CPR Hands-On Skills Evaluation Checklist For Candidates
Checklist For Adult:
| Skill Tested | Completed | |
|---|---|---|
| Yes | No | |
| Establish scene safety | ||
| Assess patient responsiveness (check for pulse/breathing, no longer than 10 sec) | ||
| Activates emergency response (calls for help/AED) | ||
| Correct CPR hand placement and positioning | ||
| Correct CPR rate (100-120/min.) and depth (2 inches) | ||
| Allows for complete recoil of chest between compressions | ||
| Airway opened appropriately (head tilt/chin lift, jaw thrust) | ||
| Delivers 2 breaths (each over 1 second) with visible chest rise | ||
| Correct AED placement without disrupting compressions | ||
| Clear of patient for rhythm analysis and shock | ||
| Compressions immediately resumed after shock | ||
Checklist For Child:
| Skill Tested | Completed | |
|---|---|---|
| Yes | No | |
| Establish Scene Safety | ||
| Assess Child Responsiveness (Check for pulse/breathing, no longer than 10 sec) | ||
| Activates Emergency Response (Calls for help/AED) | ||
| Correct Child CPR Hand Placement and Positioning | ||
| Correct Child CPR Rate (100-120/min.) and Depth (2 inches) | ||
| Allows for Complete Recoil of Chest Between Compressions | ||
| Airway Opened Appropriately for Child (Head tilt/Chin lift, Jaw thrust) | ||
| Delivers 2 Breaths (Each over 1 second) with Visible Chest Rise | ||
| Correct AED Placement Without Disrupting Compressions | ||
| Clear of Patient for Rhythm Analysis and Shock | ||
| Compressions Immediately Resumed After Shock | ||
Checklist For Infant:
| Skill Tested | Completed | |
|---|---|---|
| Yes | No | |
| Establish Scene Safety | ||
| Assess Infant Responsiveness (Check for pulse/breathing, no longer than 10 sec) | ||
| Pulse Check (Brachial artery location, inner part of the upper arm) | ||
| Activates Emergency Response (Calls for help/AED) | ||
| Correct Infant CPR Hand Placement and Positioning | ||
| Correct Infant CPR Rate (100-120/min.) and Depth (About 1.5 inches) | ||
| Allows for Complete Recoil of Chest Between Compressions | ||
| Airway Opened Appropriately for Infant (Head tilt/Chin lift, Jaw thrust) | ||
| Delivers 2 Breaths (Each over 1 second) with Visible Chest Rise | ||
| Correct AED Placement Without Disrupting Compressions (If applicable, use of infant/child pads) | ||
| Clear of Patient for Rhythm Analysis and Shock | ||
| Compressions Immediately Resumed After Shock | ||
ACLS Hands-On Skills Evaluation Checklist For Candidates
| Skill Tested | Completed | |
|---|---|---|
| Yes | No | |
| Assigns roles | ||
| Ensures high quality CPR (rate, depth, recoil, ventilation) | ||
| Demonstrates good communication | ||
Primary assessment:
| Skill Tested | Completed | |
|---|---|---|
| Yes | No | |
| Places monitor leads properly | ||
| Recognizes hypoxemia and administers oxygen | ||
| Places intravenous access | ||
Bradycardia:
| Skill Tested | Completed | |
|---|---|---|
| Yes | No | |
| Identifies symptomatic bradycardia | ||
| Assesses for other underlying causes | ||
| Determines the presence of hypotension or shock symptoms | ||
| Administers correct dose of atropine (1mg, q 3-5 minutes) | ||
| Prepares for transcutaneous pacing | ||
Ventricular fibrillation:
| Skill Tested | Completed | |
|---|---|---|
| Yes | No | |
| Identifies ventricular fibrillation | ||
| Clears the patient before analysis and shock | ||
| Resumes CPR immediately after shock | ||
| Administers epinephrine 1mg q3-5 minutes | ||
| Demonstrates appropriate drug, shock and CPR cycles | ||
| Advanced airway is placed with capnography | ||
Post Cardiac Arrest Care:
| Skill Tested | Completed | |
|---|---|---|
| Yes | No | |
| Identifies ROSC | ||
| Optimizes oxygenation (>94%) and ventilation (10 breaths/min) | ||
| Obtains a blood pressure | ||
| 12-lead ECG | ||
| Considers targeted temperature management | ||