Heartsaver
®
Child CPR
Skills Testing Checklist
Student Name __________________________________________________ Date of Test _______________________________
Scenario: “You are home alone with a child, and the child suddenly collapses in front of you. The scene is safe and you
have a cell phone with you, but no AED nearby. Demonstrate what you would do next.”
Assessment and Activation
Checks responsiveness
Shouts for help/Phones 9-1-1 on cell phone
Checks breathing
Cycle 1 of CPR (30:2) *CPR feedback devices preferred for accuracy
Child Compressions
Performs high-quality compressions*:
Hand placement on lower half of breastbone
30 compressions in no less than 15 and no more
than 18 seconds
Compresses at least one third the depth of the
chest, about 2 inches (5 cm)
Complete recoil after each compression
Child Breaths
Gives 2 breaths with a barrier device:
Each breath given over 1 second
Visible chest rise with each breath
Gives 2 breaths in less than 10 seconds
Cycle 2 of CPR (repeats steps in Cycle 1) Only check box if step is successfully performed
Gives 30 high-quality compressions
Gives 2 effective breaths
STOP TEST
Instructor Notes
Place a in the box next to each step the student completes successfully.
If the student does not complete all steps successfully (as indicated by at least 1 blank check box), the student must receive
remediation. Make a note here of which skills require remediation (refer to Instructor Manual for information about remediation).
Test Results
Check PASS or NR to indicate pass or needs remediation:
PASS NR
Instructor Initials __________ Instructor Number _____________________________ Date _____________________________
© 2016 American Heart Association
Instructor says, “EMS has arrived and is taking over.”
Cycle 3 of CPR (repeats steps in Cycle 1) Only check box if step is successfully performed
Gives 30 high-quality compressions
Gives 2 effective breaths
Heartsaver
®
Child CPR
Skills Testing Critical Skills Descriptors
1. Assesses victim and activates emergency response system (this must precede starting compressions) within
a maximum of 30 seconds. After determining that the scene is safe:
Checks for responsiveness by tapping and shouting
Shouts for help and phones 9-1-1
Checks for no breathing or no normal breathing (only gasping)
Scans from the head to the chest for a minimum of 5 seconds and no more than 10 seconds
2. Cycle 1: Performs high-quality chest compressions (initiates compressions immediately after recognition of
cardiac arrest)
Correct hand placement
Lower half of breastbone
1- or 2-handed (second hand on top of the first)
Compression rate of 100 to 120/min
Delivers 30 compressions in 15 to 18 seconds
Compression depth and recoil—compress at least one third the depth of the chest, about 2 inches (5 cm)
Use of a commercial feedback device/manikin is highly recommended
Complete chest recoil after each compression
3. Cycle 1: Provides 2 breaths by using a barrier device
Opens airway adequately
Uses a head tilt–chin lift maneuver
Delivers each breath over 1 second
Delivers breaths that produce visible chest rise
Avoids excessive ventilation
Resumes chest compressions in less than 10 seconds
4. Cycle 2: Performs same steps for compressions and breaths as in Cycle 1
5. Cycle 3: Performs same steps for compressions and breaths as in Cycle 1
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