HeartCode ACLS Skills Testing Checklist
HeartCode? ACLS Skills Testing Checklist
Student Name: ______________________________________________________________ Test Date: _______________________
HeartCode ACLS Bag-Mask Ventilation Testing Checklist Performance Guidelines and Critical Actions
BLS Survey and Interventions
Checks for responsiveness ? Taps and shouts, "Are you all right?"
and ? Scans chest for movement (5-10 seconds) Activates the emergency response system ? Activates the emergency response system and gets the AED
or ? Directs second rescuer to activate the emergency response system and get the AED Checks carotid pulse (5-10 seconds). Notes that pulse is present Does not initiate chest compressions or attach AED Performs ventilations at the correct rate of 1 breath every 5-6 seconds
(10-12 breaths per minute)
ACLS Survey Case Skills
Inserts oropharyngeal or nasopharyngeal airway Administers oxygen Performs correct bag-mask ventilation for 1 minute
Critical Actions
Effectively ventilates with a bag-mask device for 1 minute Gives proper ventilation--rate and volume
if done correctly
Skill Step
1
2
HeartCode ACLS CPR Testing Checklist 1-Rescuer CPR Test
Critical Performance Steps
Checks for responsiveness: Taps and shouts, "Are you all right?" and scans the chest for movement (5-10 seconds) Tells someone to activate the emergency response system and get an AED
if done correctly
3 Checks carotid pulse (minimum 5 seconds; maximum 10 seconds)
4 Bares patient's chest and locates CPR hand position
5
Delivers first cycle of compressions at correct rate (acceptable: 18 seconds or less for 30
compressions)
6 Gives 2 breaths (1 second each)
7 Delivers second cycle of compressions at correct hand position (acceptable: greater than 23 of 30 compressions)
8 Gives 2 breaths (1 second each) with visible chest rise
The next step is performed only if the manikin is equipped with a feedback device, such as a clicker or light. If there is no feedback device, STOP THE TEST.
9 Delivers third cycle of compressions of adequate depth with complete chest recoil (acceptable: greater than 23 compressions)
STOP TEST
Test Summary
Circle P or NR to Indicate Pass or Needs Remediation:
P
NR
Pass = Steps all checked (done correctly) NR = Needs remediation
1-Rescuer CPR
1-Rescuer Bag-Mask Ventilation
Pass
NR
Pass
NR
Instructor signature affirms that skills tests were done according to AHA Guidelines.
Save this sheet with course record.
Instructor Signature: ____________________________________ Print Instructor Name: ___________________________________ Date: _______________________
? 2011 American Heart Association
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