HCP ADULT CHOKING ASSESSMENT CHECK-LIST

Student Name: Date of test:

Skill Performance Check box

Danger Verbalise the scene safety

Identify Mild & Severe obstruction?

Instructor verbalise: Unable to make sounds
5 back blows

5 abdominal thrusts

Alternate 5 back blows with 5 abdominal thrusts if obstruction not relieved

Perform chest thrust for pregnant and very obese victim

Instructor verbalise: The person become unconscious now
Verbalise put patient in supine position:
1. Activate 999/AED
2. Look in mouth for foreign body, remove if seen
3. Start CPR with 30 chest compressions
CPR 4. Open the mouth to look for FB each time before
attempt to ventilate, if unsuccessful, reposition
victim’s head and reattempt ventilation.
5. Repeat steps 3 & 4 until able to give 2 successful
ventilations.

STOP TEST
Instructor notes
Place a / in the box next to each step the student completes successfully.
Test Results Pass NR
Check PASS to indicate pass or NR needs remediation
Instructor initials Instructor Name Date