EVAC CPR Program Heartsaver Child CPR Skills Testing Checklist

Child CPR Skills Testing Checklist

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

MonthDayYear
Date
Scenario: “You are at a park and notice a child suddenly collapse. The scene is safe and you have a cell phone with you but no AED nearby. Demonstrate what you would do next.
Assessment and Activation*

Checks responsivenessShouts for help/Sends someone to phone 9-1-1Checks breathing
Once student shouts for help, instructor says, “Here's the barrier device. I am going to phone 9-1-1 and get the AED.”
Cycle 1 of CPR (30:2)
Child Compressions*

Performs high-quality compressions*:
- Hand placement on lower half of breastbone
- 30 compressions in no less than 15 and no more than 18 seconds
- Compresses at least one third the depth of the chest, approximately 2 inches (5 cm)
- Complete recoil after each compression
Child Breaths*

Gives 2 breaths with a barrier device
- Each breath given over 1 second
- Visible chest rise with each breath
- Gives 2 breaths in less than 10 seconds
Cycle 2 of CPR (repeats steps in Cycle 1) Only check box if step is successfully performed*

Gives 30 high-quality compressionsGives 2 effective breaths
Cycle 3 of CPR (repeats steps in Cycle 1) Only check box if step is successfully performed*

Gives 30 high-quality compressionsGives 2 effective breaths
Instructor says, "EMS has arrived and is taking over."
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 student must receive remediation. Make a note here of which skills require remediation (refer to instructor manual for information about remediation
Test Results Check PASS or NR to indicate pass or needs remediation:*

PASSNR
Instructor Name & Number*
Date*

MonthDayYear
Date
Should be Empty:

Child CPR Skills Testing Checklist

Cycle 1 of CPR (30:2)

STOP TEST