 APPLICATION P ROCESS:
L EARN THE S TEPS TO
B ECOMING A P ENN STATE
L IFEGUARD ................ 2
FALL
OF OUR LIFEGUARDS
BEFORE YOU APPLY ..... 4
SUMMER
The Pennsylvania State University
McCoy Natatorium
University Park, PA 16802
(814) 865-1433
 S AFETY FIRST : L EARN
ABOUT OUR L IFEGUARD DRIVEN I N-S ERVICE
TRAINING P ROGRAM .... 3
 J OB E XPECTATIONS:
L EARN WHAT WE EXPECT
SPRING
Penn
State
aquatics
P R O F E S S I O N A L I S M ● S A F E T Y ● T E A MW O R K
Thank you for your interest in becoming part of the Penn State
Lifeguarding team. This information packet was designed to give you
an overview of what it means to be a Penn State Lifeguard.
~ Shawn P. DeRosa, Esq.
Director of Aquatics
Information for PSU
lifeguard applicants
As a Penn State lifeguard you will play
an important role in protecting the public
at each of our swimming pools. Please
carefully read this information packet. It
contains detailed information regarding
our employment requirements and has
been designed to assist you with our
application process.
Please keep in mind that we select only
the best applicants to join our safety
team. We are quick to make staffing
adjustments to ensure that we operate
one of the safest collegiate aquatic
programs in the nation.
There
are
several
employment
requirements for all Penn State
lifeguards, starting with employment
eligibility and qualifications. Those
applicants that meet our eligibility
requirements will be invited to
participate in a skills and knowledge
evaluation which includes lifeguarding
and CPR skills in addition to timed
swimming events. We will then select
our strongest applicants for individual
interviews with our management team.
Please read on to see if you have what it
takes to be a Penn State Lifeguard!
Lifeguarding: A Job So Cool “It’s Hot”
Lifeguarding is a serious job, but that doesn’t mean you can’t have fun while working! As part of our
team of Penn State lifeguards, you will get to know our many patrons and make new friends working
with your fellow lifeguards who, like you, care about preventing accidents and saving lives.
Lifeguarding is a job that helps you develop skills that transcend occupational boundaries, all while
helping to make a difference in people’s lives. We look forward to welcoming you aboard our team
of award-winning lifeguards. So dive on in ~ being a PSU lifeguard is one of the best jobs on
campus!
Do YOU Have
What It Takes?
Lifeguarding at Penn State University carries a
long and proud tradition of excellence and
leadership.
ELIGIBILITY
We start by determining whether
you are eligible for employment
with Penn State University. We
do this my examining your
application materials for the
following:
U.S. Status: All employees must
be either U.S. citizens or legally
eligible to work within the
United States. Before you can
start working, you must prove
your eligibility to work with a
U.S. Passport, work permit visa,
or other federally-accepted form
of identification (e.g. both a
Social Security Card and a stateissued driver’s license).
Certification: All lifeguards
must be certified in lifeguarding
procedures, first aid, and CPR/
AED for Professional Rescuers
and Health Care Providers.
Certification
in
Oxygen
Administration is also required.
We are happy to provide
emergency oxygen training at a
reduced cost to applicants
lacking this certification.
Penn State will only accept
original certificates as proof of
certification.
Copies
of
certifications or letters from
instructors will not be accepted.
Current certification is a
condition of employment of all
PSU lifeguards.
INTERVIEWS
Criminal Background Checks:
All prospective employees must
Applicants who score highly on
undergo a criminal background
the pre-employment evaluation
check. The
will be invited to
“Lifeguards play a vital
results of the
interview for a
role in helping keep our
background
lifeguarding
Penn State community
check will be
position. We look
safe while in, on and
compared to your
to hire only
around the water.”
application.
highly-motivated
SHAWN P. DEROSA, ESQ.
Convictions will
individuals who
DIRECTOR OF AQUATICS
be evaluated with
are committed to
respect to time,
upholding our
circumstances and seriousness
standards of lifeguarding
and may result in a loss of
excellence.
employment eligibility.
QUALIFICATION
Eligible
employees
must
successfully complete the PSU
Lifeguarding Pre-Employment
Evaluation and written exam
(80% required). This includes
an evaluation of specific
lifeguarding and CPR skills in
addition
to
swimming
proficiency.
All
lifeguard
candidates,
including returning lifeguards,
must complete the following
skills evaluation:
□
Tread Water w/ 10lb
□
brick—45 seconds
25 yard rescue tube sprint—
□
26 seconds
Brick Retrieval: 30 ft
□
□
□
approach, Surface Dive,
Retrieve 10lb brick—16
seconds
Submerged Victim
In-Line Stabilization
CPR (You must bring your
own CPR Pocket Mask)
Please see below for evaluation
criteria.
HIRING
Lifeguards will be hired to help
fulfill both specific and general
staffing needs. Preference is
given to those employees with
open availability and a flexible
schedule to allow for adequate
staffing of the pools. Newly
hired lifeguards are expected to
contribute $20 toward their
initial uniform costs. Returning
guards are given a uniform
allotment from which they may
select approved uniform items.
TRAINING
Penn State lifeguards participate
in rigorous Pre-Service and InService
training
programs
designed to improve readiness
and response. National standards
dictate that lifeguards receive an
average of four hours of inservice training per month. We
at Penn State are proud to say
we meet or exceed this standard!
Participation in our training
program is a condition of
employment. Lifeguards who
fail to complete required
We Are . . .
L IFE ●GUARD :
an expert
swimmer
trained and
(n)
deployed to
watch over
swimmers, as
at a beach or
swimming
pool.
training will be removed from
the schedule or dismissed.
In-service training sessions are
held
every
other
week.
Lifeguards generally sign up for
a specific training slot for the
semester.
SCHEDULING
Penn State lifeguards are
scheduled for the McCoy
Natatorium, the White Building
Pool, and our Olympic-sized
outdoor swimming facility.
We schedule lifeguards around
their class schedules, as we
firmly
believe
that
your
education should be a priority.
Schedules are available online,
along with a staff list, email
forwarding of shift change
requests, text alert capabilities
and a trade board to make
swapping shifts with your fellow
guards as easy as possible.
2
TRAINING: The Heart of A
Strong Aquatics Program
Penn State lifeguards are committed
to providing a level of service that
meets or exceeds national standards.
In fact, our well-trained lifeguards
helped pilot the Five Minute
Scanning Strategy© now used
worldwide and incorporated into
virtually all nationally-recognized
lifeguard training programs.
We recognize that emergencies can
occur at any time, even to otherwise
apparently healthy and athletic
swimmers and athletes.
Our
lifeguards understand that medical
events may precipitate aquatic
emergencies. We know that even the
most highly trained athletes may
make poor choices or simple
mistakes that could result in the need
for an immediate rescue response.
Given the wide variety of patrons at
our pools, from day care centers to
T RAIN ● ING :
(v) to make
proficient with
specialized
an active and thriving senior
population,
Penn
State
lifeguards train to respond to a
wide variety of emergencies.
Our guards have responded to
sudden
cardiac
arrests,
respiratory
emergencies,
seizures, dislocated shoulders,
and distressed swimmers.
Penn State lifeguards practice
and refine rescue and first aid
skills, including CPR/AED
procedures. They are prepared
to administer emergency oxygen
to those in respiratory distress,
and they know that their
commitment to ongoing training
can make the difference between
life and death.
PRE-SERVICE
TRAINING
Before assuming any patron
surveillance
responsibilities,
Penn State lifeguards go through
a selection and training program
designed to familiarize them
with each of the pools to which
they may be assigned.
Although each pool is different,
many of our emergency
procedures remain the same. It
is our expectation that all
lifeguards will be fully versed in
the emergency action plan
before their first shift as a Penn
State lifeguard.
instruction
and practice;
to coach in
or accustom
to a mode of
behavior or
performance.
3
Successful completion of our
Pre-Service Training program is
a condition of employment for
all Penn State lifeguards.
IN-SERVICE
TRAINING
As discussed in your lifeguard
training class, lifeguards are
expected to participate in an
ongoing program of in-service
training. The generally accepted
standard is a minimum of four
hours
of
facility-specific
training each month.
Our in-service training program
rivals any University in the
nation.
Our
lifeguards
participate in at least two
training sessions each month,
each designed to address many
of the injuries, accidents and
illnesses likely to be seen here at
Penn State.
In-service training sessions are
scheduled on alternating weeks
and established at the start of
each semester. Lifeguards must
select a recurring day/time for
training.
If you miss a
scheduled in-service, you will
be removed from the schedule
until the in-service has been
made up. This way we can be
assured that all of our lifeguards
share a core set of knowledge
and skills.
In-service training sessions are
led
by
our
Lifeguard
Coordinator and a team of
instructors and head lifeguards.
Lifeguards are often presented
with
“new”
information
designed to challenge their skills
and beliefs about lifeguarding.
As part of our lifeguard team,
you will practice responding to
real-life scenarios with full
rescue response, from victim
recognition to extrication and
follow-up care with AED’s and
emergency
oxygen.
This
scenario-based format will help
prepare you to respond with the
confidence needed to effectively
manage emergency situations.
Mandated Reporter
and
Cleary
Act
Training
Before lifeguards can be
scheduled for their first shift they
must attend the University's
professional training program
designed to help employees
recognize and report suspected
child abuse.
Lifeguards are identified as
“authorized adults” who have the
potential to work and interact
with children throughout their
assigned duties.
ADVANCE YOUR
CAREER
Using their training as PSU
lifeguards and/or interns, many
former staff members now have
management responsibilities at a
variety
of
colleges
and
Universities:
□ Rebecca Caylor, Former
Aquatic Coordinator, Penn
State University
□ Jimmy Heiner, Assistant
Director - Aquatics,
University of Maryland
Baltimore
□ Chris Whipple, Lifeguard
Manager, University of
Maryland.
. . .Penn State
Lifeguards:
Penn State Proud
Penn State lifeguards are held to the highest
performance expectations. Why? Because our
lifeguards
&
Lifeguards report to work and are in
uniform at least five minutes prior to
the start of their shift. Lifeguards
understand that they operate as part
of a safety team and as such,
tardiness or absence from work is
simply not
acceptable.
PSU
lifeguards
consistently
find
replacements for any shifts that they
may need to miss.
BEHAVIOR
Lifeguards act as role models,
following the rules they are charged
with enforcing. Lifeguards remain
alert to potential hazards, and
enforce pool rules with the goal of
educating patrons about water safety
rather than punishing misbehavior.
Lifeguards conduct themselves as
professionals, thereby fostering team
cohesion.
ATTITUDE
Penn State lifeguards consistently
display a positive attitude toward
coworkers and patrons alike. Verbal
and
non-verbal
messages
consistently demonstrate an attentive
attitude toward the task at hand.
Lifeguards
frequently
identify
concerns with supervisors in a
cooperative manner and work
together to resolve conflict in an
amicable manner.
(v) to surpass
or to be
superior to;
can and do live up to them!
APPEARANCE
ATTENDANCE
PUNCTUALITY
E X ●CEED :
FACILITY UPKEEP
Lifeguards recognize that image
Penn State lifeguards take care
is everything. How lifeguards
of their work environment.
look while on duty
They consistently
sends a strong
help
pick
up
“We are what we
message to patrons
equipment
left
on
repeatedly do.
about our
deck, dispose of
Excellence, then, is
commitment to
trash,
organize
not an act but rather a
safety. Lifeguards
equipment
storage
habit.”
consistently report
areas and assist with
ARISTOTLE
to work in the full
basic
facility
and correct uniform.
maintenance and upkeep.
ACCEPTANCE OF
SUPERVISION
Lifeguards respond positively
toward and accept feedback on
their job performance from head
guards and management. All
guards consistently cooperate
with co-workers and supervisors
to
help create a team
environment where everyone
can excel.
CARE OF
EQUIPMENT
Lifeguards
consistently
demonstrate care and concern
for proper equipment handling,
use and storage. Rescue tubes
are properly carried when in a
surveillance rotation or, when
not in use, wrapped and stored
appropriately. Except during
training programs, rescue tubes
never touch the pool deck.
TEAMWORK
Lifeguards work as part of a
team to identify and address
issues that may impact our
operations, e.g. deteriorating
equipment, cleanliness, etc.
SAFETY FIRST
Lifeguards play an important
role in helping protect swimmers
from injuries that may arise
while using our facilities.
Lifeguards take a proactive
approach to rule enforcement,
balancing patron enjoyment
without compromising safety.
Lifeguards maintain a careful
watch over swimmers, rotating
from station to station without
compromising surveillance.
CUSTOMER
SERVICE
Lifeguards are representatives of
the Athletics Department as well
as the University.
Greeting
patrons as they walk by the
guard stand is expected.
Lifeguards know that people
who smile while working are
better liked by their peers and
patrons. A smiling workforce
helps
create
a
positive
environment for patrons and
staff alike. Simple courtesies
such as “please” and “thank
you” go a long way toward
making patrons feel like invited
guests.
to be greater
than
Penn State lifeguards are
accomplished athletes and
scholars. Many lifeguards return
every semester because they
choose to exceed expectations,
to excel at their jobs. They know
that “getting by” just isn’t good
enough in today’s workplace.
Meeting expectations means that
you blend into the crowd; you’ve
failed to distinguish yourself from
your peers. Penn State
lifeguards know that success
requires commitment,
perseverance and dedication.
They choose
T O E X ●CEL
OUR AQUATIC TEAM
Shawn DeRosa, J.D.
spd10@psu.edu
Director of Aquatics
Meredith Stille
mas1000@psu.edu
Assistant Director, Aquatics
Matt Hutchison
mdh5507@psu.edu
Coordinator, Aquatics
Desiree Ramirez
dlr5462@psu.edu
Pool Operator
Jason Aikey
jaa27@psu.edu
Staff Assistant
Performance
APPLICATION FOR EMPLOYMENT
PENN STATE UNIVERSITY AQUATICS
McCoy Natatorium ● 106 Bigler Rd ● University Park, PA 16802 ● (814) 865-1432
POSITION APPLYING FOR
□ Lifeguard □
Water Safety Instructor
□ Customer Service □ Specialty Instructor/Coach: ___________
APPLICANT INFORMATION – PLEASE PRINT CLEARLY
Last Name
First
M.I.
Local Street Address
PSU ID
Apartment/Unit #
City
State
ZIP
Cell Phone
E-mail Address
Permanent Street Address
Apartment/Unit #
City
State
Indicate Availability:
ZIP
Fall 20______
Spring 20______
Summer 20______
Upon hire, will you be able to provide proof of eligibility to work in the U.S.?
YES
NO
Are you a PSU student?
YES
NO
YES
NO
If no, are you a high school student?
Work permit required.
Are you currently a PSU Varsity Athlete or being recruited by PSU Athletics?
YES
NO
Will you receive a work-study grant for the indicated semester(s)?
YES
NO
Have you ever worked for PSU before?
YES
If so, from?
To:
Department:
Supervisor:
ORIGINAL CERTIFICATIONS (NOT COPIES) OR CERTIFICATES WITH QR CODES
MUST BE PRESENTED AT INTERVIEW
CERTIFICATIONS
Type of Certification
NO
Expires
Lifeguarding
/
/
ARC
YMCA
E&A
StarGuard
CPR/AED
/
/
ARC
AHA
ECSI
ASHI
First Aid
/
/
ARC
ECSI
Oxygen Administration
/
/
ARC
ECSI
Water Safety Instructor
/
/
ARC
Lifeguarding Instructor
/
/
SCUBA
Other:
/
/
PSU Staff Must Complete
Certifying Agency (Circle)
Copies on File
YES
NO
YES
NO
ASHI
YES
NO
ASHI
YES
NO
Other:
YES
NO
ARC
Other:
YES
NO
NAUI
PADI
Other:Other:
YES
NO
AEA
ACSM
SCUBA
YES
NO
Other:
NASCO
Initial
EDUCATION
Name of School
Major
G.P.A.
Did You Graduate?
High School
YES
NO
Undergraduate
YES
NO
Graduate
YES
NO
Other
YES
NO
PREVIOUS EMPLOYMENT
Employer
Supervisor
Address
Supervisor’s Phone
Job Title
Starting Salary
$
(
)
Ending Salary
$
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
YES
NO
Employer
Supervisor
Address
Supervisor’s Phone
Job Title
Starting Salary
$
(
)
Ending Salary
$
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
YES
NO
Employer
Supervisor
Address
Supervisor’s Phone
Job Title
Starting Salary
$
(
)
Ending Salary
$
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
YES
NO
ADDITIONAL REFERENCES
If this will be your first work experience, please provide three references we may contact.
Full Name
Relationship
Company
Address
Full Name
Relationship
Company
Address
Full Name
Relationship
Company
Address
Phone
(
)
Phone
(
)
Phone
(
)
SCHEDULING INFORMATION
How many hours per week to you prefer to work?
Minimum:
8
10
12
14
20
Maximum:
12
14
20
24
CLASS SCHEDULE
Everyone on our team is expected to work weekends, early mornings, late nights and holidays when the pools are open.
Preference in hiring is given to persons able to fulfill scheduling needs as they may arise. We will, of course, accommodate
your class schedule. Please indicate your class times with a “C”. Times that you prefer to work, should be denoted with
a “P”. Times you are unavailable for other reasons should be listed with an “X” with an appropriate explanation in
the comment area provided. Not liking to work an opening or closing shift does not mean that you are not available to do
so. A copy of your eLion course schedule should be submitted with this application.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Comment
5:00 – 6:00 am
6:00 – 7:00 am
7:00 – 8:00 am
8:00 – 9:00 am
9:00 – 10:00 am
10:00 – 11:00 am
11:00 – Noon
Noon – 1:00 pm
1:00 – 2:00 pm
2:00 – 3:00 pm
3:00 – 4:00 pm
4:00 – 5:00 pm
5:00 – 6:00 pm
6:00 – 7:00 pm
7:00 – 8:00 pm
8:00 – 9:00 pm
9:00 – 10:00 pm
10:00 – 11:00 pm
11:00 – Midnight
Midnight – 1:00 am
1:00 am – 2:00 am
Are you available to work during academic breaks? (e.g. Thanksgiving, Winter, Spring)
YES
NO
To meet our staffing needs, hiring preference is given to those who are able to work during academic breaks.
DISCLAIMER AND SIGNATURE
I understand that the application process reflects my ability to follow directions, that incomplete applications may be rejected and that
only those applicants who have been selected for an interview and/or water test will be contacted. If this application leads to
employment, I understand that false or misleading information in my application or interview may result in termination of employment.
My signature authorizes the Pennsylvania State University to request employment, financial aid, and education information from current
and past employers and/or educational institutions. I certify that my answers are true and complete to the best of my knowledge.
Signature
Date
The Pennsylvania State University does not discriminate against any person because of age, ancestry, color, disability or handicap, national origin, race, religious creed, sex, sexual orientation or veteran status.
CAMPUS RECREATION
The Pennsylvania State University
McCoy Natatorium
University Park, PA 16802
Phone: (814) 865-1433
Fax: (814) 865-3728
www.studentaffairs.psu.edu/campusrec/rec/nat
Lifeguard Try-Out Skills Evaluation
Evaluation Skill
Lifeguarding, First Aid, and CPR/AED Written Exam
Deep Water Brick Retrieval
25 Yard/Meter Rescue Tube Sprint
Submerged Victim Rescue with 2 Person Removal and
Follow-Up Care (CPR Pocket Mask Required)
Description
Participants will take a 50 question, multiple choice exam on current lifeguarding, first aid,
and CPR/AED procedures. The exam is based upon American Red Cross standards. An
80% is required.
Timed Event. Participants will begin in the water, complete a 30 foot approach, surface dive
to 14 feet, and retrieve a 10 pound brick. Time will stop when the brick breaks the surface
of the water. Complete event in less than 16 seconds.
Timed Event. Participants will begin in the water, sprint 25 yards or meters with the rescue
tube underneath their bodies. The rescue tube strap must be worn, front crawl or
breaststroke may be used. Speed, approach, and rescue tube control will be evaluated.
Complete event in less than 26 seconds (yards) or less than 29 seconds (meters).
Timed Event. Participants will activate the emergency action plan, make an appropriate
entry, and perform an appropriate rescue for a submerged, passive victim. The victim will
then be removed from the water with the aid of a secondary rescuer; appropriate follow-up
care will be provided. Complete in less than 2 minutes.
Brick Tread
Timed Event. Participants will tread water for 45 seconds while holding a 10 pound brick
with both hands. A strong kick and the ability to keep both shoulders even with the surface
of the water will be required. Floating on back is not allowed.
Deep Water In-Line Stabilization: Head Splint
Participants will demonstrate the ability to properly care for a head, neck, or back injury in
deep water using the head splint. Victims will be placed in a face-down position.
CPR/AED Scenario (CPR Pocket Mask Required)
Participants will be given an adult or child scenario in which they will be required to
perform proper ventilations, CPR, and use an AED.
Lifeguard Try-Out Skills Evaluation Criteria
SKILL
3
(Mastery)
2
(Proficiency)
1
(Inadequate)
Deep Water Brick
Retrieval (Timed)
Front crawl or breaststroke approach w/head out of
water. Feet- or head-first surface dive. Ability to
locate brick. Strong push-off from bottom.
Completed in less than 13 seconds.
Front crawl or breaststroke approach. Feet- or headfirst surface dive. Ability to locate brick. Strong
push-off from bottom. Completed in less than 16
seconds.
Improper approach stroke. Difficulty/inability to
surface dive to bottom and/or to locate brick. Weak/
no push-off from bottom. Inability to resurface with
brick within 16 seconds.
25Y/ M Tube Sprint
(Timed)
Front crawl or breaststroke approach w/head out of
water. Tube centered w/perfect control during entire
event. Strong supporting kick. Completed in less than
23 sec. (yds) / 26 sec. (meters).
Front crawl or breaststroke approach w/head out of
water. Tube centered w/slight movement.
Supporting kick. Completed in less than 26 sec.
(yds.) / 29 sec. (meters).
Improper stroke usage. Tube not centered properly/
total loss of control. Inability to finish or make
forward progress. No supporting kick. Completed in
more than 26 sec. (yds.) / 29 sec. (meters).
Submerged Victim w/
2 Person Removal and
Follow-Up Care (Timed)
Activate EAP, perform appropriate entry, approach
and surface dive. Reach under victim’s armpit and
across chest. Properly pull strap to return to surface.
Position tube as you break the surface of the water,
keeping tube centered between victim and rescuer and
head/mouth above water. Swim victim to side,
maintaining open airway. Proper extraction w/
secondary rescuer. Glove up, perform initial
assessment and deliver 2 initial breaths. Full rescue
completed in less than 1 minute and 45 seconds.
Activate EAP, perform appropriate entry, approach
and surface dive. Reach under victim’s armpit and
across chest. Properly pull strap to return to surface.
Position tube as you break the surface of the water,
keeping tube centered between victim and rescuer
and head/mouth above water. Swim victim to side,
maintaining open airway. Proper extraction w/
secondary rescuer. Glove up, perform initial
assessment and deliver 2 initial breaths. Full rescue
completed in 2 minutes or less.
Enters water using a non-traditional entry. Difficulty/
inability to pull victim to surface, position tube,
maintain face above water, and/or remove victim
from water. Improper board placement. Failure to
correctly check pulse/breathing. Failure to deliver 2
initial breaths that inflate the chest. Full rescue
completed in more than 2 minutes.
Brick Tread (Timed)
With both hands, holds brick steady at surface of
water. Strong kick. Body remains vertical with
shoulders even with surface.
Ability to complete 1 minute.
With both hands, holds brick steady at surface of
water. Strong kick. Body remains vertical with
shoulders even with surface.
Ability to complete 45 seconds.
Unable to keep both hands on brick. Weak
supporting kick. Difficulty/inability to keep mouth
and head above the surface of the water. Floats on
back. Cannot meet 45 minimum time
requirement.
Deep Water In-Line
Stabilization: Head Splint
Activate EAP, slide-in entry. Approach victim from
side. Grasp arms firmly between elbow and shoulder
(R to R, L to L) to stabilize head. Swim forward and
turn victim, maintaining firm stabilization. No
movement of head. Tube stays positioned on rescuer
and away from victim. Strong kick to wall while
communicating w/victim with no break in
stabilization.
Activate EAP, slide-in entry. Approach victim from
side. Grasp arms firmly between elbow and
shoulder (R to R, L to L) to stabilize head. Swim
forward and turn victim, maintaining stabilization.
Minimal movement of head, spine stays in line.
Tube stays positioned on rescuer and away from
victim. Strong kick to wall while communicating w/
victim with no break in stabilization.
Inappropriate entry. Incorrect hand positioning on
victim. Poor head stabilization. Movement of head
and spine. Tube interferes with alignment of victim’s
head and/or spine or ability to place backboard
beneath victim. Unable to securely move victim to
side for extraction.
LG, FA, CPR/AED Exam
92-100%
80-91%
79% and Below
CPR/AED Scenario
(See CPR Scenario Sheet)
18-20 points
15-17 points
14 points and Below
Name: _________________________________________
Date: _________________________________________
ADULT or CHILD (Circle One)
Single Rescuer CPR/AED Scenario
Value
Size Up Scene: Safe? What happened? Number Injured?
Examiner Will Comment: "It is safe to approach"
Basic Precautions / PPE (Gloves)
Responsiveness: Tap & Ask "Are You Ok? "
Examiner Will Comment: "There is no response."
Direct someone: "Call 9-1-1/Get AED & O2"
Airway: Open airway using appropriate technique
Breathing/Pulse: Look, listen, feel for breathing and check for pulse for no more than
10 seconds.
Examiner Will Comment: "Victim HAS a pulse, but is NOT breathing"
Adult ONLY: Quickly scan for severe bleeding
Adult Ventilations: Give 1 breath every 5 seconds
Child ONLY: Deliver 2 initial ventilations
Child ONLY: Quickly scan for severe bleeding
Child Ventilations: Give 1 breath every 3 seconds
Quality of Ventilations (Does chest clearly rise?)
Reassessment: After about 2 minutes of ventilations (24 Breaths Adult / 40 Breaths
Child), maintains open airway, checks for pulse and breathing
Examiner Will Comment: "Victim has NO pulse, and is NOT breathing"
Give 30 compressions
Adult: Two hands on center of chest. Compress at least 2 inches.
Child: One or Two Hands on center of chest. Compress about 2 inches.
Ventilate: Give 2 Breaths (Each breath must make the chest clearly rise)
Repeat cycle of 30 compressions, 2 ventilations
Rhythm, Rate and Quality of Compressions
Examiner Will Comment: "AED arrives on scene"
Power, Pads (Top Right, Lower Left), Plug (if necessary)
Checks and announces "Analyzing Now" - No contact with manikin
Checks and announces "Stand Clear, Shocking Now" prior to shocking
Immediately resumes CPR after shocking, starting with compressions
Scenario ends when Examiner Comments: "EMS arrives takes over"
1
Total
Comments:
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
19 Adult
20 Child
Student Score