EVAC CPR Program Heartsaver First Aid Skills Testing

EVAC CPR Program First Aid Skills Testing Checklist

Heartsaver CPR/AED/First Aid
Student Name*
Date of Test*

MonthDayYear
Date
Scenario: "EMS has arrived and has taken control of the situation. You may now remove your gloves. Explain what you would do next."
Removing Gloves*

Grips one glove on the outside, near the cuff, to peel it off.Cups the inside-out glove with the gloved hand.Places 2 fingers of the bare hand inside the cuff to peel the second glove off, with the first glove inside itVerbalizes the need to dispose of the gloves properly
Scenario: "You come across a coworker on the floor in the break room. Nearby, there's a phone, a first aid kit, and an AED mounted on the wall. Describe how you would assess the situation."
Finding the Problem*

Verbalizes that the scene is safeTaps and shouts*Shouts for help/Phones 9-1-1/Gets the first aid kit and AEDChecks breathing†Looks for injury and medical information jewelryVerbalizes that he or she will stay with the person until EMS arrives
*Following the student's tapping and shouting, the instructor remarks, "The individual is unresponsive."

†Upon the student's confirmation of checking for breathing, the instructor notes, "The individual is breathing normally."

‡Upon the student's examination for injuries and medical jewelry, the instructor states, "There are no injuries, and no medical jewelry is present."
Scenario: "A coworker is experiencing a severe allergic reaction, has an epinephrine pen, and requires assistance in using it. You've completed all preceding steps and are prepared to administer the epinephrine pen. Having reviewed the manufacturer's instructions indicating a 3-second injection, explain what your next actions would be."
Using an Epinephrine Pen*

Holds epinephrine pen in fistTakes off safety capHolds leg in place; presses epinephrine pen firmly against outer side of thigh for 3 secondsRemoves epinephrine penRubs injection site for 10 seconds
Scenario: "You will illustrate the procedure for managing bleeding and subsequently applying a bandage to a minor cut on the person's forearm. Equipped with the first aid kit, you are prepared to initiate the process."
Controlling Bleeding and Bandaging*

Verbalizes putting on gloves, and places pressure over cut with a clean dressingPresses harder to ensure that bleeding is stopped†Applies bandages over the dressings
*Following approximately 15 seconds, the instructor remarks, "The bleeding persists."

After an additional 5 seconds, the instructor states, "The bleeding has ceased."
STOP TEST
Instructor Notes

• Place a check in the box next to each step the student completes successfully.

• If the student does not complete all steps successfully (as indicated by at least 1 blank check box), the studentmust receive remediation. Make a note here of which skills require remediation (refer to instructor manual forinformation about remediation)
Test Results Check PASS or NR to indicate pass or needs remediation:*

PASSNR
Instructor Name & Number*
Date*

MonthDayYear
Date
Should be Empty:

EVAC CPR Program First Aid Skills Testing Checklist

STOP TEST