CARDIOPULMONARY RESUSCITATION

Adult—Two-Rescuers— EMS Responder

 

Start Time: _______________Stop Time: _______________ Date: ______________________

Candidate’s Name: _______________________________________

Evaluator’s Name: ________________________________________

 

Points

Possible

Points

Awarded

Takes, or verbalizes, body substance isolation precautions

1

 

Establishes unresponsiveness

1

 

RESCUER #1 Remains at the victim’s head

1

 

Opens the airway (head tilt – chin lift or jaw thrust maneuver)

1

 

Assesses breathing (look, listen and feel) to identify absent or inadequate

breathing—taking no more than 10 seconds

1

 

If victim is breathing or resumes effective breathing, places victim in recovery position

1

 

If victim is not breathing, gives 2 slow breaths (without O 2 supplement over

2 seconds each; with O 2 supplement over 1 to 2 seconds)

1

 

If unable to give initial breaths, repositions the head and re-attempts ventilation.

If still unsuccessful, follows unresponsive FBAO sequence

1

 

Assesses for signs of circulation by feeling for a carotid pulse—taking no more

than 10 seconds

1

 

RESCUER #2 Positioned at the victim’s side

1

 

If there are no signs of circulation, begins chest compressions by locating

proper hand position; considers AED use if available and appropriate

1

 

Performs 15 chest compressions at a rate of approximately 100 per minute.

depressing the chest 1-1/2 to 2 inches with each compression

1

 

RESCUERS #1 and #2

1

 

Continues CPR with a compression to ventilation ratio of 15:2, with a

pause for ventilation of 2 seconds each until the airway is secured by

a cuffed endotracheal tube

1

 

When the person performing chest compressions becomes fatigued, the rescuers

should change positions with minimal interruption of chest compressions

 

1

 

RESCUER #1

1

 

Assesses the effectiveness of the partner’s chest compressions by checking

the pulse during compressions

1

 

 

 

Determines whether the victim has resumed spontaneous breathing and

circulation by stopping compressions for 10 seconds at approximately the

end of the first minute of CPR and every few minutes thereafter

1

 

If signs of circulation are present, checks for breathing

1

 

If breathing is present, places the victim in a recovery position and monitors

breathing and circulation

1

 

If breathing is absent but signs of circulation are present, provides rescue breathing

at 10 to 12 times per minute (1 breath every 4 to 5 seconds) and monitors for signs

of circulation every few minutes

1

 

17

 

 

Critical Criteria

_____ Did not take, or verbalize, body substance isolation precautions

_____ Did not establish unresponsiveness

_____ Did not open the victim’s airway

_____ Did not establish that the victim was not breathing

_____ Took longer than 10 seconds to establish the patient was not breathing

_____ Did not assess for a pulse

_____ Took longer than 10 seconds to establish the patient had no pulse

_____ Did not consider AED use

_____ Did not deliver two adequate rescue breaths

_____ Did not deliver compressions at an appropriate depth, location, or rate

_____ Did not reassess the patient’s circulatory or respiratory status

_____ Did not assess breathing status after the return of a pulse

_____ Did not provide rescue breathing as necessary after the return of a pulse