CPR, AED, and First Responder Life Safety
Objective. Students will successfully demonstrate adult, child, and infant CPR with AED operation according to current American Heart Association or American Red Cross BLS guidelines, achieving course certification.
This lesson, its worked examples and its practice questions has not yet been verified by a licensed clinician in the field 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 BLS Matters in EMS
Basic Life Support (BLS) is the foundation of every EMS response. Cardiac arrest can happen anywhere — in a home, on a street corner, or in a school gym — and the chain of survival depends on fast, high-quality CPR and early defibrillation. As an EMT or Paramedic student, earning your BLS provider certification is not optional; it is a prerequisite for clinical rotations and for sitting the NREMT cognitive exam. More importantly, it is the single skill most likely to determine whether a patient lives or dies before advanced care arrives.
The Chain of Survival
The American Heart Association describes a chain of survival that links critical actions together. In the out-of-hospital setting those links include: early recognition and activation of the emergency response system, early high-quality CPR, rapid defibrillation, advanced resuscitation by EMS, and post-cardiac-arrest care. Weakness in any link reduces survival. Your role as the first trained rescuer on scene often covers the first three links entirely.
High-Quality CPR: The Core Standards
Current BLS guidelines emphasize compression quality above all else. For an adult victim, compress the center of the chest (lower half of the sternum) to a depth of at least 2 inches but no more than 2.4 inches. Allow full chest recoil after every compression — leaning on the chest prevents the heart from refilling. Deliver compressions at a rate of 100 to 120 per minute. Minimize interruptions; pauses in chest compressions should be kept to less than 10 seconds whenever possible.
For a child (ages 1 to puberty), compress at least one-third the depth of the chest, approximately 2 inches. For an infant (under 1 year), compress at least one-third the depth of the chest, approximately 1.5 inches, using two fingers on the center of the chest just below the nipple line, or the two-thumb-encircling-hands technique when a second rescuer is present.
The compression-to-ventilation ratio for a single rescuer is 30 compressions to 2 breaths for adults, children, and infants. In two-rescuer infant and child CPR, use a 15:2 ratio. When an advanced airway is in place, compressions are delivered continuously at 100 to 120 per minute without pausing for ventilations, which are given at approximately 1 breath every 6 seconds.
Rescue Breathing and Airway Management
Each breath should be delivered over 1 second and produce visible chest rise — just enough to see the chest lift. Avoid excessive ventilation; over-inflating the lungs increases gastric inflation and aspiration risk, and interrupts compressions. Use a one-way valve pocket mask or bag-mask device with a filter whenever available to protect yourself from exposure. This is a core safety practice: do not perform mouth-to-mouth without a barrier device in a training or clinical environment.
AED Operation
An Automated External Defibrillator (AED) analyzes the heart's rhythm and delivers a shock if a shockable rhythm — ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) — is detected. Every second without defibrillation reduces the chance of survival. Your goal is to have the AED powered on and pads attached with minimal interruption to CPR.
The universal AED sequence is: Power on the AED, Apply pads to bare dry skin in the correct positions, analyze the rhythm (stop CPR, clear the patient — ensure nobody is touching the victim), deliver a shock if advised, and immediately resume CPR for 2 minutes before re-analyzing. Remember the command: "I'm clear, you're clear, everybody clear" before every shock.
For pediatric patients (generally under 8 years or under approximately 55 pounds), use pediatric attenuator pads or a pediatric key/switch if available to reduce the energy delivered. If pediatric pads are unavailable, adult pads may be used — place one pad on the front of the chest and one on the back to avoid pad contact.
Personal Safety on Scene
Before approaching any patient, confirm scene safety. Use standard precautions: gloves are minimum PPE for any patient contact. Change the manikin face shield or wipe with alcohol between students during practice. In a real cardiac arrest, assume body fluid exposure is possible. Do not allow personal risk to delay CPR — if the scene is safe and you have a barrier device, begin resuscitation immediately.
Two-Rescuer Roles and Switching
In two-rescuer CPR, one provider manages compressions while the other manages the airway and ventilations. Switch compressor roles every 2 minutes (approximately 5 cycles of 30:2) to prevent fatigue-related drop in compression quality. Communicate clearly when switching — count out loud so your partner is ready, and minimize the pause during the transition.
BLS Certification: What to Expect
Your BLS Provider course includes a written knowledge assessment and a hands-on psychomotor skills evaluation. The credentialed instructor will observe you performing the required skills stations — adult one-rescuer CPR with AED, two-rescuer CPR, infant CPR, and the relief of foreign-body airway obstruction. You must meet the performance criteria on every station. A BLS Provider card is issued upon successful completion and is typically valid for two years. This card is required before you advance to clinical hours in this program.
Key terms8
Materials: AHA BLS Provider or ARC BLS course materials, adult/child/infant CPR manikins with feedback devices, AED trainer units with pediatric pads, one-way valve pocket masks, gloves, alcohol wipes, BLS provider skills sheets, stopwatch
Check: Students must pass the written BLS knowledge assessment at the course-required threshold and pass all BLS psychomotor skills stations on the first or second attempt per provider course standards; BLS provider card issued upon successful completion.
Practice check8
Answer each question, then check it. Nothing is recorded; this is your own practice.
