CPR, AED, and First Aid Certification
Objective. Students will perform adult, child, and infant CPR with AED integration and provide basic first aid interventions for choking, bleeding, shock, and seizure to the standard required for a current AHA BLS for Healthcare Providers or equivalent Red Cross certification.
This lesson, its worked examples and its practice questions has not yet been verified by a licensed clinician in the field or by a certification or approval body. It is a study draft and may contain errors. Do not use it to make decisions about any patient or medication. Always follow your instructor, your supervising professional, and current official references and regulations.
VoTechWorks program approval and accreditation are still in progress. Credentials are issued only by the certifying bodies named in each program, after their own exams.
Why CPR, AED, and First Aid Matter for CNAs
As a nursing assistant, you will be at the bedside more than almost any other member of the care team. That means you are often the first person to notice when a patient stops breathing, begins to choke, or collapses. Your ability to act correctly in the first few minutes can mean the difference between life and death. Most states require CNAs to hold a current CPR certification — typically the American Heart Association (AHA) BLS for Healthcare Providers or an equivalent American Red Cross course — before they may work in a clinical setting. This lesson prepares you to earn and maintain that certification.
Adult CPR: The Chain of Survival
The AHA describes a "chain of survival" — a series of steps that, when performed quickly and correctly, give cardiac arrest victims the best chance of survival. For in-hospital and facility settings those steps begin with recognizing the emergency and calling for help, then starting high-quality CPR, then using an AED as soon as one is available, and finally handing care off to advanced providers.
Checking the scene and the patient. Before touching anyone, confirm the scene is safe. Then tap the patient's shoulders firmly and shout, "Are you okay?" If there is no response and no normal breathing (gasping is not normal breathing), activate the emergency response system — call out for help, use the facility call system, or direct a bystander to call 911 — and send someone for the AED.
Compressions. Place the heel of one hand on the center of the chest (lower half of the sternum), place your other hand on top, and interlock your fingers. Keep your arms straight and compress straight down. For adults, compress at least 2 inches but no more than 2.4 inches, at a rate of 100–120 compressions per minute. Allow full chest recoil after each compression — do not lean on the chest. Minimize interruptions; pauses in compressions should be no longer than 10 seconds.
Rescue breaths. With an advanced airway not in place, deliver 30 compressions followed by 2 rescue breaths (30:2 ratio). Use a pocket mask or bag-valve mask with a one-way valve — never give mouth-to-mouth without a barrier device in a healthcare setting. Each breath should last about 1 second and produce visible chest rise. Avoid excessive ventilation.
Child and Infant CPR
Children (roughly age 1 to puberty) receive the same 30:2 ratio as adults when a single rescuer is present; two rescuers use a 15:2 ratio. Compression depth is about 2 inches, or at least one-third the depth of the chest.
For infants (under 1 year), a single rescuer uses two fingers placed just below the nipple line on the sternum. Two rescuers use the two-thumb encircling technique, which generates better pressure. Depth is about 1.5 inches, or at least one-third the chest depth. The ratio remains 30:2 for one rescuer, 15:2 for two rescuers. Rescue breaths cover the infant's mouth AND nose.
AED Use
An Automated External Defibrillator (AED) analyzes heart rhythm and delivers an electrical shock to restore a normal rhythm in cases of ventricular fibrillation or pulseless ventricular tachycardia. Time to defibrillation is critical — for every minute without a shock, survival odds drop significantly.
Steps: Power on the AED. Attach pads to bare, dry skin — one pad below the right collarbone, one pad on the left side of the chest below and to the left of the heart. Plug in the connector if required. Clear everyone from the patient before analysis and before shock delivery (shout "Clear!" and visually confirm no one is touching the patient). Press the shock button when prompted. Immediately resume CPR starting with compressions after the shock. The AED will prompt you to re-analyze every 2 minutes.
For children under 8 years or under approximately 55 pounds, use pediatric pads or a pediatric key/setting if available. If only adult pads are available, use them — do not delay defibrillation.
First Aid: Choking, Bleeding, Shock, and Seizure
Choking (conscious adult/child). If a person can cough forcefully, encourage coughing. If they cannot cough, cry, or speak, perform abdominal thrusts (Heimlich maneuver): stand behind the person, make a fist just above the navel and well below the breastbone, cover it with your other hand, and give quick, firm, upward thrusts. Continue until the object is expelled or the person becomes unresponsive. If unresponsive, lower them to the floor and begin CPR — look in the mouth before each breath and remove any visible object.
Severe bleeding. Apply direct pressure with a gloved hand and gauze pad. Maintain firm, continuous pressure. Do not remove soaked gauze; add more on top. Elevate the limb if no fracture is suspected. If bleeding is life-threatening and from an extremity, a tourniquet may be indicated — follow facility protocol.
Shock. Signs include pale/cool/clammy skin, rapid weak pulse, altered mental status, and low blood pressure. Lay the patient flat, keep them warm, do not give anything by mouth, and activate emergency services. Do not elevate legs if spinal or head injury is suspected.
Seizure. Protect the patient from injury by clearing hard objects, cushion the head, and position them on their side after the seizure to protect the airway. Never restrain the person or put anything in their mouth. Time the seizure and call for emergency help if it lasts more than 5 minutes, if there is no known seizure history, or if the patient does not regain consciousness.
Safety and Scope of Practice Reminders
- Always don gloves before contact with blood or body fluids.
- A CNA does not diagnose or prescribe; your role is to recognize, respond, activate the emergency system, and support until advanced help arrives.
- Your CPR certification must remain current (typically renewed every 2 years); working with a lapsed card is a scope-of-practice and legal violation.
- Report every emergency response in the patient record per facility policy.
Key terms8
Materials: Adult and infant CPR manikins (minimum one manikin per two students); training AED units; first aid kit supplies (gloves, gauze, bandages, CPR masks, barrier devices); AHA BLS for Healthcare Providers or American Red Cross First Aid/CPR/AED course materials and certification cards; skills-check score sheets
Check: Student passes the certifying organization's written exam (per organization's current passing standard) and all required hands-on skills checkoffs without critical errors; valid certification card issued as evidence of pass.
Practice check8
Answer each question, then check it. Nothing is recorded; this is your own practice.
