Skill Performance Sheets

Student Name______________________ Date ____________

*If victim is breathing or resumes effective breathing, place in recovery position.

 Infant One-Rescuer CPR
 Performance Guidelines Performed 
 1. Establish unresponsiveness. If second
     rescuer is available, have him or her
     activate the EMS system.
 2. Open airway (head tilt–chin lift or jaw
     thrust). Check breathing (look, listen,
     feel).*
 3. Give 2 slow breaths (1 to 1½ seconds per
     breath), watch chest rise, allow for
     exhalation between breaths.
 4. Check brachial pulse. If breathing is
     absent but pulse is present, provide
     rescue breathing (1 breath every 3
     seconds, about 20 breaths per minute).
 5. If no pulse, give cycles of 5 chest
     compressions (rate, at least 100
     compressions per minute) followed by
     1 slow breath.
 6. After about 1 minute of rescue support,
     check pulse.* If rescuer is alone, activate
     the EMS system. If no pulse, continue
     5:1 cycles.

Comments _________________________________________

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Instructor __________________________________________

Circle one:     Complete     Needs more practice