Department of Health

HEALTH EMERGENCY MANAGEMENT BUREAU

BASIC LIFE SUPPORT TRAINING

1 and 2 Rescuer Adult CPR, BVM and AED Skills Sheet
for Out of Hospital Cardiac Arrest (OHCA)
Put a check ☑
Skill Steps CRITICAL PERFORMANCE CRITERIA mark if done
correctly
FIRST RESCUER EMERGENCY ACTION PRICIPLE (EAP) SKILLS EVALUATION: Evaluate the participant’s ability to initiate BLS.
EAP 1 Check for scene safety. For IPC purposes, PPE on: Gloves, Mask etc.
LR: Introduce yourself and check for responsiveness by tapping shoulders and simultaneously
EAP 2 look for breathing and movement.
HCP: Introduce yourself and check for responsiveness by tapping shoulders.
If victim is UNRESPONSIVE,
a. Shout for nearby HELP or activate emergency response system:
 via mobile device
EAP 3
 asking a bystander to call for help
 use of social media to summon rescuers via a life-saving application (if available)
b. Get an AED and BVM (for 2 rescuers). As possible, send someone to do so.
EAP 4 HCP only: Locate and check the carotid pulse for no more than 10 seconds.
EAP 5 Cover the victim’s mouth and nose with mask or cloth.
FIRST RESCUER CPR SKILLS EVALUATION: Evaluate the participant’s ability to deliver HIGH-QUALITY CPR for 5 cycles.
CORRECT HAND PLACEMENT AND COMPRESSION SITE:
CPR 1
(Hands interlocked placed on the center of the victim’s chest on the lower half of the sternum)
ADEQUATE RATE: Time
CPR 2
Compression at 100-120/min (delivers each set of 30 chest compressions in 15-18 seconds) recorded:
ADEQUATE DEPTH: Delivers compressions at least 2 inches - 2.4 inches/ 5 to 6 cm in depth (at least 23 Number
CPR 3
correct depths out of 30). recorded:
Number
CPR 4 ALLOWS COMPLETE CHEST RECOIL (at least 23 complete chest recoil out of 30).
recorded:
CPR 5 MINIMIZE INTERRUPTIONS (less than 10 seconds between cycle of chest compressions)

CPR 6 NO EXCESSIVE VENTILATION (each breathe done in 1 second)

SECOND RESCUER AED SKILLS EVALUATION: Evaluate the participant’s ability to operate AED using PAAS.
During the 5th set of compressions: SECOND RESCUER arrives with PPE on, carrying the AED and BVM device.
AED 1
He/she introduces himself/herself and starts AED operation by: Power on.
AED 2 Selects proper AED pads and Attach pads correctly.
Ensure that no one touches the victim (must be visible through hand gesture and done verbally) to allow the
AED 3
AED Analyze heart rhythm.
AED 4 If shock is advised, ensure that no one touches the victim before pressing the Shock button.

RESCUERS SWITCHING ROLES: Bag Valve Mask Ventilation and Resumption of High Quality CPR

1 SECOND RESCUER gives 30 chest compressions after shock delivery (5 cycles)

2 FIRST RESCUER delivers 2 ventilations via BVM (5 cycles).

3 BOTH RESCUERS continue HIGH QUALITY CPR while switching roles.

4 FIRST RESCUER gives 30 chest compression after shock delivery of the SECOND RESCUER.

5 SECOND RESCUER delivers 2 ventilations via BVM after 30 chest compressions.

Upon analyzing heart rhythm by the AED and SHOCK is NOT INDICATED, the FIRST RESCUER shall:
6 a. Check Responsiveness and breathing (for LR)
b. Check Pulse and breathing (for HCP)
RECOVERY POSITION: Evaluate the participant’s ability to place the victim in recovery position
If the victim becomes responsive, with breathing, and pulse (HCP only), place the victim in
Recovery Position.

Initiate BLS Skills P NR Remarks:

CPR Skills P NR Remarks:
Test Results AED Skills (as 2nd Rescuer) P NR Remarks:
Rescuers Switching Roles w/ BVM Skills P NR Remarks:
Recovery Position P NR Remarks:

Evaluated by: Concurred by:

Signature Over Printed Name | Date Signature Over Printed Name | Date
FACILITATOR PARTICIPANT