Heartsaver
®
Adult CPR and AED
Skills Testing Checklist
Student Name __________________________________________________ Date of Test _______________________________
Scenario: “You arrive on the scene for a suspected cardiac arrest. No bystander CPR has been provided. You approach
the scene and ensure that it is safe. Demonstrate what you would do next.”
Assessment and Activation
☐
Checks responsiveness
☐
Shouts for help/Sends someone to phone 9-1-1 and get an AED
☐
Checks breathing
Cycle 1 of CPR (30:2) *CPR feedback devices preferred for accuracy
Adult Compressions
☐
Performs high-quality compressions*:
• Hand placement on lower half of breastbone
• 30 compressions in no less than 15 and no more
than 18 seconds
• Compresses at least 2 inches (5 cm)
• Complete recoil after each compression
Adult Breaths
☐
Gives 2 breaths with a barrier device:
• Each breath given over 1 second
• Visible chest rise with each breath
• Gives 2 breaths in less than 10 seconds
AED (follows prompts of AED)
☐
Powers on AED
☐
Correctly attaches pads
☐
Clears for analysis
☐
Clears to safely deliver a shock
☐
Presses button to deliver shock
☐
Student immediately resumes compressions
Cycle 2 of CPR (repeats steps in Cycle 1) Only check box if step is successfully performed
☐
Gives 30 high-quality compressions
☐
Gives 2 effective breaths
Once student shouts for help, instructor says, “Here’s the barrier device. I am going to phone 9-1-1 and get the AED.”
Instructor says, “Here is the AED.”
STOP TEST
Instructor Notes
• Place a ✓ in the box next to each step the student completes successfully.
• If the student does not complete all steps successfully (as indicated by at least 1 blank check box), the student must receive
remediation. Make a note here of which skills require remediation (refer to Instructor Manual for information about remediation).
Test Results
Check PASS or NR to indicate pass or needs remediation:
PASS NR
Instructor Initials __________ Instructor Number _____________________________
Date _____________________________
© 2016 American Heart Association
Cycle 3 of CPR (repeats steps in Cycle 1) Only check box if step is successfully performed
☐
Gives 30 high-quality compressions
☐
Gives 2 effective breaths
AED trainer says, “The shock has been delivered.”
