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First Aid – Basic Life Support

Practical Observation

Colleagues name : Assessor for sign off :

Observed as competent by Assessor


Action Date
(To be signed by the Assessor)
Checking for danger

Checking for a response

Shouting for help

Checking air way/head tilt, chin lift


technique
Checking for breathing

Quick top to toe check and check


pockets
Correct technique for recovery position

Demonstrate back blows and


abdominal thrusts (where equipment is
available)
Demonstrate 30 chest compressions
given at a rate of 100-120 per minute.
(where equipment is available)

By signing here you agree that the above has been shown to you, demonstrated by you and/or
discussed.

Learner Details Assessors Details


Name Name
Job Title Job Title
Home Home
Signature Signature

Page 1 of 1 V2 – created Nov 21

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