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newSchoolWorks.com › VoTechWorks › Health & Personal Services › Pharmacy Technician › Universal Core: Safety, Pharmacy Math, Communication & Career › Lesson 2
HLT-PHAR41-01 · Lesson 2 · 8 clock hours · practice

BLS for healthcare providers: CPR, AED and first aid

Objective. Respond to a collapse, choking, bleeding or an allergic reaction in the pharmacy until EMS arrives, including epinephrine auto-injector use.

⚠ Pending professional review

This lesson, its worked examples and its practice questions has not yet been verified by a licensed pharmacist 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 Pharmacy Technicians Need Basic Life Support Skills

Pharmacy technicians work in settings where customers and coworkers can collapse, choke, bleed severely, or suffer a life-threatening allergic reaction at any moment. A cardiac arrest victim's chance of survival falls by roughly 10 percent for every minute without CPR or defibrillation. Because EMS may be several minutes away, trained staff who act immediately save lives. BLS certification is also required or strongly encouraged by many employers, and it demonstrates the patient-safety commitment that both the PTCB and NHA credential programs emphasize.

Recognizing and Responding to Cardiac Arrest

When a person suddenly collapses, first confirm the scene is safe, then tap the person firmly on both shoulders and shout, "Are you okay?" If there is no response and no normal breathing (gasping is not normal breathing), call 911 or send a bystander to call, and send another person to get the AED.

Adult and adolescent CPR (hands-only or with breaths):

1. Place the heel of one hand on the center of the chest (lower half of the sternum). Place the other hand on top, fingers interlaced.

2. Keep arms straight and compress at least 2 inches deep at a rate of 100–120 compressions per minute. Allow full chest recoil between compressions. Minimize interruptions.

3. If trained and willing, give 2 rescue breaths after every 30 compressions (30:2 ratio). Tilt the head, lift the chin, create a seal, and give each breath over about 1 second—just enough to see the chest rise.

Child (1 year to puberty): Use the same 30:2 ratio. Compress at least one-third the depth of the chest (about 2 inches). One or two hands may be used depending on child size.

Infant (under 1 year): Use two fingers (or the two-thumb encircling technique with two rescuers) on the center of the chest just below the nipple line. Compress about 1.5 inches. Ratio remains 30:2 for a single rescuer; two-rescuer infant CPR uses a 15:2 ratio.

Continue CPR until the AED is ready, the person shows obvious signs of life, or trained EMS personnel take over.

Using an Automated External Defibrillator (AED)

AEDs are designed for bystander use and give clear voice and visual prompts. As soon as the AED arrives:

1. Power it on.

2. Attach the pads to bare skin as shown in the diagrams (upper right chest; lower left side beneath the armpit).

3. Ensure no one is touching the person while the AED analyzes the rhythm.

4. If a shock is advised, make sure everyone is clear and press the shock button.

5. Immediately resume CPR after the shock. Follow AED prompts.

Use pediatric pads or a pediatric mode for children under approximately 8 years or 55 lb if available. If not available, adult pads may be used.

Choking (Airway Obstruction)

A conscious adult or child who cannot speak, cough forcefully, or breathe should receive abdominal thrusts (Heimlich maneuver): stand behind the person, make a fist above the navel and below the breastbone, grasp it with the other hand, and deliver firm inward-and-upward thrusts until the object is expelled or the person becomes unconscious. If the person becomes unconscious, lower them carefully and begin CPR; each time you open the airway to give breaths, look for and remove visible objects.

For a choking infant, alternate 5 back blows (heel of hand between shoulder blades, face-down) with 5 chest thrusts (two fingers on the sternum). Never perform blind finger sweeps on an infant.

Controlling Severe Bleeding

Apply direct, firm pressure with a clean cloth or gloves. Maintain continuous pressure; do not lift the cloth to check. If bleeding does not stop or a limb is severely injured, a commercially made tourniquet placed 2–3 inches above the wound may be needed. Note the time it was applied. Keep the person calm and still and treat for shock (lay flat, maintain warmth) until EMS arrives. Always use gloves or a barrier to protect yourself from bloodborne pathogens.

Anaphylaxis and Epinephrine Auto-Injector Use

Anaphylaxis is a rapid, life-threatening allergic reaction. Signs include hives, throat or tongue swelling, difficulty breathing, drop in blood pressure, and loss of consciousness. Call 911 immediately. Epinephrine is the first-line treatment.

An epinephrine auto-injector (such as EpiPen®) is used as follows:

1. Remove the device from its carrier and take off the safety cap.

2. Hold the device in a dominant-hand fist with the tip pointed downward.

3. Press the tip firmly against the outer mid-thigh (through clothing is acceptable) and hold for approximately 10 seconds.

4. Remove and massage the area for 10 seconds.

5. Note the time and give EMS the used device.

A second dose may be given after 5–15 minutes if symptoms do not improve and a second device is available. Epinephrine buys time—EMS transport and hospital evaluation are always required.

Opioid Overdose and Naloxone

Signs of opioid overdose include slow or absent breathing, blue lips or fingernails, pinpoint pupils, and unresponsiveness. Many pharmacies stock naloxone (Narcan®), an opioid reversal agent. Administer naloxone per your pharmacy's protocol, call 911, and begin rescue breathing or CPR as needed. Naloxone's effect may wear off before the opioid does; the person must be evaluated by EMS.

Scope of Practice and Safety Reminders

Key terms8

Cardiac arrestSudden cessation of effective heart function, causing loss of pulse and breathing; requires immediate CPR and defibrillation.
CPR (cardiopulmonary resuscitation)Chest compressions, with or without rescue breaths, performed to maintain blood flow and oxygenation until normal heart rhythm is restored.
AED (automated external defibrillator)A portable device that analyzes heart rhythm and delivers an electric shock to restore a normal rhythm in sudden cardiac arrest.
AnaphylaxisA severe, life-threatening allergic reaction involving multiple body systems; treated first with epinephrine.
Epinephrine auto-injectorA pre-filled, single-dose device that delivers epinephrine into the outer thigh to reverse the effects of anaphylaxis.
NaloxoneAn opioid antagonist medication used to rapidly reverse opioid overdose; available in nasal spray and injectable forms.
Abdominal thrust (Heimlich maneuver)Inward-and-upward pressure applied below the breastbone to expel a foreign-body airway obstruction in a conscious person.
Rescue breathA breath delivered by a rescuer into a non-breathing victim's airway to supply oxygen during CPR.
In class: Skills stations: adult/child/infant CPR, AED · Anaphylaxis and opioid-overdose scenarios (naloxone) · Certification skills check
Materials: Manikins, AED trainer, auto-injector and naloxone trainers
Check: AHA BLS card issued

Practice check8

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

Patient Safety and Quality Assurance
1. An adult customer collapses in the pharmacy waiting area. You confirm she is unresponsive and not breathing normally. What is your FIRST action?
Patient Safety and Quality Assurance
2. When performing chest compressions on an adult, which of the following is correct?
Patient Safety and Quality Assurance
3. A pharmacy coworker is performing single-rescuer CPR on a 6-month-old infant. What is the correct compression-to-ventilation ratio?
Patient Safety and Quality Assurance
4. You attach AED pads to an unresponsive adult. The AED advises a shock. What must you do immediately before pressing the shock button?
Patient Safety and Quality Assurance
5. A customer grabs his throat with both hands, cannot speak, and is turning red. He is conscious. Which action is most appropriate?
Patient Safety and Quality Assurance
6. A patient in the pharmacy breaks out in hives, has audible wheezing, and reports her throat feels like it is closing after taking a new antibiotic sample. After calling 911, what is the priority treatment?
Patient Safety and Quality Assurance
7. Which set of signs is most consistent with an opioid overdose requiring naloxone administration?
Patient Safety and Quality Assurance
8. A pharmacy technician applies direct pressure to a customer's severe laceration. Which action is correct while waiting for EMS?
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