 fingers in the center of the chest, just below the nipple line. 30 compressions in < 18 seconds.
Time: ___ sec.
Time: ___ sec.
6.
2 Breaths: Open airway using head tilt/chin lift. Use a barrier to give 2 breaths w/ visible chest rise for at least 1 breath. < 10 seconds to give 2 breaths and resume compressions.
7.
30 Compressions: About 1½” deep and with full recoil.
8.
Rescuer 2 Arrives: Prepares bag mask. Rescuers switch positions. Rescuer 2 provides 15 compressions using 2 thumb-encircling hands technique.
9.
Bag mask Use: Rescuer 1 uses bag mask to give 2 breaths w/ visible chest rise for at least 1 breath.
©EMS Safety 2011
CPR & AED for Professional Rescuers
Version A
Skill Sheet 3: Glove Removal, Choking Care Student Name
Date
Instructor Name
Instructor #
Review the Skill Sheet with students and explain the required steps. During the skill check give assessment information, but not correct actions to take. Check off each step as it is performed successfully. If the student fails any portion of the skill check, practice, provide feedback, and retest the entire skill. Use as many skill sheets as required until proficient.
Glove Removal: Required Actions
#
1.
Pinch: Pinch base of glove, gently peel off, and hold in gloved hand.
2.
Peel: Slip ungloved finger(s) under base of glove, slowly peel glove back.
3.
Pull: Gloves are inside out, one glove stored inside the other.
Adult and Child Choking Care: Required Actions
#
1.
Recognize Choking: (Show universal sign) Ask, “Are you choking?” (Nod yes)
2.
Positioning: (Use a manikin) Stand behind victim. Place fist, thumb side in, just above navel. Grasp fist with free hand.
3.
Abdominal Thrusts: Provide at least 5 quick, forceful, inward and upward abdominal thrusts.
Comments
Comments
Victim Becomes Unresponsive (lay manikin on ground) 4.
Activate EMS: Send someone to activate EMS.
5.
Unresponsive Choking Adult: (Review only) 30 compressions, look in mouth for object, attempt 2 breaths, and repeat 30 compressions.
Infant Choking Care: Required Actions
#
1.
Recognize Choking: (Use infant manikin) Describe 3 signs of a conscious choking infant. (The infant is choking)
2.
Activate EMS: Send someone to activate EMS.
3.
Position Infant: Sit or kneel. Hold infant face down on forearm with head slightly lower than body; support the jaw between the thumb and forefinger.
4.
5 Back Blows: Forceful back slaps w/ the heel of the hand between the shoulder blades.
5.
Position Infant: Support infant, turn face up, keep head lower than body.
6.
5 Chest Thrusts: Quick downward chest thrusts with 2 fingers in the center of the chest, just below the nipples.
7.
Unresponsive Choking Infant: (Review only) 30 compressions, look in mouth, remove object if seen, repeat.
©EMS Safety 2011
CPR & AED for Professional Rescuers
Comments
Version A