CPR CHECKLIST

DONE
PROCEDURE
YES NO
1. Survey the scene. “The scene is safe.”
2. Identify yourself. “I’m _____________, a trained first aider.”
3. “Please activate medical assistance or transfer facility while
I’m checking the victim.”
4. Check responsiveness. “Hey, hey, are you ok?”
5. (If unresponsive). Open the mouth and open the airway (head
tilt, chin lift). Check for any obstruction. If no obstruction,
proceed to no. 6. “No obstruction seen.”
6. Check the breathing. LLF: “1, 1002, 1003, 1004, 1005”
7. If negative breathing, give 2 initial ventilation
8. If air bounces back. Reposition the head then re-tilt, then give
another 2 ventilation. If air still bounces back, follow up
medical assistance and perform chest thrusts.
a. 5 for child and adult
b. 5 back blows and 5 chest thrusts for infant
9. Check the airway again, if obstruction seen, do finger sweep to
remove obstruction.
10. Check the breathing again LLF: 1, 1002, 1003, 1004, 1005
11. If negative breathing, give two initial ventilation, if air enters.
12. Check for circulation/pulse: carotid for child and adult; brachial
for infant. LLF: 1, 1002, 1003, 1004, 1005, 1006, 1007, 1008,
1009, 1010
13. If has negative breathing and negative pulse. “Follow up
medical assistance while I’m doing CPR.”
Compression:
1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20,
21, 22, 23, 24, 25, 26, 27, 28, 29, 30

2 ventillation

Do it for 5 cycles
14. After CPR, Re-asses the victim. Check the pulse.
15. If negative breathing but positive pulse: perform Rescue
breathing
a. Adult: blow, 1, 1002, 1003, 1001 to 1024, blow (2mins)
b. Child and infant: blow, 1, 1001 to 1040, blow (2mins)
16. After rescue breathing, Re-assess the victim, check the pulse.
17. If positive breathing and positive pulse, victim is now revive.
18. Place the victim in recovery position.

Remarks: