AHA CPR and First Aid Skills Review and Competency Check-Off

AHA CPR and First Aid Skills Review and Competency Check-Off

This lab session prepares you to pass the American Heart Association (AHA) HeartSaver skills check-off — a required step to earn your AHA CPR/First Aid course completion card. That card is recognized by employers in elder care, home health, and long-term care settings across the country. Every skill reviewed today has a direct impact on patient survival; errors in technique are not minor — they can mean the difference between life and death for a client in your care.

Why CPR and First Aid Matter in Elder Care

Older adults are at elevated risk for cardiac arrest, choking, falls, and sudden illness. As a Home Health Aide (HHA) or Certified Nursing Assistant (CNA), you may be the first — and only — person present when a life-threatening emergency occurs. Acting correctly within the first few minutes dramatically improves a client's chance of survival and recovery. Your legal and professional scope of practice requires that you maintain a current CPR/First Aid credential.

Adult CPR with AED: The Complete Sequence

Follow these steps in order every time:

1. Scene safety — Confirm the scene is safe before approaching.

2. Responsiveness — Tap shoulders firmly and shout, "Are you okay?"

3. Activate emergency response — Call 911 (or direct someone else to call) and send for an AED.

4. Check for breathing — Look for no breathing or only gasping for no more than 10 seconds.

5. Pulse check — Check the carotid pulse for no more than 10 seconds simultaneously with the breathing check.

6. Position hands — Place the heel of one hand on the center of the chest (lower half of the sternum); place the other hand on top, fingers interlaced and lifted.

7. Compressions — Push hard and fast: compress at least 2 inches deep at a rate of 100–120 compressions per minute. Allow full chest recoil after each compression; minimize interruptions.

8. Rescue breaths — After 30 compressions, give 2 rescue breaths using a barrier mask; each breath should last about 1 second and produce visible chest rise (30:2 ratio).

9. AED — As soon as the AED arrives, power it on, attach pads per the diagram, follow prompts, deliver shock if advised, and immediately resume CPR.

Critical error to avoid: Leaning on the chest between compressions prevents full recoil and reduces blood flow.

Child and Infant CPR

For children (ages 1 year to puberty), the technique is similar to adult CPR, but use one or two hands and compress approximately 2 inches (at least one-third the depth of the chest). The compression-to-ventilation ratio remains 30:2 for a single rescuer.

For infants (under 1 year), place two fingers on the center of the chest just below the nipple line. Compress about 1.5 inches deep at the same rate of 100–120 compressions per minute. For rescue breaths, cover both the infant's mouth and nose with your mouth. Use the same 30:2 ratio for a single rescuer. When applying an AED to an infant, use infant/child pads and an attenuator if available.

Choking: Conscious Adult and Child

If a victim is conscious and cannot cough, speak, or breathe:

• Stand behind the person, give 5 firm back blows between the shoulder blades with the heel of your hand.
• Follow immediately with 5 abdominal thrusts (Heimlich maneuver): make a fist above the navel and below the breastbone, cover with the other hand, and thrust inward and upward.
• Alternate 5-and-5 until the object is expelled or the victim loses consciousness.

For infants, use 5 back blows and 5 chest thrusts — never abdominal thrusts on an infant.

If the victim becomes unconscious, lower them carefully, call 911, and begin CPR. Each time you open the airway to give breaths, look for an object and remove it only if you can see it.

Controlling Uncontrolled Bleeding

• Apply firm, direct pressure with a gloved hand and a clean cloth or gauze pad.
• Do not remove the pad if it saturates — add more material on top.
• Maintain continuous pressure for a sustained period until bleeding stops or EMS arrives.
• Elevate the injured limb above heart level if no fracture is suspected.
• Use gloves at all times; blood and body fluids are potential infection hazards (Standard Precautions).

Shock Positioning and Recognition

Signs of shock include pale or mottled skin, rapid weak pulse, confusion, and weakness. Unless injury contraindicates it, help the person lie flat and elevate the legs approximately 12 inches (modified Trendelenburg position). Keep the person warm and calm, do not give anything by mouth, and activate EMS immediately. Shock is a life-threatening emergency.

Sudden Illness: Stroke, Diabetic Emergency, Seizure

• Stroke (BE-FAST): Balance loss, Eyes (vision change), Face drooping, Arm weakness, Speech difficulty, Time to call 911.
• Diabetic emergency: If the person is conscious and can swallow, offer a small amount of juice or sugar if low blood sugar is suspected; call 911.
• Seizure: Protect from injury, do not restrain, do not put anything in the mouth, time the seizure, and place in recovery position afterward.

Safety and Scope of Practice Reminders

• Always activate 911 first or have someone else do so while you begin care.
• Wear gloves and use a barrier mask to protect yourself and the client.
• Document every emergency response and report to your supervisor immediately.
• Never perform skills beyond your training or scope of practice.
• Your AHA course completion card must remain current; check your employer's renewal requirement, typically every two years.