Resuscitation

Student

Date

While functioning as 1st Rescuer

1

Verbalizes or takes BSI precautions

2

(While enroute) Assemble BVM correctly

3

Connects device to oxygen supply

O2 supply must be functioning properly

4

Turns on portable O2 supply

5

Adjusts flowmeter to correct setting

6

Equipment functioning and ready to use

7

(On scene) Establishes unresponsiveness

Shout and Shake

AVPU

8

Opens airway

Head tilt chin lift/ jaw thrust

9

Assesses breathlessness Look, Listen & Feel

10

Sizes and simulates insertion of OPA

11

Correct placement of facemask

12

Ventilates Pt. twice

13

Assesses pulselessness (up to 10 sec)

14

(?) Proper technique for delivering ventilations

15

Proper ratio(2 ventilation per 15 compressions

delivered by partner)

While functioning as 2nd Rescuer

16

Proper landmarking and hand placement

17

Compressions vertical and compression is

equal to relaxation

18

Hands stay on sternum no bouncing

19

Proper rate of compressions (100/minute)

20

Proper ratio (15:2)

21

Stops to allow partner to ventilate each cycle

Score

TA

FAIL

POINTS

BVM not correctly assembled and functional with

appropriate O2 flow @ time of application to PT.

Did not assess for breathlessness (up to 10 sec)

Did not assess for pulselessness

Did not use correct technique for delivering

ventilations

Did not deliver ventilations using BVM

Did not provide adequate chest compressions

Did not demonstrate ABCs in sequence

Did not achieve >= 70% point score (15 of 21)