CPR, AED, and Basic First Aid Certification — EKG Technician

Objective. Students will perform high-quality CPR for adult, child, and infant victims; operate an AED through a full simulated sequence; and manage common first-aid emergencies—including choking and severe bleeding—to the standard required for an accredited BLS-level or equivalent certification.

Why CPR, AED, and First Aid Matter for EKG Technicians

As an EKG technician, you work directly with patients who may have heart disease, arrhythmias, or other conditions that raise their risk of sudden cardiac arrest (SCA). Recognizing an emergency and acting immediately can be the difference between life and death. Bystander CPR and early defibrillation are the two most powerful tools available before advanced medical help arrives. This lesson prepares you to use both, and to manage other common emergencies including choking and severe bleeding.

The Chain of Survival

The American Heart Association describes a sequence of actions—called the Chain of Survival—that maximizes the chance of surviving cardiac arrest:

1. Recognize the emergency and activate emergency medical services (EMS).

2. Perform high-quality CPR immediately.

3. Provide rapid defibrillation with an AED.

4. Deliver advanced resuscitation by EMS and hospital teams.

5. Support recovery after the event.

Your role as an EKG technician covers the first three links. Every second of delay reduces survival odds, so rehearsed, automatic response is the goal.

Scene Safety

Before touching any victim, confirm the scene is safe. Look for electrical hazards, traffic, water, or anything that could harm you or bystanders. You cannot help a patient if you become one. Once the scene is safe, tap the victim's shoulders firmly and shout, "Are you okay?" If there is no response, no normal breathing (gasping is not normal breathing), and no pulse felt within 10 seconds, begin the emergency sequence immediately.

High-Quality CPR: Key Standards

High-quality CPR has five measurable components:

Rate: 100–120 compressions per minute for adults, children, and infants.
Depth: At least 2 inches (5 cm) for adults; at least 1.5 inches for children; about 1.5 inches (roughly 1.5 inches, or about one-third the depth of the chest) for infants.
Full recoil: Allow the chest to fully rise after each compression. Do not lean on the chest between compressions.
Minimize interruptions: Keep pauses in compressions to fewer than 10 seconds.
Avoid excessive ventilation: Give each breath over 1 second, enough to see the chest rise. Too much air raises pressure in the chest and reduces blood return to the heart.

Adult CPR: Place the heel of one hand on the center of the chest (lower half of the sternum), interlock fingers, keep arms straight, and compress straight down.

Child CPR (ages 1 to puberty): Use one or two hands depending on the child's size; otherwise technique mirrors adult CPR.

Infant CPR (under 1 year): Use the two-finger technique—place two fingers on the center of the chest, just below the nipple line. For two-rescuer infant CPR, the two-thumb–encircling-hands technique is preferred and produces better compression depth and recoil.

Two-rescuer CPR with bag-valve mask (BVM): One rescuer compresses while the other manages the airway and delivers ventilations through the BVM with an EC-clamp mask seal. Rescuers switch compressor roles every two minutes to maintain quality. A BVM allows delivery of room air or supplemental oxygen and avoids direct mouth-to-mouth contact.

Compression-to-ventilation ratio: 30:2 for single-rescuer adult and child CPR. For two-rescuer child or infant CPR, the ratio changes to 15:2.

Using an AED

An automated external defibrillator (AED) analyzes heart rhythm and delivers a shock if a shockable rhythm (ventricular fibrillation or pulseless ventricular tachycardia) is detected. Steps:

1. Power on the AED.

2. Attach pads to the bare, dry chest as shown in the diagram on the pads—one pad below the right collarbone, one on the lower left side of the chest.

3. Plug in the connector if required.

4. Clear the patient and allow the AED to analyze.

5. Clear and shock if the AED advises. Say "I'm clear, you're clear, everybody's clear" and visually confirm before pressing the shock button.

6. Resume CPR immediately after the shock for two minutes before the AED re-analyzes.

For children younger than 8 years, use pediatric pads or a pediatric dose-attenuating system if available. Never use pediatric pads on an adult.

First Aid: Choking

Adult and child (over 1 year) conscious choking: Confirm a complete obstruction (victim cannot speak, cry, or cough effectively). Deliver abdominal thrusts (Heimlich maneuver)—stand behind the victim, make a fist above the navel and below the sternum, and thrust inward and upward until the object is expelled or the victim loses consciousness. If the victim loses consciousness, lower them carefully and begin CPR; look in the mouth before ventilating and remove any visible object.

Infant (under 1 year) conscious choking: Give 5 back blows (firm strikes between the shoulder blades with the heel of your hand, infant face-down) followed by 5 chest thrusts (two fingers on center of chest, infant face-up). Alternate until the object is expelled or the infant loses consciousness.

First Aid: Severe Bleeding

Apply direct pressure with a clean dressing and maintain it. Do not remove soaked dressings—add more on top. For limb wounds, a tourniquet may be indicated when direct pressure is insufficient. For wounds not amenable to a tourniquet, a wound-packing and pressure-dressing technique is used. Note the time bleeding control was started and report it to EMS.

Recovery Position

For an unconscious victim who is breathing adequately and has no suspected spinal injury, place them in the recovery position (lateral recumbent): roll the victim onto their side, support the head, and bend the top knee forward to stabilize the body. This keeps the airway open and allows fluid to drain.

Scope of Practice Reminder

As an EKG technician, CPR and basic first aid represent the ceiling of your emergency response role—not a license to perform advanced interventions. Document what occurred and hand off to qualified medical personnel as soon as they arrive.

Key terms10

Chain of SurvivalA sequence of time-sensitive actions—recognition, CPR, defibrillation, advanced care, and recovery support—that together maximize survival from sudden cardiac arrest.

Sudden cardiac arrest (SCA)The abrupt loss of effective heart function, resulting in unresponsiveness and absent or abnormal breathing, requiring immediate CPR and defibrillation.

High-quality CPRChest compressions delivered at the correct rate (100–120/min) and depth, with full chest recoil, minimal interruptions, and appropriately paced ventilations.

Automated external defibrillator (AED)A portable device that analyzes cardiac rhythm and delivers an electrical shock to terminate certain life-threatening arrhythmias such as ventricular fibrillation.

Bag-valve mask (BVM)A handheld device consisting of a self-inflating bag, one-way valve, and face mask used to deliver positive-pressure ventilations without mouth-to-mouth contact.

Two-finger techniqueThe single-rescuer method of infant chest compressions using two fingers placed on the center of the chest just below the nipple line.

Abdominal thrustAn inward and upward thrust applied below the sternum and above the navel to expel a foreign-body airway obstruction in conscious adults and children over 1 year.

Recovery positionA lateral recumbent position used for unconscious breathing victims without suspected spinal injury to keep the airway open and allow fluid drainage.

Ventricular fibrillation (VF)A chaotic, disorganized heart rhythm that produces no effective pumping action and is the most common shockable rhythm in sudden cardiac arrest.

Full chest recoilThe complete return of the chest wall to its resting position between compressions, essential for allowing the heart to refill with blood before the next compression.

In class: Skills station rotation: students cycle through adult CPR on a manikin (compression depth, rate, and recoil checked by an electronic feedback manikin), child CPR, infant CPR using two-finger technique, and two-rescuer CPR with bag-valve mask, performing at least three full two-minute cycles at each station under instructor observation. · AED simulation drill: using a training AED and adult manikin, each student independently performs the full chain of survival sequence—scene safe, call for help, begin CPR, attach AED, follow prompts—timed from collapse to first shock attempt, with the instructor recording time-to-shock and technique errors. · First-aid scenario carousel: four stations (adult choking/abdominal thrusts, infant choking/back blows and chest thrusts, pressure dressing for severe bleeding, and recovery position) with each student completing all stations and self-assessing on a provided skills checklist before instructor sign-off.
Materials: Adult, child, and infant CPR manikins (with electronic feedback capability if available), training AED units, bag-valve mask trainers, first-aid scenario props (hemorrhage control dressing, choking simulation vest or demo), accredited CPR/AED/first aid provider course materials and skills verification cards, skills competency checklists
Check: Students must pass the accredited provider's written and skills evaluations to earn the CPR/AED/First Aid card; additionally, AED drill time-to-shock must be within the window specified by the certifying organization, and all critical skills steps on the instructor checklist must be marked satisfactory.

Practice check8

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