Skill Sheet 3: Glove Removal, Choking Care*
Student Name
Instructor Name
Test Date
Instructor Number
Review the Skill Sheet with students and explain the required steps. During the skill check give assessment information, but not correct actions to take.
Check off each step as it is performed successfully. If the student fails any portion of the skill check, practice, provide feedback, and retest the entire
skill. Use as many skill sheets as required until proficient.
Skill Check 3A: Glove Removal
#
Required Action
1.
Pinch: Pinch base of glove, gently peel off, and hold in gloved hand.
2.
Peel: Slip ungloved finger(s) under base of glove, slowly peel glove back.
3.
Pull: Gloves are inside out, one glove stored inside the other.

Skill Check 3B: Adult/Child Choking Care
Required Action

#
1.
Recognize Choking: (Show universal sign) Ask, “Are you choking?” (Nod yes)
2.
Positioning: (Use a manikin) Stand behind victim. Place fist, thumb side in, just
above navel. Grasp fist with free hand.
3.
Abdominal Thrusts: Provide (5 or more) quick, forceful, inward and upward
abdominal thrusts.
Comments
Comments
Victim Becomes Unresponsive (lay manikin on ground)
4.
Activate EMS: Send bystander to call 9-1-1.
5.
Unresponsive Choking Adult: (Review only) 30 compressions, look in mouth for
object, attempt 2 breaths, and repeat 30 compressions.
Skill Check 3C: Infant Choking Care*
Required Action

#
1.
Recognize Choking: (Use infant manikin): Verbalize 3 signs of a conscious choking
infant. (The infant is choking)
2.
Activate EMS: Send bystander to call 9-1-1.
3.
Position Infant: Sit or kneel. Hold infant face down on forearm with head slightly
lower than body; support the jaw between the thumb and forefinger.
4.
5 Back Blows: Forceful back slaps w/ the heel of the hand between the shoulder
blades.
5.
Position Infant: Support infant, turn face up, keep head lower than body.
6.
5 Chest Thrusts: Quick downward chest thrusts with 2 fingers in the center of the
chest, just below the nipples.
7.
Unresponsive Choking Infant: (Review only) 30 compressions, look in mouth,
remove object if seen, repeat.
Comments
_______________________________________________________________________________________________
Instructor Signature
Date
*Skill Check 3C: ‘Infant Choking Care’ is required for Infant certification.
©EMS Safety 2011
CPR & AED for Community Rescuers, Basic First Aid
Version A