BLS Checklist

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Pamantasan ng Lungsod ng Marikina

Rainbow St., Concepcion Dos, Marikina City


College of Health Sciences

NAME: _______________________________ GRADE: ______________

BLS CHECKLIST - Adult (Single Rescuer)

Skill Tested 5 4 3 2 1

1. The student secures the scene. (Scene is safe)

2. Assesses patient responsiveness. (No pulse present, no breaths


observed; checks for no longer than 10 seconds))

3. Demonstrates correct CPR hand placement and body


positioning over patient.

4. Demonstrates correct compression rate (100-120/min) and


depth (2 in.).

5. Allows for complete chest recoil between compressions.

6. Demonstrates opening the airway (head tilt/chin lift, jaw


thrust).

7. Gives effective breaths, and observes visible chest rise.

8. Have the student perform a second round of CPR. (AED has


arrived, switch providers giving compressions)

9. Demonstrates correct placement of AED, without interrupting


CPR. (AED analyzes rhythm)

10. Demonstrates correct position once the patient recovers.

TOTAL: 50 = 100%

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