CPR, First Aid & Emergency Response in the Rehab Setting — Physical Therapy / Rehab Aide

Objective. Students will perform adult, child, and infant CPR, use an AED trainer, and demonstrate first aid responses to common clinic emergencies including fainting, choking, and falls, meeting American Heart Association or American Red Cross skill verification standards.

Why CPR and First Aid Matter in the Rehab Setting

Physical therapy clinics treat patients who are recovering from surgery, managing chronic illness, or returning to activity after injury. Many of these patients have cardiovascular risk factors. A cardiac emergency, a fainting episode, or a choking incident can happen with little warning. As a rehab aide, you may be the first person to recognize an emergency and act. Your response in the first few minutes can directly determine whether a patient survives and recovers. Earning your CPR/First Aid credential through the American Heart Association (AHA) or American Red Cross is therefore a core requirement of this program — not an optional add-on.

The Emergency Action Plan

Every clinic is required to have a written emergency action plan (EAP). Before you perform any skill, you need to know your clinic's EAP. This plan identifies where the AED is located, who calls 911, who meets the ambulance, and how patients are protected. When an emergency occurs, follow this sequence:

1. Ensure scene safety. Never approach a patient if doing so puts you in danger.

2. Recognize the emergency. Is the person unresponsive? Not breathing normally? Choking?

3. Activate the emergency response system. Shout for help and direct someone to call 911. In a clinic, also alert the supervising physical therapist immediately.

4. Provide care within your scope and training until EMS arrives.

Memorise your clinic's EAP location, the AED location, and the address of the facility before your first day on the floor.

Adult CPR: Core Steps

For an unresponsive adult who is not breathing normally:

Tap and shout to confirm unresponsiveness.
Call or direct someone to call 911 and send another person for the AED.
Position the patient on their back on a firm, flat surface.
Check for a pulse (carotid) for no more than 10 seconds. If absent or uncertain, begin compressions.
Compressions: Push hard and fast at the center of the chest (lower half of the sternum). Compress at least 2 inches deep at a rate of 100–120 compressions per minute. Allow full chest recoil between compressions. Minimize interruptions.
Rescue breaths: Give 2 breaths after every 30 compressions (30:2 ratio) if trained and willing. Each breath should last about 1 second and produce visible chest rise.
Continue until the patient shows obvious signs of life, an AED is ready, trained help takes over, or you are too exhausted to continue.

Child and Infant CPR Differences

For a child (age 1 to puberty), compression depth is about 2 inches, and you may use one or two hands depending on the child's size. The ratio remains 30:2 for a single rescuer.

For an infant (under 1 year), use two fingers on the center of the chest just below the nipple line. Compress about 1.5 inches deep. Use the same 30:2 ratio with a single rescuer. When giving rescue breaths to an infant, cover both the mouth and nose with your mouth.

Always activate EMS. For a witnessed cardiac arrest in children, it is acceptable to perform about two minutes of CPR before leaving to call 911 if you are alone — but in a clinic you should never be the only adult present.

Using an AED

An automated external defibrillator (AED) analyzes heart rhythm and delivers a shock if needed. Steps:

1. Power on the AED (open the lid or press the power button).

2. Attach the pads to bare, dry skin — one pad below the right collarbone, one on the left side below the armpit. Use pediatric pads or a pediatric key for children under 8 years if available.

3. Allow the AED to analyze — ensure no one is touching the patient.

4. If a shock is advised, loudly announce "Clear!" confirm nobody is touching the patient, and press the shock button.

5. Immediately resume CPR, starting with compressions.

6. Follow AED prompts every two minutes.

AED trainers used in lab look and sound identical to real units but deliver no electrical charge — they are safe for repeated practice.

First Aid: Fainting (Syncope)

Fainting is one of the most common clinic emergencies. A patient who stands too quickly from a treatment table may experience a sudden drop in blood pressure. Signs include sudden unresponsiveness, pale or sweaty skin, and a weak pulse.

Lower the patient safely to the floor or recline the treatment table.
Elevate the legs about 12 inches if no injury is suspected — this helps return blood to the heart.
Check responsiveness and breathing. If the patient regains consciousness quickly, keep them calm and still.
Call for the supervising PT and activate 911 if the patient does not regain consciousness promptly, if injury occurred during the fall, or if you are in doubt.

First Aid: Choking

For a conscious choking adult or child: ask "Are you choking?" If the person cannot speak, cough forcefully, or breathe, perform abdominal thrusts (Heimlich maneuver). Stand behind the patient, give 5 back blows between the shoulder blades with the heel of your hand, then 5 abdominal thrusts. Alternate until the object is expelled or the patient loses consciousness. For an infant, use 5 back blows and 5 chest thrusts rather than abdominal thrusts.

First Aid: Falls

If a patient begins to fall, never try to catch them fully — you risk injuring yourself or wrenching the patient. Instead, guide them to the floor by supporting their head and torso. Once they are on the floor, do not move them until you have checked for injury. Call for the supervising PT. If head, neck, or spine injury is possible, keep the patient still and activate 911.

Safety Rules for the Lab

Always use a face shield or manikin barrier when practicing rescue breaths.
Disinfect manikin faces between each student per instructor instructions.
Tell the instructor immediately if you feel unwell during compressions — high-quality CPR is physically demanding.
Never practice on a real person.
Follow the supervising PT's direction in all simulated and real clinic emergencies.

Key terms9

Cardiac arrestSudden cessation of the heart's pumping function, causing loss of consciousness and the absence of normal breathing; requires immediate CPR and defibrillation.

CPR (cardiopulmonary resuscitation)A life-saving technique combining chest compressions and rescue breaths to circulate oxygenated blood when the heart has stopped beating effectively.

AED (automated external defibrillator)A portable device that analyzes a patient's heart rhythm and delivers an electrical shock to restore a normal rhythm if a shockable rhythm is detected.

Emergency action plan (EAP)A facility's written procedure describing roles, communication steps, and resources to be used when a medical or safety emergency occurs.

Syncope (fainting)A brief, sudden loss of consciousness caused by insufficient blood flow to the brain, commonly triggered by standing quickly, pain, or dehydration.

Abdominal thrusts (Heimlich maneuver)A first aid technique for relieving a severe airway obstruction in a conscious person by delivering quick inward-and-upward thrusts just above the navel.

Chest recoilThe full return of the chest wall to its normal position between compressions, which allows the heart to refill with blood before the next compression.

Rescue breathA breath delivered by a rescuer into a patient's airway to provide oxygen when the patient cannot breathe on their own.

Scene safetyThe first step of any emergency response: confirming that the environment is free from hazards that could injure the rescuer before approaching the patient.

In class: Complete the full AHA Heartsaver or equivalent American Red Cross CPR/AED/First Aid course delivered by a certified instructor, including all hands-on skill stations on adult, child, and infant CPR manikins and AED trainer. · Practice clinic-scenario first aid responses in pairs: one student acts as a patient who has fainted after standing up from a treatment table, and the partner works through the emergency action sequence — calling for help, positioning, checking responsiveness and breathing, and initiating CPR if indicated — while the instructor uses a skill verification checklist. · Debrief after each scenario using a stop-start instructor coaching method, where students verbalize each step aloud before performing it, reinforcing the link between decision-making and physical technique.
Materials: AHA Heartsaver or American Red Cross CPR/First Aid course kit (manikins, AED trainer, face shields, course cards), emergency action plan template, clinic scenario cards, skill verification checklist
Check: Passing AHA or American Red Cross skills verification and written test per course standards; valid CPR/First Aid card issued. Maps to CPR/First Aid credential exam area: all skill stations.

Practice check8

Answer each question, then check it. Nothing is recorded; this is your own practice.