Competency-Checklist-for-CardioPulmunary Rescuitation

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Competency on Cardiopulmonary Resuscitation (Adult)

Name _________________________________________________________________ Date_________________


Teacher______________________________________________________________

1. Survey the scene, the scene is safe I am (state your name) Able to Able to Unable Initials
Perform Perform with to and
trained first aider Can I help? Assistance Perform Date

2. Please activate Medical Assistance and transfer facility


and report back

3. Check the consciousness and responsiveness of the victim


(By tapping twice at the shoulder of the victim
“Hey ma’am/sir are you ok?” (2x)

4. The victim is unresponsive, check airway


(Head, Tilt, Chin lift)
Airway is clear, No obstruction
5.Check Breathing for at least 10 seconds
(Count 1001-1010)
6. The victim is breathless I will give two initial ventilatory
maneuver(BUGA ,LLF )2x
Check Breathing (Count 1001-1010)

7. The victim has no signs of circulation and breathless, I’ll


perform CPR
Count 1-20, 1-9 and 1 (BUGA LLF Twice) repeat counting up
to 5 cycle
Check breathing (Count 1001-1010)

8.The victim has a sign of circulation but still breathless, I’ll


perform rescue breathing
(BUGA then Count 1-1002, 1003, 1001
BUGA (1, 1002, 1003, 1002)
Buga( 1, 1002, 1003, 1003 up to 1024)
Check Breathing Count 1001-1010

9. The victim has a sign of circulation and now breathing,


Place the victim in a recovery position
1. Survey the scene, the scene is safe I am (state your name) Able to Able to Unable Initials
Perform Perform with to and
trained first aider Can I help? Assistance Perform Date

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