GOLDEN GATE COLLEGES

P. Prieto St., Batangas City

COLLEGE OF NURSING

Nursing Care Management 118

Procedural Checklist in Basic Life Support

Name: ____ Year/Sec: __ Rating:

General Objective:

Given an actual or simulated situations/conditions, the students will be

able to systematically demonstrate appropriate application of the BLS procedure
especially during emergency situations.

Specific Objectives:

1. Define BLS
2. State the purpose of BLS
3. Enumerate the reasons for rescuers to stop CPR
4. To perform an appropriate BLS to an emergency patient

Item Weight Descriptors Verbal Interpretation

1.50 Excellent Performed the procedure with great ease and

confidence, observing work ethics (prudent, accepts
criticisms and suggestions), able to rationalize
scientifically and always shows diligence in documenting
observations.

1 Very Performed the procedure with less confidence, observing

work ethics (prudent, accepts criticisms and
Satisfactory suggestions), able to rationalize scientifically and shows
minimal diligence in documenting observations.

.75 Satisfactory Performed the procedure but requires close supervision

and shows potential for improvement.

.50 Needs Failed to perform the procedure, unable to function well

and needs repeated specific/ detailed guidance or
Improvemen direction.
t
 GOLDEN GATE COLLEGES
P. Prieto St., Batangas City

COLLEGE OF NURSING

CRITERIA:

I. Skills 1.50 1 .75 .50 Remarks

1. Survey the scene for safety and number of

casualties.
2. Check for the availability of PPEs.

3. Introduce self (name, trained first aider, how may I

help?)

4. Explain to the purpose of the procedure.

5. Assess the patient. Check for responsiveness. If

unresponsive, call for help.

6. Check the airway and identify for foreign body

obstruction. Perform head-tilt, chin-lift and remove
the cause of obstruction.
7. Check the breathing for not more than 10 sec (Look,
Listen, and Feel).
8. Check for the circulation (carotid or brachial). If
there is no breathing and no pulse, activate medical
assistance.
9. Perform CPR until the rescue arrives.

10. If the patient is revived before the rescue arrives,

place the client in a recovery position.

COMMENTS:

Strengths:

Weaknesses:

CONFORME: EVALUATED BY:

____________________________ _______________________________
Signature over Printed Name Signature Over Printed Name

Student Clinical Instructor