First Aid and CPR/AED Certification

Why CPR, AED, and First Aid Matter in Practical Nursing

As an LPN, you will encounter emergencies before a physician or advanced provider arrives. Knowing how to act in the first minutes of a cardiac arrest, severe bleeding event, or airway obstruction can preserve life and brain function. The skills in this lab are not optional background knowledge — they are a required, tested competency and a condition of your enrollment in clinical sites.

All students in this program must earn a valid certification card from an accredited course provider (such as the American Heart Association BLS for Healthcare Providers or an equivalent recognized program) before advancing. This card demonstrates you can perform these skills to a verified standard.

The Chain of Survival

The chain of survival is the sequence of actions that gives a cardiac arrest victim the best chance of survival:

1. Early recognition and activation — recognize that the person is unresponsive and not breathing normally; activate emergency response (call 911 or call for the crash cart in a facility).

2. Early CPR — begin high-quality chest compressions immediately to maintain circulation.

3. Rapid defibrillation — apply an AED as soon as one is available; early defibrillation dramatically improves outcomes in shockable rhythms.

4. Advanced life support — EMS or the facility's code team takes over with medications and advanced airway management.

5. Post-cardiac-arrest care — ongoing care after return of spontaneous circulation (ROSC).

As a first responder in the chain, your role covers steps one through three.

High-Quality CPR: Adults, Children, and Infants

Adult CPR

• Place the heel of one hand on the center of the chest (lower half of the sternum), place the other hand on top, and interlace fingers.
• Compress at least 2 inches deep but no more than 2.4 inches.
• Rate: 100–120 compressions per minute.
• Allow full chest recoil between compressions; do not lean on the chest.
• Minimize interruptions; limit pauses to less than 10 seconds.
• Compression-to-ventilation ratio: 30:2 when no advanced airway is in place.

Child CPR (1 year to puberty)

• Use one or two hands depending on child size; compress at least one-third the depth of the chest (approximately 2 inches).
• Rate and ratio are the same as adults: 100–120 per minute, 30:2 with one rescuer.

Infant CPR (birth to 1 year, excluding newborns)

• Use two fingers on the center of the chest, just below the nipple line; with two rescuers, use the two-thumb encircling technique.
• Compress at least one-third the depth of the chest (approximately 1.5 inches).
• Rate: 100–120 per minute; ratio 30:2 with one rescuer.

Rescue Breathing

Deliver each breath over about 1 second, enough to see the chest rise. Avoid excessive ventilation, which can cause gastric inflation and reduce cardiac output.

Using an AED

1. Power on the AED as soon as it arrives.

2. Attach pads — adult pads go on the upper right chest and the lower left side. For children under 8 years or under approximately 55 pounds, use pediatric pads or pediatric attenuation keys if available; if not, adult pads may be used.

3. Clear the victim — make sure no one is touching the patient while the AED analyzes rhythm.

4. Deliver shock if advised, then immediately resume CPR starting with compressions.

5. Continue following AED prompts until advanced providers take over or the patient shows signs of ROSC.

Safety note: Never use an AED near standing water. Remove any medication patches from the chest before placing pads. If a patient has an implanted pacemaker or defibrillator, place pads at least 1 inch away from the device.

First Aid: Choking (Airway Obstruction)

Conscious adult or child: Deliver five back blows between the shoulder blades with the heel of your hand, then five abdominal thrusts (Heimlich maneuver). Alternate until the object is expelled or the person becomes unresponsive.

Conscious infant: Five back blows followed by five chest thrusts (never abdominal thrusts on an infant). If the infant becomes unresponsive, begin infant CPR and look in the mouth for the object before delivering breaths.

Unresponsive victim: Begin CPR. Before delivering breaths, look in the mouth and remove any visible object — do not perform blind finger sweeps.

Hemorrhage Control

Severe external bleeding is life-threatening within minutes. Use the following progression:

1. Direct pressure — apply firm, continuous pressure with a dressing. Do not lift the dressing to check; add additional dressings on top.

2. Wound packing — for deep wounds that cannot be controlled with surface pressure, pack the wound tightly with gauze before applying direct pressure.

3. Tourniquet — for life-threatening limb bleeding that cannot be controlled with direct pressure, apply a commercial tourniquet (such as a CAT) approximately 2–3 inches above the wound. Note the time of application. Never remove a tourniquet once applied; leave removal to advanced providers.

Shock Management

Shock is a state of inadequate tissue perfusion. Early signs include pale, cool, clammy skin; rapid weak pulse; and altered mental status. Nursing actions at the first-aid level:

• Control any identified source of bleeding.
• Keep the patient warm and calm.
• Position the patient flat unless contraindicated by suspected spinal injury or breathing difficulty.
• Activate emergency response immediately and monitor continuously.
• Do not give food or fluids.

Recovery Position

An unresponsive patient who is breathing and has no suspected spinal injury should be placed in the recovery position (on their side) to keep the airway open and reduce the risk of aspiration.

Safety Reminders

• Don gloves before contact with any patient when available.
• Use a face shield or pocket mask for rescue breathing on manikins and in clinical practice.
• Perform a scene safety assessment before approaching any emergency.
• Know your facility's emergency response system and your role within it.