BACHELOR OF SCIENCE IN NURSING

RLE UNIT SKILLS CHECKLIST WEEK

NCMA 219 PEDIATRIC CARDIOPULMUNARY RESUSCITATION LF2F | 02

PERFORMING BASIC LIFE SUPPORT – INFANT (Single Rescuer)

PROCEDURE: 4 3 2 1
1. Surveys and secures the scene. (Scene is safe)
2. Assesses victim and activates emergency response system (this must precede
before starting compressions) within 30secs. after determining that the scene is safe.
a. Checks for responsiveness by tapping gently the infant’s foot or shoulder and
shouting.
b. Checks for breathing (no breathing or gasping) by scanning from head to chest
for a minimum of 5 secs. and no more than 10 secs.
c. Checks brachial pulse for a minimum of 5 seconds and no more than 10 secs
(can be done simultaneously with checks for breathing).
3. Demonstrate / perform correct CPR placing fingers in the center of the chest and with
correct body positioning over patient. (Must be initiated within 10 seconds of
identifying cardiac arrest)
4. Demonstrates correct compression rate (100-120/min) and depth (1.5 in. or 4cm).
5. Allows for complete chest recoil between compressions.
6. Provides effective breaths with a barrier device, and observes visible chest rise.
7. Have the student perform a second round of CPR. (AED has arrived, switch providers
giving compressions)
8. Demonstrates correct placement of AED, without interrupting CPR. (AED analyzes
rhythm)
9. Student clears patient for rhythm check and shock. (Shock delivered)
10. Student immediately returns to CPR after shock delivered.
SCORE ( / 56 ) * 100 = .

Scale:
4 – Exemplary (Competent and Independent)
3 – Proficient ( Requires minimum guidance)
2 – Satisfactory (Requires frequent guidance)
1 – Developing (Requires close guidance)

Name: Section & Group:

Grade:
Signature over Printed Name of Clinical Instructor Date:

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