BLS Skills Testing 1- and 2-Rescuer Child BLS With AED feat Skills Testing Sheet Assocation. reenact Denson al me sus a: sm ee —_ese a none pe Neat tains eosin rn ar 1 ASSESSES hak or ponte afro reting ony SSB tS acon no imran sos bower Sands someone o ACTIVATE anarperey apanse oa (Geka PULSE fo mare than 0 soca) (GVES GI GUALTY > Cares earpreation HAND PLACEMENT ABET, SATE Ast Ory, deb ich ot 9S conresTH ‘ig ssonds ores using tar tan, / ADEOUATE DEPT: Deere cones aaa irdhe dpi of chek ‘Sopra 2 hos (S on east 35 cto 90, = = ALLOWS COMPLETE CHEST RECOIL ts 25 ot 090 INIMZES NTERAUPTIONS: Gives 2 ret wth pocket mask eh 1 scone 18] BURINGFFTH SET OF COMPRESSIONS Scored rsa arives with AED er bag sk dois, fama on AED, ane apo pe Fst evar conus conpresone wile econ es AED and pion pa | Second seve cows vein, towing AED io welyas—AESCUERS SWC 1 |irAED ndcates a rockon, seca easier car vein agin ae delves Shock 1 | Bath ence RESUME HIGH-QUALITY GR sere ar shok vey ‘Qeei | Que? > SECOND RESCUER oho 15 coroesos fi sacri re my aroha ene ssi ter ee “ony > FIRST RESCUER succes dvr 2 brats wih oa mack davio for 2 cle) te det completes a stops suecessuly a7 I each box the fof of Crea Parence Car) he sus passed Ns ite sien oes not cope al tps sucontuy fs dated bya lnk bx oe it of any of the Ciel Prtomance ‘itera ae ho om ote san fovea pe of sts medion + ter reser he or, the sient gehen ote rte fmt the side. The td wit ‘paar be reson, nts nue a no obra on Ba + iterations be dene at ile tne, rca shoul cal th at Dt te slur aes isto, emedation (freed: Irsructor Sina Instructor Sat Pent netuctor Name Print nstuctor NameBLS Skills Testing ‘American 1- and 2-Rescuer Infant BLS Heart Skills Testing Sheet ‘Associations, See 1 and 2-Rescver fat BLS Sil Testing Cera and Doseipers on est page ‘Student Na ‘oot ate ‘Rescuer BLS and CPR Skil (cree one Needs Remediation ‘2 Rescuer CPR Skil BegeMask (crle one): Pes Needs Remediation 2 Thumb-Encrcling Hands (ciclo once ass Nowds Remodaton ra ety 1 | ASSESSES: Checks fr eeponge and fr no bathing or ony gasping (at ast § acon but ro more an 10 scones). 2 _| Sends someone to ACTWATE erargancy response astm (po AED aval) ‘3 | Checks for PULSE fo more han 10 seconds) “| GES HIGH QUALITY CPR: Ea + Goretcomgresson FINGER PLACEMENT eet * ADEQUATE BATE fest Gon fe cevomeachaet|DDchteomesersn | eee | Te ADEQUATE DEPTH: Daves compressions east ope Wika the Gopi othe chow cor (Gporoxmaicy 1 nes (cn teat 23 out of $0) ALLOWS COMPLETE CHEST RECON. at 25 out of 0) Oe MINIMIZES INTERRUPTIONS: Gives 2 beat wih pocket maskin es than TO seconds| O65 '5- | OURING FIFTH SET OF COMPRESSIONS: Second recur aries wih fag-mak dev, RESCUERS SMITCH ROLES. ‘6 | oth rescuers RESUME HIGH QUALITY CPR * SECOND RESCUER gives 15 compressions ind seconds arene By using 2 taumb- rove anos ect (or 2 eles) FIRST RESCUER success Salva 2 bets wih bag-nask doce (or? eee) "7 [oth rescuers RESUME HIGH-QUALITY CPR ‘FIRST RESCUER gives 18 comprosins in 9 conde oes by vahg 2 thanb-=nvalng ard tecique for eee ~ SECOND RESCUER successuly caver 2 bela wih bag-mank doi for? oyee) * ite ster compl tps sce feat box he ih of Cal Parmar Geko hw ten + He stucent does rot complete all tos succosstuty as ndested by 2 ark bx to the right of any of the Cal Pesorance Crt) ge the fort he ste x rv a pt of sents rection + tr eviewng the form th etude wil ge th fart the tuctr who a eosin he etc. Te student wi ‘mpedorn the entre sconar, and he nto il oe the eealton ona sae frm, + te eovausten tobe done at fet tne, te nstuctor shuld alerts shat ble th tudor laaes re csrear. Remediation (i needed Instractor Signa Instructor Signa Print Inter Name Pit netuctor Name at Dat:Management of Respiratory Emergencies Skills Station Competency Checklist Critical Perfor err Verbalizesdiference between high-low and low-flow O, deivaryeysteme ‘High fow (210 Uniny , on exosad pati insplory ow, prevering enivanment of oom iif system Is tght-ting; delves nearly 1.00 Fo, ep, norwebrething mask with reservoir + Low flow (<10 Lin: patent inspeatry flow exceeds 0; fo, allowing entainment of room a ‘yplcaly devs 0.29 fo 0.80 Fic, og, nasal cannula, simple O, mask Verbalizes maximum 3 cannula flow rate (L/min) ‘Opens airway by using head it-chin it maneuver while Keeping mouth pan Jaw thrust for ‘ume viet) \erbalizos diferent indcatons for OPA and NPA "OPA only fr unconscious vit without 2 pag rele + NPA for conscious rsemiconsclous tin ‘Selects corel sized airway by measuring "OPA tram comer of mouth sgl of mane Inserts OPA correctly Verbalizes assessment fr adequate breathing after Insrtion of OPA ‘Suetons with OPA in place; states suctioning not to exceed 10 seconds Selocts correct mask size for ventions ‘Assembles bag-mask device, opens alway, and oreates seal by using E-C clamp technae ‘With bagrmask device give 4 breath avery 9105 seconds for about 20 eesonde, Givce each breath in approximately 1 second; each oath should cause chest i Endotrachea! intubation "Stats equipment needed fr endotracheal (ET ube intubation proce + Demonstrates technique to conti proper ET tube placement by physica exam and by using an oxtsled GO, device + Secures ET tube + Suctons with ET tube place Endotracheo! intubation "Prepares equpment for ET intubation + Insets ET tube corectyALS Coe Case Teng Checklist ‘Amor Respiratory Core Case 1 Hoste Upper Airway Obstruction ‘Association: ‘Student Name: Test Date: Critical Performance Steps ee Assigns team mombor oes ‘Uses efactve communication troughaut Directs assessment of airway, breathing, cicuaton,dsabity, and exposure, nud vital sons Discs manual away manewee with admination of 70036 oxygen Diets placement of patisads and pulse oximetry Recognizes signe and symptoms of upper away abstuction Catogorz a5 respatory dstess fale ‘Verbalizes indations for selsted vnilatons or CPAP 1 the studeot dows not verbatzo the above, prompt the student with the folowing question: What are the nlcatons {or assisted vetiatone or CPAP?" Directs W oO access Dects reassessment of paint in response to treatment ‘Summeraes specific westmants fr upper away ebstiction \orbalzs incicaton fox endotachoa intubation and special considerations when intubation ie vipated 17 student cows not varbalze the above, prompt the student wit io flowing question: “What are the Iations for endotracheal intubation, and what are the special stuns when intubation should be anicpated?” stop Test The student drools or verbalzes any gros inappropriate ation or the Sudont needs renedation,dassrbe spect blow Tate Pass P) or Needs Remediation (NRF Instroctor Signature: Ineractor Nam rin: “Tost Results Instructor sonatas that student prormed according to AHA Guidelines. ‘Soe thie shoot with course rcora Date——— senaean Respiratory Core Case 3 @ rer Lung Tissue Disease fiero tae akan er Veer fete cormanlon oi [ei ns Sea] Dies seer of vay trang cen chabay nd eeoery leg Viel ne Diath rian o 10% og Erne et ara ie ec pacer pda an pe ome esas sd npn fing eae Soe Cogn aay es ae rc Ver aos ‘Docs eassecsmont of pant in esponse to veatmant ‘te student does 001 summarize the above, prompt te student withthe flowing question: “What are the specie trestments forking tissue disease?” ‘The folowing step fs evaluated ony f the students Scope of practice apes \Verbalzes Inccatons for endotracheal tubation 1 the student doesnot verbalize the above, prompt the student wit he following question: “What ae the indications forendotrachea! intubation?” ‘STOP TEST Tithe student drocs or varales any sly napproprate action or the student needs venedation, describe specties below: Tra Pos War Reds Ronnies WH] P| wa] Tnsrutorslgnatre afire that student | Instructor Signatie: performed according to AHA Gulden, Instructor Namo (rin ‘Save thi sheet with course record. atePALS Core Case Testing Checks Shock Core Case 5 bpd Hypovolemic Shock ‘Association. ‘Student Name: Cy ead ‘Assigns team member oes ‘Uses effective communication throughout Drools agsegsmant of arway breathing, crculation,csabily, and exposure, inctdng vital signs Dis eariaton of 10% coe cs pace peat we ae oa esis re yon foo sac Cgofn conpeneld pene ac res Vera Crea pl ernsreion ofa bobo nolo yaa seen fal epeee rater Ree See | [at pe et ere dring ook merger Ife student doesnot verbalize the above, prompt the student wit tho flowing question: "What are the therapeu ond points during shock management?” ‘STOP TEST Tite student arociso verbalzes any ross appropiate acon or he stadent needs remaclation, describe spect below [Testronns | retorts ened wae. _P [a _] Tnsrtorelgnatre afr tat student] insructorSignatre: performed according to AHA Guanes, ‘Save this sheet with course reco Instructor Name pint DatePALS Core Case Testing Checklet Shock Gore Case 7 nan Distributive Shock ‘Association, Student Name; at te ‘Assigns team member ris Use fective communication throughout Diocts ascesemont of airway, breathing, ckcultio, dsabilly, and exposure, ckdng via lgne ‘Dies ainistaton of 700% oxynen ‘ects placoment of paces and pute oximetry Recognises signs and symptoms of cstbutve (cept shock ‘ategorizes as Compensated or hypotensive shock recs or 1 access cts rap adminstation ofa Rud bole of tone oystalon Drects reassessment of patent in response to wean The net Stp is evaluated only te student's so9pe of practice app Fecal tha ery acniitration of antticice le enon neoptieahook Ifthe stent doesnot inccate te above, prompt te student withthe folowing question: "What else mnt be essen ti for soptie shock?" ‘Summaries Inccstion for vasoxctive dug support ifthe student doesnot surmarie the above, promot te student withthe elowing question: "Wha are the inca tons for vasoactive drug support?” \Verbaizesthaapautc end points durin shock management Ifthe student does not verbal the above, promt the student with he folowing question: “Wht ere the therapeutic 2nd pols cunng shock management? ‘STOP TEST 1 the stadt drects or verbalzes ay gros nappropta acon orl the sudent rede remediation, describe species bow: Toot Rosul "Por Needs Remediation (A Insructor lgnature atfeme tat student] ierutor Signature performed according to AHA Guidelines. ‘Save this sheet wih course record. Insuctor Nam (rin atePALS Cove Case Testing Chactt Cardiac Core Case 9 Heart” ‘Supraventricular Tachycardia ‘Association. Student Name: Critical Performance Steps Assign team member 96 Uses efetve communication troushout Deects assessment of airway, breathing, ckeulstion,csabily, and exooei, intudng vital sans Directs administration of supplementary oxygen Directs placement of padseads and pulse oximetry ‘Recognizes narrow-complex tachycardia and verbalize how to dstinguish between ST and SVT (Catagorzes as Compensated or hypotensive "te student doesnot verbalize the above, prompt the Student with the flowing question: “ow do you etinglsh between ST and SUT?" Dist perfomance of appropriate vagal manowers Dts W oO acce68 Discs preparation and administration of appropriate does of adenosine Directs reassessment of paint in response to treatment \erbalizes indications anc appropriate energy doses fr synchronize cardioversion the student doesnot verbalize the above, prompt the student with the flowing question: What ae the indatons| nd appropriate anergy doses for synclvenzed carcovarsion?* stop Test Tie stadt rects or verbalizes ny grossly appropiate acton orf the student needs remediation, describe specs blow: [TeResute | ___tccato Pas) orNoode Remediation me] Tnsrutor signature arms that tudent | rstrctor Signature arlormed accoring to AHA Gulcesnes ‘Save he shoot with course recor Irstuctor Name (rin Date @|PALS Core Caso Testing Checkiet ‘American Heart Association, “Toot Date ‘Assign team membres ‘Uses efectve communication troughout Recognizes cardiopulmonary arest ‘Deets ination of CPR by using the G-A-B Sequence and ensures prformance of high-qualty CPR at al times Dects placement of paved and actvaton of monitor Recognizes asystoleor PEA Dec 10 or aozee8 Dects preparation of appronrite dose of pinephine Dts aminstaton of epnepine at appropiate nerve ‘Dace checking rythm onthe monitor proximally every 2 minutes ‘Veroaies consideration of at east 3 oversbe causes of PEA or anystol Irie student dows not vembalze the above, prompt the student wth he fllowing statement: Tol me atleast 3 revers- Ib caus of PEA or ays." ‘stop Test Te stadt arects or verbales any grossly Mapproprata action or W the Sudan reads emediaon, Goscbe specties below: [Textron [rei Pos erent Reneamtan | Tnstctorelgnatre aire tat ucent | Inerutor Signature perlormed socotng lo AHA Guidelines. Inatuctr Name (pt ‘Save this shoot with course recor Date