First Aid, CPR, and AED — Fire Service Context

Why First Aid and CPR Matter in the Fire Service

Firefighters are often the first medically trained personnel to reach a patient. Whether you are responding to a structure fire with an injured civilian, a vehicle accident, or a medical emergency in your own station, the ability to recognize a life threat and act immediately is a core job duty. NFPA 1001 Standard for Fire Fighter Professional Qualifications identifies emergency medical care as a foundational Firefighter I job performance requirement. The AHA Heartsaver First Aid/CPR/AED certification you earn in this lab gives you a nationally recognized baseline credential and prepares you for the more advanced patient-care content in your NREMT EMT studies.

Recognizing a Life Threat: Scene Safety First

Before you touch any patient, assess the scene. On a fireground or roadway, hazards — traffic, smoke, unstable structures, energized lines — can injure or kill a rescuer. Verify the scene is safe or made safe before approach. Don appropriate PPE: at minimum, gloves and a barrier device (face shield or pocket mask) before beginning CPR or wound care. If blood or airborne hazards are present, eye protection and appropriate respiratory protection apply. This is not optional — bloodborne pathogen exposure is a real occupational risk.

Adult CPR with AED

For an unresponsive adult who is not breathing normally or is only gasping, begin CPR immediately:

1. Check for responsiveness and normal breathing (no more than 10 seconds).

2. Call — activate EMS or direct a bystander to call 9-1-1 and retrieve an AED.

3. Compress — position the heel of one hand on the center of the chest (lower half of the sternum), second hand on top, arms straight. Push hard and fast: at least 2 inches deep at a rate of 100–120 compressions per minute. Allow full chest recoil after each compression.

4. Ventilate — after every 30 compressions, give 2 breaths, each lasting about 1 second, enough to produce visible chest rise. Use a bag-mask device or pocket mask with a one-way valve whenever available.

5. AED — as soon as the AED arrives, power it on and follow its voice prompts. Apply pads to bare, dry skin: one below the right collarbone, one to the lower left side of the chest. Ensure no one is touching the patient before analyzing or delivering a shock. Immediately resume CPR after the shock.

Minimize interruptions to compressions. High-quality CPR — adequate rate, adequate depth, full recoil, minimal pauses — is the single most important factor in survival.

Two-Rescuer CPR

In the fire service, you rarely work alone. With two rescuers, one compresses while the other manages the airway with a bag-mask device. Switch compressor roles every two minutes or at any sign of fatigue to maintain compression quality. The airway rescuer also operates the AED and communicates clearly during rhythm checks.

Infant and Child CPR

For children (roughly 1 year to puberty): use one or two hands, compress at least 2 inches at 100–120 per minute, 30:2 ratio for one rescuer. For infants (under 1 year): use two fingers on the center of the chest just below the nipple line, compress at least 1.5 inches, 30:2 ratio for one rescuer. With two rescuers on an infant, use the two-thumb encircling technique for better depth and consistency. AED use in pediatric patients follows local protocol and manufacturer guidance; pediatric pads or an attenuator are used when available.

Relief of Choking

For a conscious choking adult or child, deliver up to 5 firm back blows between the shoulder blades with the heel of your hand, then up to 5 abdominal thrusts (Heimlich maneuver). Alternate back blows and abdominal thrusts until the object is expelled or the patient becomes unresponsive. If the patient becomes unresponsive, begin CPR — look in the mouth before each ventilation attempt and remove any visible object.

For a conscious choking infant, hold face-down on your forearm and deliver 5 back blows, then turn face-up and give 5 chest thrusts. Never perform blind finger sweeps on an infant.

Severe Bleeding Control

Severe, uncontrolled bleeding is rapidly fatal. Apply direct pressure immediately using a gloved hand and a clean dressing. Maintain firm, continuous pressure — do not lift the dressing to check the wound. Add additional dressings on top if blood soaks through. For limb wounds where direct pressure does not control bleeding, apply a commercial tourniquet or improvised tourniquet proximal to the wound, note the time of application, and do not remove it in the field. For wounds where a tourniquet cannot be applied (junctional or truncal), pack the wound firmly with gauze and maintain pressure.

Suspected Spinal Injury

At a fireground or trauma scene, suspect spinal injury any time the mechanism of injury involves significant force to the head, neck, or back. Minimize movement of the head and spine. If a patient must be moved for life safety, use a team approach with a designated leader controlling the head. Cervical collar application and full spinal precautions are covered in NREMT EMT coursework; at the Heartsaver level, recognize the mechanism and limit unnecessary movement.

Connecting to NFPA 1001 and NREMT

NFPA 1001 Firefighter I requires candidates to demonstrate emergency medical care including patient assessment and initial treatment. Every skill in this lab — airway management, CPR, bleeding control — corresponds directly to those job performance requirements. These same skills map to the NREMT EMT cognitive exam domains of airway, respiration and ventilation; cardiology and resuscitation; and trauma. Keeping this connection clear reinforces that you are not just checking a certification box — you are building the clinical foundation your future patients depend on.