Course: First Aid Academic Year: 2020-2021

Cardiopulmonary Resuscitation for Adult Checklist

Student’s Name: ________________________ Sex: ___________________

Group: _______________________________ Evaluate by:___________________

Instruction:

● The video recording must not be less than 5 minutes and not exceed 15 minutes.
● Do not perform CPR on conscious person
● Can be replaced by a pillow, or plush toys

Equipment: CRP manikin

Fully
Need to Unacceptable
No Description Successful
Improve Performance
Performance

1. Check if the victim is responsive

● Shake the victim’s shoulder gently
● Ask the victim “What has happened”
● If the victim is unresponsive

2. Check carotid pulse

● Put 2 finger between the larynx and the
anterior border of the sternocleidomastoid
muscle at the level of the cricoid cartilage
● Palpate not more than 10 seconds
● If you cannot palpate the pulse

3. Ask a helper
● Ask standby to help you call 119

4. Check and remove foreign body from the victim’s

mouth by using 2 fingers

5. Kneel beside the victim level with her/his chest

6. Find and place

● 2 finger on extreme sternum (xiphoid
process)
● Place heel of one hand next to 2 fingers
● Place the heel of another hand on top of
the first hand and interlock the fingers
● Check and make sure the fingers are kept
off the rib

Course: First Aid Academic Year: 2020-2021

Course: First Aid Academic Year: 2020-2021

Chest compression

7. Compress the chest 30 times (rate 100-120/min)

8. Press down vertically on the sternum (dept 5-6 cm

or 2-2½ inch)

9. Count 1 & 2 & 3 & 4 & 5, & 1 & 2 & 3 & 4 & 10,
& 1 & 2 & 3 & 4 & 15, 1 & 2 & 3 & 4 & 20, 1 & 2
& 3 & 4 & 25, 1 & 2 & 3 & 4 & 30.

10. Release the pressure without removing your hands

from victim’s chest

11. Allow the chest to come back up fully (recoil)

before giving the next compression

Give 2 rescue breaths (mouth-to-mouth)

12. Put one hand on the victim’s forehead and 2 fingers

of another hand under the tip of the victim's chin. 

13. Move the hand that was on the forehead down to

pinch the soft part of the nose with the finger and
thumb. Allow the victim’s mouth to open.

14. Make sure that the nostrils are closed to prevent air
from escaping.

15. Take a deep breath & place your lips around the
victim’s mouth.

16. Rescue 1st breath by blowing into the victim’s

mouth until the chest rises (A complete rescue
breath takes 1 second).

17. Keep head tilted and chin lifted, take your mouth
off & look to see the chest fall then give 2nd breath.

18. The chest rises visibly and falls fully in each blow.

19. Complete 5 cycles (complete 2 minutes) of 30:2

then check carotid pulse

20. Continue CPR until the emergency help arrives and

takes over or continue CPR until the victim
responds (breathe, cough, speak, open eyes, or
move)

Course: First Aid Academic Year: 2020-2021

Course: First Aid Academic Year: 2020-2021

Course: First Aid Academic Year: 2020-2021