First Aid, CPR, and Emergency Response in Behavioral Crises

Why Emergency Response Skills Matter for Paraprofessionals

Behavioral crises in school settings can escalate quickly. A student who is dysregulated may fall, strike a surface, or injure themselves or others before help arrives. As a paraprofessional, you are often the closest adult. Knowing how to respond—calmly, correctly, and in the right order—can prevent a serious situation from becoming a life-threatening one. This lab builds the hands-on skills and the decision-making steps you need for both CPR/first aid and broader emergency response.

Hands-Only CPR and the Full Compression Cycle

The American Heart Association (AHA) and the American Red Cross both recognize hands-only CPR as an effective first response for witnessed cardiac arrest in adults and older children. However, for young children and infants, rescue breaths remain part of the recommended sequence. Your certified instructor will walk you through the current guidelines for each age group.

Key compression facts:

• Rate: approximately 100–120 compressions per minute (think of the beat of the song "Stayin' Alive").
• Depth: at least 2 inches for adults; about 2 inches (or roughly one-third the depth of the chest) for children.
• Hand position: heel of one hand on the center of the chest, over the lower half of the breastbone; second hand on top, fingers interlaced and lifted off the chest.
• Full recoil: allow the chest to fully rise between compressions; do not lean on the chest.
• Minimize interruptions: pause compressions only when necessary (AED analysis, rescue breath delivery).

If you are not trained in rescue breathing or feel uncertain, hands-only CPR at the correct rate and depth is still highly effective for adults until emergency medical services (EMS) arrive.

Using an AED

An Automated External Defibrillator (AED) analyzes heart rhythm and delivers a shock only when needed. Steps:

1. Power on the device (open the lid or press the button).

2. Attach pads to bare, dry skin—one below the right collarbone, one on the lower left side of the chest.

3. Follow the audio or visual prompts exactly.

4. Ensure no one is touching the student when the device analyzes or shocks.

5. Resume compressions immediately after the shock unless the device instructs otherwise.

AED trainers used in this lab look and sound like real devices but deliver no electrical charge. Treat every practice repetition as if it were real.

Emergency Response Steps Following a Student Injury

When a behavioral crisis results in a student injury—such as a fall causing a head injury—follow this sequence:

1. Ensure scene safety. Do not put yourself in danger. If another student poses an ongoing threat, call for additional staff first.

2. Call for help immediately. Activate the school emergency response system (walkie-talkie, intercom, or send another student to the office). Call 911 if the injury appears serious.

3. Do not move the student if a head, neck, or spine injury is possible. Moving the student can worsen a spinal injury.

4. Provide basic first aid within your scope (applying pressure to a bleeding wound, keeping the student calm and still) until the school nurse or EMS arrives.

5. Contact the school nurse. The nurse takes over medical assessment as soon as possible.

6. Complete an incident report before the end of your shift. Document what you observed, what actions were taken, and the time of each event. Accuracy matters—the report becomes a legal record.

7. Notify parents or guardians. The school administrator or nurse typically makes this contact, but know your school's protocol.

Universal Precautions and Exposure Incidents

Universal precautions treat all blood and certain body fluids as potentially infectious. Any time there is a risk of contact with blood or broken-skin exposure, you must:

• Wear gloves before providing first aid.
• Use a barrier device (face shield or pocket mask) for rescue breathing.
• Wash hands thoroughly with soap and water before and after care, even if gloves were worn.

If a student bites and breaks your skin:

1. Wash the wound immediately with soap and running water for several minutes.

2. Apply an antiseptic if available.

3. Report the exposure to your supervisor and the school nurse right away—do not wait until the end of the day.

4. Follow your school or district's bloodborne pathogen exposure protocol; this may include seeking medical evaluation.

5. Complete an exposure incident report as required by school policy and OSHA bloodborne pathogen standards.

Failing to report promptly can delay medical follow-up and complicate any workers' compensation or health documentation.

PPE and Safety Reminders for This Lab

• Wear gloves during all manikin practice that involves airway or compression contact.
• Do not share manikin face shields without cleaning between users; use the disposable barriers provided.
• If you feel faint or lightheaded during compressions, stop and notify the instructor.
• Treat the AED trainer with the same respect as a live device to build accurate muscle memory.

Connecting This Lab to Your Credentials

The CPR/First Aid credential issued by the AHA or Red Cross requires both a skills check and a knowledge component. The skills check in this lab—compressions at the correct rate and depth, correct AED pad placement—directly mirrors what the credentialing organization's instructor will assess. Keep your certification current; most school districts require it before you work unsupervised with students.