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Name Period

CPR Skills Test-Adult

Adult

1. Survey the scene(2pts)


2. Check for consciousness(2pts)
3. Call 911(2 pts)
4. Open Airway(2pts)
5. Check breathing 10 seconds
a. Look(1pt)
b. Listen(1pt)
c. Feel(1pt)
6. Give 30 compressions
a. Hand placement (1pt)
b. Body positioning (1pt)
c. Number of compressions(1pt)
d. Depth of compressions (1 pt)
e. Pacing (1pt)
7. Give 2 breaths
a. Pinch nose(1pt)
b. Make chest rise(1pt)
8. Repeat cycles of compressions and breaths (2pts)

TOTAL / 20pts
Name Period

CPR Skills Test-Child

Child

1. Survey the scene(2pts)


2. Check for consciousness(2pts)
3. Call 911(2 pts)
4. Open Airway(2pts)
5. Check breathing 10 seconds (2pts)
6. Give 2 breaths
a. Pinch nose (1pt)
b. Make chest rise (1pt)
7. Scan for severe bleeding (1pts)
8. Give 30 compressions
a. Hand placement (1pt)
b. Body positioning (1pt)
c. Number of compressions(1pt)
d. Depth of compressions (1 pt)
e. Pacing (1pt)
9. Give 2 breaths and repeat cycles of CPR(2pts)

TOTAL/ 20pts
Name Period

CPR Skills Test-Infant

Infant

1. Survey the scene(2pts)


2. Check for consciousness(2pts)
3. Call 911(2 pts)
4. Open Airway(2pts)
5. Check breathing 10 seconds (2pts)
6. Give 2 breaths
a. Cover nose and mouth (1pt)
b. Make chest rise (1pt)
7. Scan for severe bleeding (1pts)
8. Give 30 compressions
a. Hand placement (1pt)
b. Body positioning (1pt)
c. Number of compressions(1pt)
d. Depth of compressions (1 pt)
e. Pacing (1pt)
9. Give 2 breaths and repeat cycles of CPR (2pts)

TOTAL/ 20pts

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