First Aid, CPR, and Jobsite Emergency Response

Why First Aid and CPR Matter on a Roof

Construction workers face a higher rate of fatal injuries than workers in most other industries, and falls are the leading cause of roofing fatalities. When a co-worker collapses or is injured on a jobsite, the first few minutes determine whether that person survives. Emergency medical services (EMS) may take several minutes to arrive, especially on remote or high-rise sites. A trained responder on the scene—you—can be the difference between life and death.

This lesson prepares you to act immediately, confidently, and correctly until professional help arrives.

Recognizing a Life-Threatening Emergency

Before you can help, you must recognize that an emergency exists. Signs that require immediate action include:

• Unresponsiveness: The worker does not react when you tap their shoulders and shout, "Are you okay?"
• Absent or abnormal breathing: No chest rise, or only occasional gasping (agonal breathing), is not normal breathing.
• Severe bleeding: Blood that is soaking through clothing rapidly or spurting from a wound.
• Suspected spinal injury: Any fall from height should be treated as a possible spinal injury until EMS says otherwise—minimize movement of the head and neck.

If you see any of these signs, activate the emergency response system immediately.

Activating the Emergency Response System

Every jobsite must have a written emergency action plan. Know it before you need it. The standard sequence is:

1. Ensure scene safety. Before approaching, confirm the area is safe—no live electrical hazards, no unstable structure, no ongoing fall risk. Do not become a second victim.

2. Call or direct someone to call 911. Point to a specific person: "You—call 911 now." Give the dispatcher the site address, the nearest cross street, and GPS coordinates if available. Stay on the line and follow dispatcher instructions.

3. Send someone to meet EMS at the site entrance to guide them directly to the patient.

4. Begin care with the skills you are certified in.

Adult CPR: The Chain of Survival

Cardiopulmonary resuscitation (CPR) circulates blood to the brain and heart when the heart has stopped. The American Heart Association (AHA) and American Red Cross (ARC) teach the same core sequence for adult lay responders:

1. Check for responsiveness – tap and shout.

2. Call 911 (or direct a bystander to call) and send for an AED.

3. Check breathing for no more than 10 seconds.

4. Begin chest compressions – place the heel of one hand on the center of the chest (lower half of the breastbone), place your other hand on top, lock your elbows, and compress at least 2 inches deep at a rate of 100–120 compressions per minute. Allow the chest to fully recoil after each compression.

5. Deliver rescue breaths (if trained and willing) – tilt the head, lift the chin, seal the mask or give mouth-to-mouth, and watch for chest rise. Give 2 breaths after every 30 compressions (30:2 ratio).

6. Continue until the AED is ready, EMS takes over, or the scene becomes unsafe.

High-quality compressions—correct rate, correct depth, full recoil, minimal interruptions—are the most critical factor in survival.

AED Operation

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—the device will talk you through the rest).

2. Attach pads to the patient's bare, dry chest as shown in the diagram on the pads.

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

4. If a shock is advised, shout "Clear!" visually confirm no contact, then press the shock button.

5. Immediately resume CPR beginning with compressions.

6. Follow AED prompts every 2 minutes.

Controlling Severe Bleeding

Several roofing injuries—lacerations from sheet metal, punctures from fasteners, or trauma from a fall—can cause life-threatening blood loss within minutes.

Direct pressure: Apply firm, continuous pressure with a clean cloth or gauze. Do not remove the material; add more on top if it soaks through. Maintain pressure for a minimum of 10 minutes.

Wound packing: For deep wounds (such as punctures), pack gauze firmly into the wound cavity while maintaining pressure.

Tourniquet application: For severe limb bleeding that direct pressure cannot control, apply a commercial tourniquet (such as a CAT or SOFTT-W) 2–3 inches above the wound. Tighten until bleeding stops. Note the time of application. Never remove a tourniquet in the field once applied.

Always wear disposable gloves before contact with blood or body fluids—this is standard bloodborne pathogen precaution.

The Jobsite Emergency Card

You will build a laminated emergency card for your career portfolio. It must include:

• Local emergency number (911) and any site-specific emergency line
• The jobsite address and nearest cross street
• GPS coordinates (look them up in advance for each new site)
• Step-by-step responder sequence (scene safe → call 911 → CPR/AED → bleeding control → meet EMS)

Post a copy at the site office or gang box. Update it whenever you move to a new site.

PPE and Safety Reminders

• Wear disposable gloves for all bleeding-control practice and real incidents.
• Use a CPR face shield or mask—never skip barrier protection.
• On a real scene, do not enter an area that is not confirmed safe; a rescuer who is injured helps no one.
• If a fall victim is on a roof, treat all movement of the head and neck with extreme caution until EMS clears a spinal injury.