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newSchoolWorks.com › VoTechWorks › Health & Personal Services › Surgical Technology › Universal Core: Safety, Math, Communication & Career for Surgical Technology › Lesson 2
HLT-SURG65-01 · Lesson 2 · 16 clock hours · lab

First Aid, CPR & Emergency Response in the OR Setting

Objective. Students demonstrate adult, child, and infant CPR and AED use, and perform first aid for shock, hemorrhage control, and wound care on manikins and simulated patients to the standard required for healthcare provider certification.

⚠ Pending professional review

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 Emergency Response Skills Matter in the OR

Surgical technologists work in a controlled environment, but emergencies can occur without warning. A patient's heart may stop during or immediately after a procedure. A team member may collapse. A patient may fall during transfer. Anaphylaxis can develop within minutes of drug or latex exposure. Because the surgical team is already present and already gloved, every member—including the surgical technologist—must respond immediately and correctly. Delay costs lives. Mastery of adult, child, and infant CPR, AED operation, hemorrhage control, and first aid for shock is therefore a core professional competency, not an optional add-on.

Healthcare Provider CPR Standards

Healthcare provider CPR differs from lay-rescuer CPR in key ways. As a surgical technologist student you are trained to meet the standard set by the American Heart Association (AHA) or an equivalent accredited body such as the American Red Cross. That standard requires two-rescuer technique, use of a bag-valve mask (BVM), and the ability to manage an airway while a partner delivers compressions without stopping.

Adult CPR cycle: Compress the center of the chest at least 2 inches deep at a rate of 100–120 compressions per minute. Allow full chest recoil between compressions. Do not lean on the chest. In two-rescuer CPR, deliver 30 compressions followed by 2 breaths (30:2) until an advanced airway is placed; once a definitive airway is in place, deliver continuous compressions at 100–120 per minute with one breath every 6 seconds without pausing compressions.

Child CPR (ages 1 year to puberty): Compress at least one-third the anterior-posterior depth of the chest (approximately 2 inches). One rescuer uses 30:2; two rescuers use 15:2.

Infant CPR (under 1 year): Use two fingers or the two-thumb encircling technique. Compress approximately 1.5 inches. Two-rescuer ratio is 15:2.

Minimize interruptions. Any pause in compressions must be no longer than 10 seconds. Rotate compressors every 2 minutes to maintain quality.

AED Use in the OR Environment

Defibrillation as soon as possible dramatically improves survival from ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT). AED trainer units simulate both shockable rhythms (VF, pVT) and non-shockable rhythms (asystole, pulseless electrical activity). In the OR, a defibrillator is typically present; however, the principles of AED use apply when you are outside the main OR suite.

Safe pad placement: Place one pad on the upper right chest below the clavicle and the second pad on the lower left lateral chest. Ensure pads do not touch each other, do not cover an implanted device (shift pads if needed), and are not placed on a wet surface without first drying the skin.

Verbal clearance: Before every analysis and every shock, announce clearly: "I'm clear, you're clear, everybody clear!" Visually confirm that no one is touching the patient or the stretcher before pressing the shock button.

Non-shockable rhythms: The AED will advise no shock. Continue high-quality CPR and treat reversible causes (the H's and T's).

Hemorrhage Control

Hemorrhage is a leading cause of preventable death following trauma. In a perioperative setting, uncontrolled bleeding may follow a patient fall, an inadvertent instrument injury, or a vascular complication.

Always don gloves and a face shield before contact with blood or body fluids. Standard Precautions apply in every emergency.

Recognition and First Aid for Shock

Shock is inadequate tissue perfusion. Early signs include restlessness, pale or mottled skin, rapid and weak pulse, cool and clammy skin, and falling blood pressure. In the OR, alert the surgeon and anesthesia provider immediately if you observe these signs in a conscious patient.

First aid measures while awaiting definitive treatment:

Anaphylactic shock follows allergen exposure (latex, drugs, contrast media). Signs include hives, bronchospasm, stridor, and rapid cardiovascular collapse. Call for emergency help immediately; epinephrine administration is the definitive treatment and is within the physician's or advanced provider's scope—your role is to recognize the emergency, call for help, and support CPR if the patient loses a pulse.

Communicating Emergencies: SBAR

Structured communication prevents errors during a crisis. SBAR stands for Situation, Background, Assessment, Recommendation. When handing off to a responding team or calling a code, state: what is happening now (Situation), relevant patient history (Background), your clinical impression (Assessment), and what you need (Recommendation). Clear, concise SBAR communication can shave critical minutes from the response time.

Safety Rules for This Lab

Key terms9

Cardiopulmonary resuscitation (CPR)A combination of chest compressions and rescue breaths that maintains circulation and oxygenation when a patient has no pulse and is not breathing normally.
AED (Automated External Defibrillator)A portable device that analyzes cardiac rhythm and delivers an electrical shock to convert a shockable rhythm such as ventricular fibrillation back toward a normal rhythm.
Ventricular fibrillation (VF)A chaotic, disorganized electrical rhythm of the heart that produces no effective pumping action; the most common shockable cardiac arrest rhythm in adults.
SBARA structured communication tool—Situation, Background, Assessment, Recommendation—used to convey critical patient information rapidly and accurately during handoffs and emergencies.
Hemorrhage controlInterventions used to stop or slow uncontrolled bleeding, including direct pressure, wound packing, and tourniquet application.
ShockA life-threatening state of inadequate tissue perfusion that, if untreated, leads to organ failure and death; types include hypovolemic, cardiogenic, distributive (including anaphylactic), and obstructive.
AnaphylaxisA severe, systemic allergic reaction involving multiple organ systems that can rapidly cause airway compromise, vasodilation, and cardiovascular collapse; epinephrine is the primary treatment.
Bag-valve mask (BVM)A handheld device consisting of a self-inflating bag, one-way valve, and face mask used to deliver positive-pressure ventilation without mouth-to-mouth contact; standard equipment for healthcare provider CPR.
Standard PrecautionsInfection-prevention practices applied to all patient care regardless of diagnosis, including use of gloves, face shields, and other PPE whenever contact with blood or body fluids is anticipated.
In class: Practice adult, child, and infant CPR cycles on manikins with real-time feedback devices, rotating through compressor, ventilator, and team-leader roles until each student completes a full uninterrupted two-minute cycle at correct depth and rate. · Work through three simulated OR emergencies in pairs—a circulator cardiac event, a patient fall with suspected hemorrhage, and an anaphylactic reaction—using a skills checklist to document each step taken. · Complete AED trainer scenarios for shockable and non-shockable rhythms, practicing safe pad placement, verbal clearance commands, and hand-off communication using SBAR format.
Materials: Adult, child, and infant CPR manikins with feedback devices; AED trainer units; hemorrhage-control bandaging supplies; PPE (gloves, face shields); American Heart Association or American Red Cross Healthcare Provider CPR course materials; SBAR reference card.
Check: Each student must pass the skills station checkoff for CPR/AED to the standard required by the certifying organization (American Heart Association or equivalent) and score 80% or above on the written first aid knowledge check; students who do not pass the skills station on the first attempt receive remediation and one additional attempt within the same course week.

Practice check8

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

Patient and Worker Safety
1. During adult two-rescuer CPR before an advanced airway is placed, what is the correct compression-to-ventilation ratio?
Patient and Worker Safety
2. A circulator suddenly collapses in the OR. After confirming unresponsiveness and calling for help, the first action should be:
Patient and Worker Safety
3. What is the correct chest compression depth for adult CPR according to current healthcare provider standards?
Patient and Worker Safety
4. Before delivering a shock with an AED, the operator should:
Patient and Worker Safety
5. An OR patient sustains a deep laceration to the thigh from an instrument. Direct pressure has been applied for several minutes but the dressing is soaked through. What is the most appropriate next action?
Patient and Worker Safety
6. A surgical technologist notices that a patient who received a new antibiotic intraoperatively is developing hives, audible wheezing, and a rapidly falling blood pressure. These signs are most consistent with:
Communication
7. When using SBAR to communicate a cardiac emergency to the responding rapid-response team, which component describes your clinical impression of what is wrong with the patient?
Patient and Worker Safety
8. During two-rescuer infant CPR, the preferred chest compression technique and the correct compression-to-ventilation ratio are:
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