Cardiopulmonary Resuscitation

CPR, or cardiopulmonary resuscitation, is an emergency procedure that can help save the life of someone suffering cardiac arrest, a state in which the heart has stopped beating. Automated external defibrillators (AEDs) are portable machines that deliver an electric shock to help restart the heart. CPR should be continued after using an AED until emergency services arrive.

If someone near you is unresponsive without a pulse and normal breathing, initiate CPR per your training.

Actions

1. Call 911 right away.
2. Use universal precautions and check the scene for safety.
3. Perform CPR if you are trained.
4. If you’re unsure of what to do, place the dispatcher on speaker and listen to the 911 emergency dispatcher for directions on hands only CPR (do not hang up with the dispatcher until they give you permission to hang up).
5. If an automated external defibrillator (AED) is available nearby, have someone retrieve it for you.
6. Use the AED as directed and follow the instructions carefully. 
7. Remain with the student until help arrives.
8. Wash your hands.
9. Document the date and time, any delegated or certified interventions provided, observations, the student response to intervention (if applicable), and your signature and credentials (if applicable).
10. Follow any additional school or program procedure(s).
11. Debrief with the school nurse.

Hands-only CPR (used on adults only)

1. Have someone call 911 and get the AED (if available).
2. Ensure the adult is on their back on a firm, flat surface.
3. Kneel beside the person.
4. Use correct hand placement: Place the heel of one hand in the center of their chest, with your other hand on top.
5. Interlace your fingers and make sure they are up off the chest.
6. Position your body so that your shoulders are directly over your hands and lock your elbows to keep your arms straight.
7. Give continuous compressions by pushing hard and fast (at least 2 inches; 100-120 compressions per minute).
8. Allow the chest to return to its normal position after each compression.
9. Use the AED as soon as it is available.
10. Remain with the student until help arrives .                                        

Child or Baby CPR

1. Perform CPR if you are trained.
2. Place the child or baby on their back on a firm, flat surface:
   1. Child: kneel beside the child
   2. Baby: stand or kneel to the side of the baby, with your hips at a slight angle
3. Give 30 compressions:
   1. Child: Place the heel of one hand in the center of the child’s chest, with your other hand on top and your fingers interlaced and off the child’s chest:
      1. Position your shoulders directly over your hands and lock your elbows
      2. Keep your arms straight
      3. Push down hard and fast about 2 inches at a rate of 100 to 120 per minute
      4. Allow the chest to return to normal position after each compression
   2. Small Child: Use a one-handed CPR technique
      1. Place the heel of one hand in the center of the child’s chest
      2. Push down hard and fast about 2 inches at a rate of 100 to 120 per minute
   3. Baby: Techniques:
      1. place both thumbs (side-by-side) on the center of the baby’s chest, just below the nipple line:
         1. Use the other fingers to encircle the baby’s chest toward the back, providing support
         2. Using both thumbs at the same time, push hard down and fast about 1 ½ inches at a rate of 100 to 120 per minute
         3. Allow the chest to return to its normal position after each compression
4. Two Finger Technique: Use two fingers placed parallel to the chest in the center of the chest:
   1. push hard down and fast about 1 ½ inches at a rate of 100 to 120 per minute
   2. Allow the chest to return to its normal position after each compression
5. Give 2 breaths
   1. Child: open the airway to a slightly past-neutral position using the head-tilt/chin-lift technique
   2. Baby: open the airway to a neutral position using the head-tilt/chin-lift technique
      1. Blow into the child or baby’s mouth for about 1 second:
         1. Ensure each breath makes the chest rise
         2. Allow the air to exit before giving the next breath
      2. If the first breath does not cause the chest to rise, retilt the head and ensure a proper seal before giving the second breath. If the second breath does not make the chest rise, an object may be blocking the airway
6. Continue giving sets of 30 chest compressions and 2 breaths until:
   1. You notice an obvious sign of life
   2. An AED is ready to use
   3. Another trained responder is available to take over compressions
   4. EMS personnel arrive and begin their care
   5. You are alone and too tired to continue
   6. The scene becomes unsafe
   7. You have performed approximately 2 minutes of CPR (5 sets of 30:2), you are alone and caring for baby, and you need to call 911                               (American Red Cross, 2025)