FOOTHILL COLLEGE
Candidate Name: _________________________________________ Date: ______________________
Examiner Name and Signature: _________________________________________________________
Time Started: __________ Time Ended: __________ Points: _____/11 PASS/FAIL (Circle One)
| Points Possible | Points Awarded | |
| Checks patient responsiveness | 1 | |
| Assesses breathing and pulse simultaneously | ||
| - Assesses patient for signs of breathing (observing patient and determining the absence of breathing or abnormal breathing [gasping/agonal respirations]) | 1 | |
| - Checks carotid pulse for no less than 5 seconds & no more than 10 seconds | 1 | |
| Immediately begins chest compressions at an adequate depth and rate, allowing chest to recoil completely | 1 | |
| Requests additional EMS response | 1 | |
| Performs 2 minutes of high quality, 1 rescuer adult CPR
- Adequate depth and rate - Correct compression to ventilation ratio - Allows complete chest recoil - Adequate volumes for each breath - Minimal interruptions of <10 seconds |
1 | |
| AFTER 2 MINUTES (5 CYCLES), PATIENT IS REASSESSED AND SECOND RESCUER RESUMES COMPRESSIONS WHILE CANDIDATE OPERATES AED | ||
| Turns on power to AED | 1 | |
| Follows prompts and correctly attaches AED to patient | 1 | |
| Stops CPR and ensures all individuals are clear of patient during rhythm analysis | 1 | |
| Ensures all individuals are clear of patient and delivers shock from AED | 1 | |
| Immediately directs rescuer to resume chest compressions | 1 | |
Points Possible: 11 Total Points Awarded_______________
Critical Criteria
____ Failure to immediately begin chest compressions when pulselessness is confirmed
____ Failure to deliver shock in a timely manner
____ Interrupts CPR for more than 10 seconds at any point
____ Failure to demonstrate acceptable high-quality 1-rescuer adult CPR
____ Failure to operate or attach AED correctly
____ Failure to assure all individuals are clear of patient during rhythm analysis and when delivering shock
____ Failure to immediately resume chest compressions after shock
____ Failure to manage patient as a competent EMT
____ Uses or orders dangerous or inappropriate intervention