DE LA SALLE LIPA

COLLEGE OF NURSING

Nursing Care Management 118

Procedural Checklist in
Cardiovascular Resuscitation

Name: Year/Sec: Rating:

General Objective:
The students will be able to perform the Cardiopulmonary Resuscitation safely and accurately

Specific Objectives:
1. To identify the indications of Cardiopulmonary Resuscitation.
2. To perform complete and proper assessments before, during and after the procedure.
3. To implement the correct techniques in Cardiopulmonary Resuscitation as well as initiating and
discontinuing the treatment.

CRITERIA:
Item Weight Descriptors Verbal Interpretation

2.0 Excellent Performed the procedure with most ease and confidence, observing work
ethics (prudent, accepts criticisms and suggestions), able to rationalize
scientifically and always shows diligence in documenting observations.
1.5 Very Good Performed the procedure with more confidence and requires close
supervision, observing work ethics (prudent, accepts criticisms and
suggestions), able to rationalize scientifically and shows minimal diligence in
documenting observations.
1.25 Good Performed the procedure with less confidence and requires close
supervision, observing work ethics (prudent, accepts criticisms and
suggestions), able to rationalize scientifically and shows minimal diligence in
documenting observations.
1 Needs Failed to perform the procedure, unable to function well and needs repeated
Improvement specific/ detailed guidance or direction.

I. Values Based 2.0 1.5 1.25 1 Remarks

1. Establish Unresponsiveness. First tap the victim and
shout.“HEY!HEY! Are you OK?”
2. Check for Breathing
Absent or abnormal breathing by watching the chest for movements
for 5 to 10 seconds.
3. Use the head tilt–chin lift maneuver to open the airway. Place one
hand on the victim’s forehead and apply firm, backward pressure
with the palm to tilt the head back. Place the fingers of the other
hand under the bony part of the lower jaw near the chin and lift the
jaw upward to bring the chin forward and the teeth almost to
occlusion.
4. If trauma to the head or neck is present or suspected, use the jaw-
thrust maneuver to open the airway. Place one hand oneach side of
the patient’s head. Rest elbows on the flat surface under the
patient, grasp the angle of the patient’s lower jaw, and lift with both
hands.
II. Knowledge Based
5. Check for Pulse
Simultaneously check the carotid pulse for a minimum of 5
seconds—but no more than 10 seconds—to determine if there is a
pulse present.

. 6. Call a code
7. If the patient is without signs of circulation, position the heel of one
hand in the center of the chest between the nipples, directly over the
lower half of the sternum. Place the other hand directly on top of the
first hand. Extend or interlace fingers to keep fingers above the
chest. Straighten arms and position shoulders directly over hands.
.
 8. Perform 30 chest compressions at a rate of 100 per minute, counting
“one, two, etc.” up to 30, keeping elbows locked, arms straight, and
shoulders directly over the hands
9. Give two rescue breaths after each set of 30 compressions. Do five
complete cycles of 30 compressions and two ventilations
10. Place the Electrodes (ask someone to place the electrodes)
11. Assess for the Rhythm
a. Shockable Rhythm
Administer shock

b. Non-Shockable Rhythm
Administer Epinephrine
Continue CPR
12. Do the Pulse Check (After 2 minutes)
a. With No pulse
Continue CPR
b. With pulse
position the patient in recovery position
III. Outcome Oriented
13. Identify Reversible Causes (5Hs and 5Ts)
IV. Leadership and Governance
14. Do hand hygiene

15. Document the procedure

Comments / Strengths & Weaknesses:

Conforme: Evaluated by:

Student’s Signature Clinical Instructor’s Signature

Date: Date: