ACLS Skills Checklist

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ACLS​ 

​Advanced Cardiac Life Support​ ​ Skills Checklist


Student Name:​ _________________________________________ ​Test Date:​ ________________________ 

ACLS Bag-Mask Ventilation  Check if done 
correctly 
Testing Checklist Performance Guidelines and Critical Actions 
BLS Survey and Interventions 
Checks for responsiveness
● Taps and shouts, “Are you alright?”
● Scans check for movement (5-10 seconds)

Activates the emergency response system


● Activates the emergency response system and gets the AED
Or
● Directs second rescuer to activate the emergency response system and get the AED

● Check carotid pulse (5-10 seconds). Note that pulse is present


● Does not initiate check compressions or attach AED
● Performs ventilations at the correct rate of 1 breath every 6 to 8 seconds (10-12 breaths
per minute)

ACLS Survey Case Skills 
Inserts oropharengeal or nasopharengeal airway

Administer oxygen

Performs correct bag-mask ventilation for 1 minute

Critical Actions 

Effectively ventilates with a bag-mask device for 1 minute 

Gives proper ventilation - rate and volume 
ACLS​ ​Advanced Cardiac Life Support​ ​ Skills Checklist
Student Name:​ _________________________________________ ​Test Date:​ ________________________ 

Check if done 
Steps Adult/Child/ BLS - 1 and 2 Responders correctly 

First Rescuer Bag-Mask Ventilation 
● Note: Evaluate the first rescuer’s ability to give breaths with a bag mask.

Checks for responsiveness: Taps and shouts, “Are you all right?” and scans 
1  the chest for movement (5-10 seconds) 

2  Tells someone to activate the emergency response system and get an AED 

3  Checks carotid pulse (minimum 5 seconds, maximum 10 seconds) 

4  Bares patient’s chest and locates CPR hand position 

Delivers first cycle of compressions. Adult: 30 compressions Child: 15


5  compressions. 

6  Gives 2 breaths (1 second each) 

Delivers second cycle of compressions at correct hand position (acceptable: 
7  greater than 23 of 30 compressions) 

8  Gives 2 breaths (1 second each) with visible chest rise 

▢ PASS    ▢ Needs Retest

Instructor Name:​ _________________________________________  ​Date:​ __________________ 

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