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College of Nursing
CPR FOR ADULT
Name:____________________________________________________Date:__________________Score:______
Procedure: 5 4 3 2 1
1. Check the scene for immediate danger. Make sure you're not putting
yourself in harm's way by administering CPR to someone unconscious.
Is there a fire? Is the person lying on a roadway? Do whatever is
necessary to move yourself and the other person to safety.
2. Assess the victim's consciousness. Gently tap his or her shoulder and
ask "Are you OK?" in a loud, clear voice. If he or she responds, CPR is
not required. Instead, undertake basic first aid and take measures to
prevent or treat shock, and assess whether you need to contact
emergency services.
3. Send for help. The more people available for this step, the better.
However, it can be done alone. Send someone to call for emergency
medical services (EMS).
4. Do not check for a pulse. If you're not a trained medical professional,
odds are you'll spend too much valuable time looking for a pulse when
you should be doing compressions.
5. Check for breathing. Put your ear close to the victim's nose and mouth,
and listen for slight breathing. If the victim is coughing or breathing
normally, do not perform CPR. Doing so could cause the heart to stop
beating.
6. Place the victim on his or her back. Make sure he or she is lying as flat
as possible - this will prevent injury while you're doing chest
compressions.
7. Place the heel of one hand on the victim's breastbone, exactly between
the nipples.
8. Place your second hand on top of the first hand, palm-down
9. Position your body directly over your hands, so that your arms are
straight and somewhat rigid.
10. Perform 30 chest compressions. Press down with both hands directly
Direction : On the right hand column, kindly check extent of the performance of the
Health Care Services student in carrying the different tasks and
responsibilities.
5 - Outstanding - The clinical objective has been met with a high level of
competency, beyond expectation.
4 - Very Satisfactory - The clinical objective has been met at a level exceeding
expectation.
3 - Satisfactory - The clinical objective has been met by the student.
2 - Fair - The clinical objective has been minimally met by the
student.
1 - Poor - The clinical objective has not been met by the student.
over the breastbone to perform a compression, which helps the heart
beat. Chest compressions are more critical for correcting abnormal
heart rhythms (ventricular fibrillation or pulseless ventricular
tachycardia).
11. Minimize pauses in chest compression that occur when changing
providers or preparing for a shock. Attempt to limit interruptions to
less than 10 seconds.
12. Make sure the airway is open. Place your hand on the victim's forehead
and two fingers on their chin and tilt the head back to open the airway.
13. Give two rescue breaths (optional). The American Heart Association no
longer considers rescue breaths necessary for CPR, as the chest
compressions are more important. You can give them if you choose to,
though.
14. Repeat the cycle of 30 chest compressions. If you're also doing rescue
breaths, keep doing a cycle of 30 chest compressions and 2 rescue
breaths.
15. Continue CPR until someone takes over for you, emergency personnel
arrive, you are too exhausted to continue, an AED is available for
immediate use, or signs of life return.
16. Use an AED (automated external defibrillator). If an AED is available in
the immediate area, use it as soon as possible to jump-start the victim's
heart.
__________________________ ________________________
Students Signature Clinical Instructor Signature
Over Printed Name
