Airway Skills Competency Checklist

Airway Skills Competency Checklist - ACLS provider course

"*" indicates required fields

Participant Name:*

Date*

Competences

Discuss the difference between high flow and low flow Oxygen*

Checked if correctly done

Not Done Correctly

Opens airway using head-tilt/chin-lift technique, or jaw-thrust maneuver*

Checked if correctly done

Not Done Correctly

Suction if needed by using a soft or rigid catheter, not exceed 10 seconds.*

Checked if correctly done

Not Done Correctly

States the indications of NPA and OPA*

Checked if correctly done

Not Done Correctly

Select the proper size of the airway adjunct OPA from the angle of the mouth to the angle of the jaw NPA from the nostril to the ear lobe*

Checked if correctly done

Not Done Correctly

OPA- Insert flange to the hard palate and turn 180 degrees NPA- Lubricates and inserts with the bevel toward the septum gently in the correct way*

Checked if correctly done

Not Done Correctly

OPA Checks to see the flange resting on the patient's lips NPA Checks to see the flange resting on the patient's nostril*

Checked if correctly done

Not Done Correctly

Select the appropriate size of the Bag mask device and connect to O2 supplement*

Checked if correctly done

Not Done Correctly

Opens airway and seal the mask with the E-C clamp technique*

Checked if correctly done

Not Done Correctly

Provides 1 breath every 6 seconds for 1 minute, each breath in 1 second, and should cause chest rise.*

Checked if correctly done

Not Done Correctly

Endotracheal intubation (optional)

Prepare the needed equipment for intubation Insert the E.T tube in the correct way

Confirm the correct placement by physical exam(visualization, auscultation) and use a confirmation device like a CO2 detector then secure the tube

Checked if correctly done

Not Done Correctly

Evaluator Name*

Evaluator ID#*

Result*

Pass

Need Remediation

Comments

This field is for validation purposes and should be left unchanged.

ACLS provider course