EIB TEST SCORE SHEET

Station C - First Aid - Point C-1

For use of this form, see USAIC Pam 350-6. The proponent is USAIS, DOTD.

Candidate's Name______________Rank________Unit_________________

TASK 1: PERFORM MOUTH-TO-MOUTH RESUSCITATION.


PERFORMANCE MEASURES-----Mark by each measure-------------PASS (P)or FAIL (F)

SCORER STATES: "The casualty is unconscious."

1. Performed the following actions in sequence.

a. Rolled the casualty onto his or her back, if necessary.

b. Opened the airway using the head-tilt/chin-lift method.

c. Checked for breathing within 3 to 5 seconds by placing an ear over the casualty's mouth and looking toward his or her chest.

SCORER STATES: "The casualty is not breathing, and the airway is open."

d. Give breaths to ensure an open airway.

SCORER STATES: "The chest is rising."

e. Checked for a pulse, for 5 to 10 seconds using your first two fingers, in the groove in the casualty's throat beside the adam's apple.

SCORER STATES: "There is a pulse and the casualty is not breathing. "

f. Continued mouth-to-mouth resuscitation, at the rate of about 10 to 12 breaths per minute.

SCORER ALLOWS CANDIDATE TO CONTINUE FOR ABOUT ONE MINUTE AND ANNOUNCES: "THE CASUALTY IS BREATHING."

g. Performed all necessary steps in the correct sequence.

NOTE: This task has been modified for EIB test only.

CHECK: PASS______ FAIL______

REASON(S) FOR FAILURE

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SCORER'S SIGNATURE________________DATE________________

Is this a retest? YES______NO______


FB FORM 20-5-R, 17 JAN 97

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