CPR Assessment

Name:

  Skill   The candidate Yes No

   
Check for hazards   Demonstrates assessment of environment for hazards
 
   
 Assess responsiveness   Gently taps victim, call out to wake them up

   
  Call for help   Demonstrates calling for help with a clear response back

  Assess breathing   Demonstrates looking, listening, and feeling for normal breathing for  
 
 
no more than 10 seconds whilst maintaining head tilt / chin lift
 
   
  Open airway Demonstrates head tilt and chin lift technique
 
 
  Demonstrates pinching nose and 2 effective rescue breaths sufficient
Pinch nose & 2 Rescue to cause the chest to rise and fall as in normal breathing
breaths

  Demonstrates 30 effective chest compressions     

  Chest compressions
  (correct hand position, rate, and depth)

Continuation of cycle until

Continuation of cycle until help arrives
   
help arrives  

Name:

  Skill   The candidate Yes No

   
Check for hazards   Demonstrates assessment of environment for hazards  
 
   
 Assess responsiveness   Gently taps victim, call out to wake them up
 
   
  Call for help   Demonstrates calling for help with a clear response back
 
  Assess breathing   Demonstrates looking, listening, and feeling for normal breathing for    
 
 
no more than 10 seconds whilst maintaining head tilt / chin lift  
   
  Open airway Demonstrates head tilt and chin lift technique  
 
 
Pinch nose & 2 Rescue Demonstrates pinching nose and 2 effective rescue breaths sufficient
Breaths to cause the chest to rise and fall as in normal breathing

  Demonstrates 30 effective chest compressions    

  Chest compressions
  (correct hand position, rate, and depth)  
Continuation of cycle until
Continuation of cycle until help arrives
   
help arrives