CPR, First Aid, and Pediatric Emergency Response

CPR, First Aid, and Pediatric Emergency Response

As a paraprofessional working in a school setting, you may be the first adult to reach a child or colleague in a medical emergency. Knowing how to act quickly and correctly can mean the difference between life and death. This lab prepares you for the skills required by the American Heart Association (AHA) or American Red Cross certification and for your daily responsibilities on the job.

Why This Training Matters in Schools

Cardiac arrest, severe allergic reactions, choking, and traumatic injuries can all occur in a school yard, gymnasium, cafeteria, or classroom. Paraprofessionals are often positioned throughout the building alongside teachers. You may arrive at an emergency before any other trained adult. Your certification card demonstrates to employers that you have met a nationally recognized skill standard — and many state paraprofessional licenses require it.

Hands-Only CPR and Full CPR

Hands-Only CPR (compressions only, no breaths) is appropriate when you are untrained or unwilling to give rescue breaths to an adult victim. Push hard and fast in the center of the chest at a rate of 100–120 compressions per minute. Allow full chest recoil between compressions.

Full CPR (compressions plus rescue breaths) is the standard for trained responders and is required for child and infant victims. The compression-to-ventilation ratio for a single rescuer is 30 compressions to 2 breaths for adults, children, and infants. For infants, use two fingers on the center of the chest, just below the nipple line. For children, use one or two hands depending on the child's size. Compression depth is at least 2 inches for adults, at least 2 inches (or one-third the depth of the chest) for children, and about 1.5 inches for infants.

Always activate emergency services — call 911 or direct someone by name to call — before or as soon as possible after beginning CPR.

AED Operation

An automated external defibrillator (AED) can restore a normal heart rhythm during certain life-threatening arrhythmias. AEDs are designed for lay rescuers and provide voice and visual prompts. The steps are:

1. Power on the AED.

2. Attach the pads to the victim's bare, dry chest as shown in the diagram on the pads (one pad below the right collarbone, one on the left side below the armpit).

3. Allow the AED to analyze the heart rhythm — stop CPR and ensure no one touches the victim during analysis.

4. If a shock is advised, call out "Clear!" and visually confirm no one is touching the victim before pressing the shock button.

5. Resume CPR immediately after the shock is delivered and continue until EMS arrives or the victim shows obvious signs of life.

Use pediatric pads or a pediatric dose attenuator if available for children under approximately 8 years old or under 55 pounds. If pediatric equipment is unavailable, use adult pads placed so they do not touch each other.

Controlling Severe Bleeding

For severe external bleeding, apply firm, continuous direct pressure with a clean cloth or sterile dressing. Do not remove a blood-soaked dressing — add more on top and continue pressure. For life-threatening limb bleeding that cannot be controlled with direct pressure, a tourniquet may be applied. Place it 2–3 inches above the wound (not over a joint), tighten until bleeding stops, and note the time of application. Tell EMS immediately when they arrive. Never remove a tourniquet once applied — this is an EMS decision.

PPE note: Always put on disposable gloves before making contact with blood or other body fluids. Gloves are your primary barrier against bloodborne pathogens.

Recognizing and Responding to Anaphylaxis

Anaphylaxis is a severe, life-threatening allergic reaction. Signs include hives, swelling of the face or throat, difficulty breathing, vomiting, and a sudden drop in blood pressure. In a school, many students carry prescribed epinephrine auto-injectors (such as an EpiPen®). If a student is showing signs of anaphylaxis:

1. Call 911 immediately.

2. Assist the student in using their prescribed auto-injector, or use a school-supplied device if authorized under your state's law and school policy.

3. Have the student lie down with legs elevated unless breathing is difficult.

4. Be prepared to begin CPR if the student loses consciousness and stops breathing normally.

5. A second dose may be given after approximately 5–15 minutes if symptoms do not improve and EMS has not yet arrived.

During this lab you will practice technique with an epinephrine auto-injector trainer — a device that contains no medication.

Head, Neck, and Spinal Injuries

If you suspect a head, neck, or spinal injury — for example, after a fall from playground equipment or a collision — minimize movement of the head and spine. Instruct the student to stay still. Do not attempt to move the student unless they are in immediate danger (e.g., in a burning area). Maintain an open airway by using a jaw thrust rather than a head-tilt if you must manage breathing. Call 911 and stay with the student, providing reassurance, until EMS takes over.

Safety Rules for This Lab

• Always use manikins and trainer devices — never practice compressions or auto-injector technique on a live person without clinical supervision.
• Wipe manikin faces with the provided disinfectant wipes between users to prevent transmission of illness.
• Wear gloves during bleeding-control stations.
• Report any dizziness or discomfort to the instructor immediately; stop the activity until cleared.
• The certified instructor has final authority over the skills checklist. A critical skill failure — such as failing to call 911 or failing to deliver any compressions — requires a full repeat of that station before a certification card can be issued.