Cardiopulmonary Resuscitation: A Study Guide for CPR/AED Class

This CPR/AED study guide was created to give you an overview of what to learn in the certification course and ensure that you're ready for your certification exam. This quick CPR/AED study guide is easy to use and provides a variety of visual aids and text-based information vital for your success on the course. It also includes the latest information from the American Heart Association and Emergency Cardiovascular Care.

Learn what CPR is, the chain of survival and your place in it, and what are the appropriate steps to increase the person's chances of survival. You will also learn about choking, the right ways to use chest compressions, and how to use an AED machine. Topics included are as follows:

  • What is CPR
  • Assessing Emergency Situations
  • Chain of Survival
  • Good Samaritan Law
  • CAB Sequence
  • Adult CPR
  • Child CPR
  • Infant CPR
  • 2 Rescuer CPR
  • Automated External Defibrillator
  • Adult/Child Choking
  • Infant Choking
  • Rescue Breathing
  • Recovery Position

Key Takeaway

According to the Centers for Disease Control and Prevention, when a person's heart stops beating, they are in cardiac arrest. Cardiopulmonary Resuscitation is a lifesaving procedure that can increase the chances of survival of victims suffering a heart attack or cardiac arrest. It will maintain the oxygenated blood flow to the victim's brain until advanced lifesaving techniques are available. The steps of CPR will depend on whether the victim is an infant, child, or adult. The American Heart Association strongly encourages everyone to learn CPR and save lives. If you are interested in getting certified in CPR, we offer CPR and First Aid training online. CPR classes are typically completed in 1 hour, depending on which format you choose. We follow the latest guidelines of the American Heart Association and Emergency Cardiovascular Care. After successful completion of the CPR certification class and passing the certification exam, you will be able to get a certificate that will allow you to respond to a wide variety of medical emergencies.

Chapter 1: What is CPR?

When your heart stops, the oxygenated blood is no longer being pumped through the body to organs that need it. When this happens, the victim only has 4 minutes before brain damage occurs. Cardiopulmonary Resuscitation is a specific sequence of activities that replicates the heart's pumping and breathing of the lungs to carry oxygen throughout the body. Although CPR is unlikely to restart a stopped heart, it will maintain blood flow to the victim's brain until advanced lifesaving techniques are available. 

Rescuers trained in CPR/AED can assess emergencies, call 911 to seek professional help, and begin lifesaving measures. This study guide is an accessible way for you to find out what information will be included in your online coursework and certification exam.

Chapter 2: How to Assess the Situation Before administrating CPR?

In an emergency, it's essential to keep calm and avoid panic responses. Assessing an emergency situation will help you make proper decisions and help to identify the most appropriate response to the emergency. Be aware of your surroundings and your options for making it safe, both for yourself and anyone else on the scene. 

How to assess an emergency situation?

  1. Watch out for danger - Your first aim is to avoid anyone else being put at risk. It won't be helpful if you become a second victim.
  2. Assess the victim - Check the patient's response and condition. Do not move or shake the victim if you suspect that a victim has suffered a spinal or neck injury.
  3. Call 911 - One of the most important things to do in any emergency situation is to ensure that the emergency response team is contacted fast and gives relevant information as clearly and accurately as possible.
  4. Resuscitate and treat injuries as necessary 

Chapter 3: What is the Chain of Survival?

When preparing to perform CPR, keep the Emergency Cardiovascular Care's Chain of Survival in mind. These are the five crucial steps in the chain of survival:

  • Immediate recognition of cardiac emergencies, call 911.
  • CPR with emphas is on chest compressions. Decreasing the delay in beginning compressions increases survival rates.
  • Provide rapid defibrillation with an AED (this is necessary to restore a normal heartbeat) within minutes of the onset of symptoms.
  • Trained medics administer advanced life support.
  • Post-cardiac arrest care is administered in a hospital setting.

Chapter 4: What is Good Samaritan Law?

Under Good Samaritan Laws, a person assisting an injured person is free from civil liability under the following conditions:

  • The person helping must be acting voluntarily
  • Without the expectation of reimbursement or compensation in any form
  • Aid must be given at the scene of the emergency.

Good Samaritan Laws do not apply to persons providing advice and aid through their regular employment, such as paramedics, doctors, nurses, and other healthcare professionals.

Chapter 5: What is the C-A-B Method?

With the Compressions – Airway – Breathing (C-A-B) method, a victim receives compressions faster and provides for quicker critical blood flow to vital organs.

  • "C" for Compressions - You should give at least 100 to 120 compressions per minute in cycles of 30 compressions and two breaths (30:2). Chest recoil is vital after each compression.
  • "A" for Airway - Tilt the victim's head slightly backward and open the airway.
  • "B" for B - For adults, pinch the nose and breath into the mouth at 10 to 12 breaths per minute. For infants and smaller children, cover the mouth and nose with your mouth and breath in at 12 to 20 breaths per minute. Each breath should last for at least one second. 

Chapter 6: What are the Steps for Adult CPR?

Step 1: Check for consciousness
To check for consciousness, tap on the adult victim's shoulder firmly and ask, "Are you OK?" loudly.

Step 2: Call 911
Call 911 or ask someone else to call before performing CPR. Even if you perform CPR on the spot, getting paramedics to the scene as quickly as possible is crucial. If possible, ask a bystander to look for an AED.

Step 3: Check for breathing and open the airway
While waiting for the emergency medical team, check the breathing for about 10 seconds. If the breathing is normal, put the victim in the recovery position and wait for the responders to arrive. If you do not hear breathing or only hear a few gasps, begin CPR immediately.

Step 4: Begin CPR
Place the victim on their back on a firm, flat surface. Alternate between 30 chest compressions and two rescue breaths, with 2 inches compression depth. Compression rate is 100-120 compressions per minute. Blow until the chest rises. 

Step 5: Use AED if available
If an AED is available, a bystander in a public place or a family member can use it to deliver a shock to the heart to restore regular rhythm.

Recommendations:
  • 2-2.4 inches compression depth
  • 100-120 compressions per minute
  • 30:2 compression to ventilation ratio
  • One breath every 6 seconds

Chapter 7: What are the Steps for Child CPR?

The CPR procedure for children between 1 to 8 years old is basically the same as that for an adult.

Step 1: Check for Consciousness
Tap the child's shoulder and ask, "Are you OK?" loudly. It's also important to check the scene for factors that could put you in danger, such as traffic or fire.

Step 2: Call 911
If the child is not responding, call 911 immediately or ask a bystander to call and search for an AED machine. You can find AEDs in most offices and public buildings. If you are alone, contact 911 first before performing CPR. 

Step 3: Check for breathing and open the airway
Place your ear next to the child's mouth and listen for 10 seconds. If you do not hear breathing or only hear occasional gasps, begin CPR immediately.

If the child is unconscious but still breathing, do not perform CPR. Keep monitoring their breathing and perform CPR if they stop breathing.

Step 4: Begin CPR
Place two hands (or one hand if the child is tiny) on the child's sternum. Push hard and fast to a compression depth of at least two inches until the child responds. Your hands shouldn't bounce, but you should lift your entire body weight off the patient between each compression.

If you have had CPR training and feel comfortable performing the steps, push on the chest 30 times, then give two rescue breaths.

Step 5: repeat the Cycle
Repeat the cycles of 30 chest compressions and two rescue breaths until help arrives or the child wakes up.

Recommendations:
  • 2 inches compression depth
  • 100-120 compressions per minute
  • 30:2 compression to ventilation ratio
  • One breath every 6 seconds

Chapter 8: What are the Steps for Infant CPR?

Step 1: Check for Consciousness
Flick the bottom of the infant's foot to elicit a response. This takes the place of tapping the shoulder of an older person.

Step 2: Call 911
If there is no response from the infant, call 911 immediately or ask a bystander to call. If you are alone, contact 911 first before performing CPR. 

Step 3: Give Chest Compressions
Place two fingers of your one hand in the center of the chest. Gently use your fingers to compress the chest about 1.5 inches deep. Perform two compressions per second, just as you would when giving an adult CPR.

Step 4: Perform Rescue Breathing
If you are comfortable giving rescue breaths, give two of them between each series of 30 chest compressions, just as you would with an older person.

Step 5: Repeat
Repeat cycles of 30 chest compressions and two rescue breaths until help arrives or the infant wakes up.

Recommendations:
  • Compression depth: 1/3 of the chest circumference or about 1.5 inches
  • 100-120 compressions per minute
  • One Rescuer - 30:2
  • Two or more Rescuers - 15:2
  • One breath every 6 seconds

Chapter 9: 2-Rescuer CPR

If you come across an unconscious victim and another person is available to help, ask that person to call 911 and find an AED while assessing whether the victim needs CPR. If the victim requires CPR, start CPR, beginning with compressions. Here's how to perform CPR when there are two rescuers present:

Step 1: Check for Consciousness
Tap the victim's shoulder and ask if they are okay. If the victim is not breathing or only gasping, stay with the victim.

Step 2: Call 911
Rescuer 2 will call 911 and leaves to retrieve an AED.

Step 3: Check for breathing and pulse.
Rescuer 1 checks for a pulse. If there's no pulse, the rescuer will begin CPR, starting with chest compressions.

Step 4: Begin CPR
Rescuer 1 will continue giving chest compressions and rescue breaths until Rescuer 2 returns with an AED.

Step 5: Use an AED

  • When rescuer 2 arrives with an AED, place it on the side opposite Rescuer 1, who is performing chest compressions. 
  • Rescuer 2 will turn on the AED and attaches the pads to the victim's chest. Rescuer 1 will continue CPR while the pads are being placed until it is time to analyze the heart rhythm. 
  • Rescuer 2 clears the victim, ensuring neither rescuer touches the victim and waits for the AED to analyze. 
  • Rescuer 2 will push the SHOCK button if a shock is indicated.
  • If no shock is needed, rescuer 2 will resume chest compressions. 
  • During analysis, Rescuer 2 and Rescuer 1 should switch positions to prevent rescuer fatigue and ensure that rescuers provide high-quality chest compressions at the proper rate and depth. 

When the second rescuer returns without an AED:

  • Continue performing chest compressions and count the compressions aloud.
  • Rescuer 2 should keep the person's airway open using the head tilt chin lift maneuver.
  • The second rescuer will give two rescue breaths after every 30 compressions.
  • Rescuers 1 and 2 should switch positions every two minutes, so neither gets tired.  

Chapter 10: What is an Automated External Defibrillator?

An AED or Automated External Defibrillator is a mechanical device used to increase the victim's chances of survival. It is designed to assess the electrical output of a victim's heart and provide an electrical shock if needed. It is utilized when a victim experiences sudden cardiac arrest.

  • Assess the victim for SCA.
  • Immediately call 911.
  • If more than one rescuer is present, provide CPR while the AED is retrieved and prepared.
  • Once powered on, the machine will instruct the rescuer to place the electrodes (pads) over the victim's heart.
  • The device will scan the victim's heart, checking if the shock is necessary. Ensure that no other person is in contact with the victim while the AED assesses the situation. Rescuers should follow the prompts given by the machine.
  • If necessary, the device will charge and automatically shock the victim. Ensure that no one else is touching the victim to reduce the risk of bystanders being shocked.
  • Following the initial shock, the machine will reassess the victim to determine if an additional shock is necessary.
  • Continue CPR when prompted.

Chapter 11: How to Treat Choking? (Adult and Child)

A person chokes when a foreign object becomes trapped at the back of the throat, either blocking the airway or causing a muscle spasm. If a choking person is conscious, do the Heimlich maneuver. If he is unconscious, perform CPR.

Heimlich Maneuver

  • Stand behind the victim, bringing your arms around the abdomen.
  • Make a fist with one hand, placing your thumb against the victim's abdomen. The opposite hand reaches around the victim and grasps the fist to provide support.
  • Place your hand below the victim's ribcage and pulls inward and upward with a steady force until the object is expelled.
  • Discontinue the Heimlich Maneuver when the victim begins to cough, speak, or lose consciousness.

Steps for treating Unconscious Choking Victims

  • Call 911.
  • Lay the victim face-up on the floor.
  • Open the victim's airway and attempt to ventilate the victim as explained in the CPR guidelines. If the airway is still blocked, reposition the head and try to clear it again. If this is still ineffective, begin compressions.
  • Kneel next to the victim and deliver a series of 15 compressions, as used for CPR. Alternate series of 15 compressions with attempts to clear the victim's airway and ventilate, as described in the earlier steps.
  • Discontinue compressions when the object is ejected, rescue breathing is successful, or the victim begins to breathe independently.
  • Place the revived victim in the recovery position.

Chapter 12: How to Treat Infant Choking?

Do not use the Heimlich Maneuver with infants. Instead, you must put the baby face down on your forearm, supporting the head and chest. Using the other hand, give five sharp blows to the back. Use your index finger as a hook to clear objects from the baby's mouth, but do not reach blindly down the throat.

If the baby has not stopped choking, use two fingers to administer five chest compressions, as used for CPR. Check the baby's mouth for additional foreign objects. Repeat this sequence three times. If choking continues, call 911. Continue the series of back blows, mouth sweeps, and compressions until help arrives.

Chapter 13: Rescue Breathing

Rescue breathing or mouth-to-mouth ventilation is used when someone has stopped breathing. Do not give breaths too rapidly or forcefully to avoid air getting into the victim's stomach. It may cause vomiting, distention, and less room for lung expansion.

How to provide mouth-to-mouth ventilations?

  • Gently tilt the victim's head back. Use one hand to hold their chin and lift it. Keep the victim's mouth open using your thumb.
  • Place your hand on their forehead and pinch the nose closed with your other hand.
  • Create a proper seal when using your lips to surround the victim's mouth
  • Blow into the victim's mouth for one full second and watch for the chest to rise.
  • If the chest does not rise, tilt the victim's head further back and give a second breath.
  • If you cannot see the chest rise in two breaths, continue giving chest compressions.

Chapter 14: Recovery Position

If the victim is breathing and has a pulse, put him in the recovery position while waiting for EMS to arrive. This position keeps the victim's airway open, prevents aspiration of fluids into the lungs, and allows fluid to drain from the mouth. Here's how to put the victim into a recovery position:

How to provide mouth-to-mouth ventilations?

  1. Extend the victim's arm closest to you above the victim's head.
  2. Place the victim's leg farthest away from you over his other leg.
  3. Place the victim's arm farthest from you across his chest.
  4. Supporting the head and neck, roll the victim towards you.
  5. Position the victim's top leg so the knee props up the victim's body
  6. Place the victim's hand or arm under the chin to keep the airway open. 

Frequently Asked Questions

How long should it take to determine a victim is not responsive, not breathing, and has no pulse before you begin compressions?

When assessing signs of cardiac arrest in an unresponsive patient, check the breathing and pulse for 10 seconds.

Why is it important to push hard and fast?

It's essential to push hard and fast to create blood flow during compressions. 

How do you know that your breaths are getting into the victim?

You need to check if your breaths are getting into the victim by watching for the chest to rise. If the chest doesn't rise, open the airway again and give rescue breaths. 

What device should you use to provide ventilation to a victim?

In one-rescuer CPR, breaths should be supplied using a pocket mask. Bag-valve-mask devices are also preferred equipment to deliver positive pressure ventilation to the victim.