"*" indicates required fields Your DetailsName* First Last Email* Learner Assessment InstructionsYou are required to undertake observable tasks that provide evidence of your skills. Your trainer/ assessor may ask you to perform additional tasks. Observations should occur over a period of time, to be nominated by your trainer/ assessor. Performance can be observed in an actual workplace or in a simulated environment as determined by your trainer/ assessor. Performance evidence You must show evidence of the ability to: Perform the tasks outlined in the elements and performance criteria Perform the specific requirements outlined in the performance evidence Manage tasks and manage contingencies in the context of the work role If performance of particular tasks cannot be observed, you might be asked to explain a procedure or enter into a discussion with your trainer/ assessor. In some instances, tasks might relate to the production of work products (portfolios/ documents/ outcomes). Although it might not be possible for the assessor to observe the total process, the end product of work can provide evidence of performance. Performance evidence — unit specific requirements Practical Task 1: Manage an unconscious breathing casualty, including appropriate positioning to reduce the risk of airway compromise, and hand over to emergency services Practical Task 2: Manage an unconscious, non-breathing casualty, respond appropriately in the event of regurgitation or vomiting, follow the prompts of an automated external defibrillator (AED) to deliver at least one shock, demonstrate a rotation of single rescuer operators with minimal interruptions to compressions Practical Task 3: Perform CPR on an unconscious, non-breathing infant Assessment Conditions This training will be delivered in a simulated environment that will provide you with the opportunity to respond to realistic scenarios that could occur in your workplace or a community setting. Resources for Assessment Infant manikins Adult manikins Lung bags CPR face shield Automated External Defibrillator (AED) Learner DeclarationLearner Declaration*Links: Course Details Online Assessment Information Complaints and Appeals Policy I have been advised of the physical requirements to undertake the practical component of this unit of competency I have been fully advised of the theoretical and practical assessment instructions I have been advised of the Learner Support Services and reasonable adjustment that is available to me if needed I have discussed with the assessor any special needs that may need to be considered during my assessment I have been made aware of how to appeal against an assessment decision I have been made aware of the complaints policy and procedure I declare that the assessment submitted is my own work Learner Signature*By signing below, you confirm the above Learner Declaration.Date* DD slash MM slash YYYY ASSESSOR USE ONLYPractical Task 1 – Manage an unconscious, breathing casualtyInstructions In pairs, you will take turns to play the role of rescuer and the role of the casualty to manage an unconscious, breathing casualty. You will be required to demonstrate: How you would manage a casualty who is unconscious but breathing Positioning the casualty appropriately to reduce the risk of airway compromise Checking for danger How you would assess a casualty’s response, evidence of breathing How you would send for emergency services, monitor the casualty until services arrive, and how you would report the incident You will need to successfully demonstrate:Assessment: Respond to an emergency situation and check for danger• Assesses the emergency scene • Identifies potential risk to self and others • Send for help - allocate 000 call to self or bystander • Obtain consent and/or follow procedures if consent cannot be gained ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Respond to an emergency situation and check for danger• Assesses the emergency scene • Identifies potential risk to self and others • Send for help - allocate 000 call to self or bystander • Obtain consent and/or follow procedures if consent cannot be gained ✓ Satisfactory ✘ Not yet satisfactory Assessment: Assess the casualty, using the talk and touch method to check for response• Can you hear me? • Open your eyes? • What’s your name? • Squeeze my hand? ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Assess the casualty, using the talk and touch method to check for response• Can you hear me? • Open your eyes? • What’s your name? • Squeeze my hand? ✓ Satisfactory ✘ Not yet satisfactory Assessment: Check for breathing• Looks across the chest for rise and fall • Listens for air escaping from nose and mouth • Feels for air from nose and mouth • Use available resources to ensure casualty is as comfortable as possible ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Check for breathing• Looks across the chest for rise and fall • Listens for air escaping from nose and mouth • Feels for air from nose and mouth • Use available resources to ensure casualty is as comfortable as possible ✓ Satisfactory ✘ Not yet satisfactory Assessment: Manages the casualty• Positions casualty on their side • Opens airway with head tilted slightly to the ground • Monitors breathing • Checks for other injuries • Displays respectful behaviour ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Manages the casualty• Positions casualty on their side • Opens airway with head tilted slightly to the ground • Monitors breathing • Checks for other injuries • Displays respectful behaviour ✓ Satisfactory ✘ Not yet satisfactory Assessment: Communicate the details of the incident• Accurately convey incident details to emergency services • Verbally report incident to workplace supervisor (Trainer) and discuss • Maintain confidentiality of casualty ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Communicate the details of the incident• Accurately convey incident details to emergency services • Verbally report incident to workplace supervisor (Trainer) and discuss • Maintain confidentiality of casualty ✓ Satisfactory ✘ Not yet satisfactory Assessment: Review the incident• Discuss potential psychological impacts on self or others with the workplace supervisor (Trainer) • Discuss what went well and what could be improved upon ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Review the incident• Discuss potential psychological impacts on self or others with the workplace supervisor (Trainer) • Discuss what went well and what could be improved upon ✓ Satisfactory ✘ Not yet satisfactory Trainer Notes and ObservationsCompletion of Assessment ✓ Satisfactory ✘ Not yet satisfactory Practical Task 2 – Manage an unconscious, non-breathing casualtyInstructions In this scenario you will be required to respond to an adult casualty who is unconscious and who has stopped breathing. You will need to demonstrate: At least 2 minutes of uninterrupted single rescuer cardiopulmonary resuscitation (CPR) (5 cycles of both compressions and ventilations) on an adult resuscitation manikin placed on the floor Operating and safely using an AED to revive a casualty, delivering at least one shock A rotation of single rescuer operators with minimal interruptions to compressions How you would manage the casualty in the event of regurgitating/vomiting You will need to successfully demonstrate:Assessment: Respond to an emergency situation and check for danger• Assesses the emergency scene • Identifies potential risk to self and others • Send for help - allocate 000 call to self or bystander ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Respond to an emergency situation and check for danger• Assesses the emergency scene • Identifies potential risk to self and others • Send for help - allocate 000 call to self or bystander ✓ Satisfactory ✘ Not yet satisfactory Assessment: Assess the casualty• Obtain consent and/or follow procedures if consent cannot be gained • Use the talk and touch method • Check for breathing • Use available resources to ensure casualty is as comfortable as possible ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Assess the casualty• Obtain consent and/or follow procedures if consent cannot be gained • Use the talk and touch method • Check for breathing • Use available resources to ensure casualty is as comfortable as possible ✓ Satisfactory ✘ Not yet satisfactory Assessment: Perform CPR compressions on an adult manikin on the floor• Position the casualty on their back • Use the correct hand technique to apply chest compressions (one hand over the other on the sternum, middle of the chest, elbows locked) • Perform the correct ratio of compressions 30:2 • Perform the appropriate depth for compression (1/3 chest) • Perform the appropriate cycle 5 cycles (100 to 120 compressions per minute) • Perform at least 2 minutes of uninterrupted CPR ✓ Satisfactory ✘ Not yet satisfactory Assessment: Perform CPR compressions on an adult manikin on the floor• Position the casualty on their back • Use the correct hand technique to apply chest compressions (one hand over the other on the sternum, middle of the chest, elbows locked) • Perform the correct ratio of compressions 30:2 • Perform the appropriate depth for compression (1/3 chest) • Perform the appropriate cycle 5 cycles (100 to 120 compressions per minute) • Perform at least 2 minutes of uninterrupted CPR ✓ Satisfactory ✘ Not yet satisfactory Assessment: Perform rescue breaths• Full head tilt and chin lift • Seal the nose with fingers or the cheek • Seal casualty’s mouth with own, or use a CPR • Resuscitation Device • Give breath for one second until chest rises • Turn face toward casualty’s chest to check for rise and fall of chest • Complete second breath and watch for rise and fall • Continue with chest compressions ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Perform rescue breaths• Full head tilt and chin lift • Seal the nose with fingers or the cheek • Seal casualty’s mouth with own, or use a CPR • Resuscitation Device • Give breath for one second until chest rises • Turn face toward casualty’s chest to check for rise and fall of chest • Complete second breath and watch for rise and fall • Continue with chest compressions ✓ Satisfactory ✘ Not yet satisfactory Assessment: Respond to the casualty regurgitating or vomiting• Promptly place casualty in the recovery position • Head tilt, chin down • Clears mouth/airway using the finger sweep method ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Respond to the casualty regurgitating or vomiting• Promptly place casualty in the recovery position • Head tilt, chin down • Clears mouth/airway using the finger sweep method ✓ Satisfactory ✘ Not yet satisfactory Assessment: Perform rotation of single rescuer with minimal delays• Rescuer 1 performers 5:2 duration and cessation cycles • Rotates to rescuer 2 with minimal delays ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Perform rotation of single rescuer with minimal delays• Rescuer 1 performers 5:2 duration and cessation cycles • Rotates to rescuer 2 with minimal delays ✓ Satisfactory ✘ Not yet satisfactory Assessment: Operate AED• Follow the manufacturer’s instructions to operate the AED equipment • Turn the AED on • Follow auditory prompts to apply electrode pads whilst the second rescuer continues with • CPR • Place pads in correct position (one pad slightly below right collarbone and the second pad below the left armpit) • Ensure pads do not touch when on casualty’s chest • Ensure the safety of self and second rescuer and direct others to stand clear whilst administering the AED shock ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Operate AED• Follow the manufacturer’s instructions to operate the AED equipment • Turn the AED on • Follow auditory prompts to apply electrode pads whilst the second rescuer continues with • CPR • Place pads in correct position (one pad slightly below right collarbone and the second pad below the left armpit) • Ensure pads do not touch when on casualty’s chest • Ensure the safety of self and second rescuer and direct others to stand clear whilst administering the AED shock ✓ Satisfactory ✘ Not yet satisfactory Assessment: Communicate the details of the incident• Accurately convey incident details to emergency services • Verbally report incident to workplace supervisor (Trainer) and discuss • Maintain confidentiality of casualty ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Communicate the details of the incident• Accurately convey incident details to emergency services • Verbally report incident to workplace supervisor (Trainer) and discuss • Maintain confidentiality of casualty ✓ Satisfactory ✘ Not yet satisfactory Assessment: Review the incident• Discuss potential psychological impacts on self or others with the workplace supervisor (Trainer) • Discuss what went well and what could be improved upon ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Review the incident• Discuss potential psychological impacts on self or others with the workplace supervisor (Trainer) • Discuss what went well and what could be improved upon ✓ Satisfactory ✘ Not yet satisfactory Trainer Notes and ObservationsCompletion of Assessment ✓ Satisfactory ✘ Not yet satisfactory Practical Task 3 – Perform CPR on an unconscious, non-breathing infantInstructions In this scenario you will be required to respond to an infant casualty who is unconscious and who has stopped breathing. You will be required to demonstrate: At least 2 minutes of uninterrupted single rescuer CPR (5 cycles both compressions and ventilations) on an infant resuscitation manikin placed on a firm surface You will need to successfully demonstrate:Assessment: Respond to an emergency situation and check for danger• Assesses the emergency scene • Identify potential risk to self and others • Send for help - allocate 000 call to self or bystander ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Respond to an emergency situation and check for danger• Assesses the emergency scene • Identify potential risk to self and others • Send for help - allocate 000 call to self or bystander ✓ Satisfactory ✘ Not yet satisfactory Assessment: Assess the casualty• Obtain consent and/or follow procedures if consent cannot be gained • Use the talk and touch method • Check for breathing • Use available resources to ensure casualty is as comfortable as possible ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Assess the casualty• Obtain consent and/or follow procedures if consent cannot be gained • Use the talk and touch method • Check for breathing • Use available resources to ensure casualty is as comfortable as possible ✓ Satisfactory ✘ Not yet satisfactory Assessment: Position infant casualty on firm surface• Keep infant in a neutral position ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Position infant casualty on firm surface• Keep infant in a neutral position ✓ Satisfactory ✘ Not yet satisfactory Assessment: Perform 2 minutes of uninterrupted single rescuer CPR• Use two fingers on the lower half of the sternum • Compress 1/3 chest depth at a rate of 100 to 120 per minute ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Perform 2 minutes of uninterrupted single rescuer CPR• Use two fingers on the lower half of the sternum • Compress 1/3 chest depth at a rate of 100 to 120 per minute ✓ Satisfactory ✘ Not yet satisfactory Assessment: Perform rescue breaths• Support the chin in a neutral position • Seal the mouth and nose with lips • Give two small puffs of air • Rescuer turns head toward chest looking for rise and fall of chest ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Perform rescue breaths• Support the chin in a neutral position • Seal the mouth and nose with lips • Give two small puffs of air • Rescuer turns head toward chest looking for rise and fall of chest ✓ Satisfactory ✘ Not yet satisfactory Assessment: Communicate the incident• Accurately convey incident details to emergency services • Verbally report incident to workplace supervisor (Trainer) and discuss • Maintain confidentiality of casualty ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Communicate the incident• Accurately convey incident details to emergency services • Verbally report incident to workplace supervisor (Trainer) and discuss • Maintain confidentiality of casualty ✓ Satisfactory ✘ Not yet satisfactory Assessment: Review the incident• Discuss potential psychological impacts on self or others with the workplace supervisor (Trainer) • Discuss what went well and what could be improved upon ✓ Satisfactory ✘ Not yet satisfactory Reassessment: Review the incident• Discuss potential psychological impacts on self or others with the workplace supervisor (Trainer) • Discuss what went well and what could be improved upon ✓ Satisfactory ✘ Not yet satisfactory Trainer Notes and ObservationsCompletion of Assessment ✓ Satisfactory ✘ Not yet satisfactory Final Assessment OutcomeOverall Assessment Result ✓ Satisfactory ✘ Not yet satisfactory Assessor Declaration* I, the person conducting the assessment, declare that the above-mentioned learner participated in an appropriate assessment in accordance with the assessment plan, and outcomes and objectives of the unit of competency. The information recorded above is a true reflection of this learner’s assessment. The learner has been provided with verbal feedback and has been informed of the assessment result and the reasons for the decision. Assesor Name* First Last Assessor Signature*
