This guide is designed for layperson Heartsaver / First Aid classes. Healthcare providers should reference the [BLS Healthcare Provider Study Guide](bls-healthcare-provider-study-guide.html) instead.

Memorize the CPR Summary of Steps to successfully complete classes.

Foundational definitions

First Aid: First assistance rendered to a patient in any injury or illness emergency situation.

Duty to act: No rescuer is required to render aid solely because trained. However, workplace expectations may mandate assistance during emergencies as part of job duties.

Legal protections

Good Samaritan Laws protect rescuers who:

  • Do what they've been trained to do
  • Act to the best of their ability
  • Act in the patient's best interest
  • Receive no compensation

Healthcare providers are typically covered by employer liability insurance.

Initial assessment protocol

Before treatment: ensure scene safety. Always call 911 when uncertain.

For adults: request permission to assist. Competent adults may refuse aid. Call 911 for those with altered mental status.

For minors: attempt to obtain parental/guardian consent. Assume consent if no one is present.

Determining if assistance is necessary

If the patient is conscious, ask directly.

If the patient is unconscious or unresponsive:

  1. Determine scene safety
  2. Determine patient's response level
  3. Assess normal breathing
  4. Decide if 911 is needed
  5. Call 911 and retrieve AED if not breathing
  6. Check and correct immediate life threats (control bleeding; begin CPR)
  7. If no immediate threats, address secondary issues; look for medical alert jewelry

Pediatric safety emphasis

Most pediatric fatalities result from accidents and injuries. Prevention is critical, as children often show minimal symptoms before life-threatening situations develop.

Child restraint requirements: Children should use approved restraints until age 8, weighing 65+ pounds, or reaching 4'9" height. Safe lap/shoulder belt use requires: back touching seat back, knees bending at seat edge.

Contamination prevention

Best practice: Wash hands frequently; wear gloves and personal protective equipment.

Proper glove removal:

  1. Grasp one glove's palm using thumb and forefinger of opposite gloved hand; pull straight off
  2. Completely envelop removed glove in remaining gloved hand
  3. Place two fingers under remaining glove's back cuff
  4. Pull off over closed fist without touching exterior
  5. Grasp removed gloves only near fingers
  6. Dispose in biohazard bag, sealed Ziploc, or double-sealed plastic bags

Wound care: Wash area with soap and running water to clean and assess injury scope.

Heart attack

Symptoms: chest pain (dull, crushing, burning); upper or lower back pain; arm pain (either side); radiating pain (back/chest to neck/jaw); nausea; vomiting; shortness of breath; cold, clammy sweat; fullness or indigestion feeling; mental distraction or disconnection; increased foot/hand pain (diabetics); denial.

Treatment:

  1. Call 911 immediately — time is critical
  2. Have patient sit comfortably or lie down and rest
  3. Ask patient to cough forcefully at regular intervals
  4. If conscious and able to swallow: administer one non-coated 325 mg aspirin OR two to four 81 mg baby aspirin tablets
  5. Prepare to begin CPR and use AED

Stroke

Symptoms: balance loss; one-sided paralysis or muscle control loss; facial droop; slurred, unintelligible, or inappropriate speech; altered mental status; sudden severe headache (unknown cause); blurred vision; eye pain.

Treatment:

  1. Call 911 immediately — treatments must begin within 3 hours of symptom onset
  2. Do NOT administer aspirin
  3. Prepare to begin CPR and use AED

Diabetic emergency

Symptoms: altered mental status (confusion, combativeness, dazedness, excessive fatigue); loss of consciousness; excessive thirst; excessive urination; fruity or alcohol-smelling breath; seizures.

Diabetic emergencies indicate low blood sugar and can be life-threatening.

Treatment: if conscious and able to swallow, provide sugar-containing items: fruit juice, non-diet soda, sugar packets, honey, cake icing, or candy. Call 911 if patient loses consciousness or doesn't respond well to sugar.

Seizure

A seizure is a symptom of another problem. Causes include fever, head injury, infection, seizure disorders (epilepsy), heat stroke, stroke, poisoning, and low blood sugar.

Treatment:

  1. Call 911
  2. Do not restrain seizing person
  3. Do not place anything in mouth
  4. Move nearby objects to prevent injury
  5. Allow time for normal physical and mental recovery
  6. If seizure lasts > 5 minutes or more than 5 sequential seizures occur, prepare to begin CPR

Asthma

Triggers: extreme temperatures, exertion, allergies, stress.

Treatment:

  1. Seat person upright comfortably, away from trigger if possible
  2. If trained, assist with prescribed inhaler
  3. Call 911 if breathing difficulty continues

Choking

Recognition: cannot speak; cannot cough loudly; makes choking sign; bluish lips or skin.

Adult/child treatment with permission:

  1. Kneel or stand braced behind person
  2. Wrap arms around waist
  3. Make fist; place thumb-side down slightly above belly button, well below breastbone
  4. Grasp fist with other hand; give firm upward thrusts
  5. Continue thrusts until object is expelled or person stops responding

If person stops responding:

  1. Lower gently to floor; call for help
  2. Have someone call 911 and get AED
  3. Begin CPR steps
  4. Perform 30 chest compressions
  5. Open airway — look in mouth for object; remove safely if visible
  6. Give 2 breaths (reposition head after first breath if needed)
  7. Perform 30 chest compressions
  8. Repeat 30:2 cycle (checking mouth before breaths) until help arrives or AED available

For a large person or late pregnancy: if unable to wrap arms around waist, give chest thrusts instead.

Infant choking (back slaps + chest thrusts)

  1. Hold infant face-down on forearm
  2. Support infant's head/jaw in hand
  3. Sit or kneel, supporting forearm on lap/thigh
  4. Keep infant's head lower than torso
  5. Using heel of other hand, deliver up to 5 back slaps mid-way between shoulder blades
  6. If object doesn't come out, support back of head and turn infant onto other forearm
  7. Support forearm on thigh/lap; maintain head lower than torso
  8. Using two fingers, perform up to 5 chest thrusts on center breastbone, just below nipple line
  9. Repeat sequences of back slaps and chest thrusts until object comes out or infant stops responding
  10. If infant stops responding, call 911 and start CPR
Follow-up: encourage all choking victims to consult healthcare providers. Infants who choked on hard objects MUST see a healthcare provider.

Poisoning

Symptoms: nausea or vomiting; pain; trouble breathing; pinpoint or dilated pupils; excessive eye tearing, nose running, salivation, urination, defecation; seizures; loss of consciousness.

Treatment:

  1. For ingested poison, determine amount and substance
  2. Call Poison Control: 1-800-222-1222
  3. Call 911 if patient experiences breathing trouble, seizures, loss of consciousness, or excessive bodily fluid output

Shock

May result from internal bleeding, low fluid volume, or other problems causing inadequate body circulation. Untreated shock is fatal.

Treatment:

  1. Call 911 immediately
  2. Have person lie down and rest
  3. Maintain body temperature — cover with blanket if necessary
  4. Maintain open airway
  5. Maintain constant verbal communication
  6. Prepare to begin CPR if needed

Anaphylactic shock

Symptoms: skin rash; hives; itchiness; face, tongue, eyelid swelling; trouble breathing; respiratory arrest.

Treatment: call 911 if any breathing difficulty occurs.

  1. Assist patient in using prescribed Epi-Pen if needed
  2. Note injection time; inform EMS upon arrival
Epi-Pen medication may only control symptoms for 20 minutes. Always call 911 when anyone uses an Epi-Pen.

Bleeding

  1. Apply direct pressure to wound; maintain with pressure bandage if needed
  2. Elevate area if possible
  3. Apply cold source (never directly to bare skin)
  4. Apply pressure to pressure points (brachial and femoral arteries) if necessary
  5. If bleeding still uncontrolled, apply tourniquet to limb above wound; record placement time

Call 911 when: bleeding won't stop; tourniquet has been applied; patient has lost > 16 oz of blood (≈ 1½ soda cans).

Burns

  • First-degree (red, painful skin): if small (no larger than patient's palm), flush with cool water; cover with dry sterile dressing if desired
  • Second-degree (red, blistered/weeping skin): cover with dry sterile dressing. Do not treat with water
  • Third-degree (white or black charred skin): cover with dry sterile dressing; seek medical help. Do not treat with water
  • Dry chemical burns: brush off substance; remove affected clothing/jewelry; flush with water for 20 minutes
  • Liquid chemical burns: remove affected clothing/jewelry; flush with water for 20 minutes
  • Never apply butter, mayonnaise, petroleum jelly, or other barrier substances — these trap heat inside skin
  • Electrical burns: don't touch patient until power is off. Treat for potential cardiac, internal organ, and spinal injuries

Sprains and strains — RICE

  • R est affected area; remove jewelry/shoes near injury
  • I ce/cold source: 20 minutes on, 20 minutes off
  • C ompression wrap to reduce swelling and limit movement
  • E levate above heart level if possible
Wrap from below to above a joint. Don't apply cold directly to bare skin.

Dislocations and fractures — IACT

  • I mmobilize area
  • A ctivate EMS — call 911 for suspected large bone, pelvic, or hip injuries
  • C are for potential shock
  • T reat other injuries
Do not reposition or relocate fractures or dislocations.

Head, neck, and spinal injuries

Symptoms (may appear immediately or be delayed): confusion or altered mental status; headache; nausea; vomiting; balance loss; tingling or sensation loss in one or more body areas; cold, clammy sweat.

Treatment: never move person with suspected neck/back injuries unless in life-threatening situation. Stabilize head to restrict all movement; call 911.

Heat emergencies

Heat cramps

Remove person from heat. Provide water. Massage affected areas. Do not apply cold source directly to cramped muscles.

Heat exhaustion

Remove person from heat. Provide water or other fluids. Cool by removing clothing, wetting skin, and fanning.

Heat stroke

  1. Call 911 — heat stroke is life-threatening
  2. Remove person from heat
  3. Aggressively cool by removing clothing, wetting skin, immersing in cool water, fanning, applying ice packs to neck back, armpits, and groin
  4. Provide fluids if conscious and able to swallow

Cold emergencies

Frostbite: remove person from cold; do not rub affected area; rewarm in lukewarm water if no re-freezing danger; apply dry, sterile dressing; replace cold, wet clothing with warm, dry clothing; seek medical attention.

Hypothermia: remove person from cold; replace cold, wet clothing with warm, dry; warm gradually using heating pads, blankets, dryer-warmed towels, or hot packs in armpits and groin; seek medical attention. Call 911 if person loses consciousness.

Snake or spider bites

  1. Wash area with soap and water
  2. Apply light pressure bandage to entire limb (if bitten)
  3. Call 911 or go immediately to nearest ER
  4. Do NOT cut wound or attempt to suck out venom
  5. Do NOT attempt to catch or kill snake; move away
  6. Give snake description to hospital
Assume all snakes are poisonous.

Tick bites

Ticks must be embedded 2–12 hours to transmit diseases.

Removal: grasp tick head with tweezers, close to skin; pull straight out.

Aftercare: wash with soap and water; save tick by taping to file card or paper; watch for flu-like symptoms or bull's-eye rash; seek immediate medical assistance with diagnostic blood tests if symptoms appear.

Jellyfish stings

Rinse liberally with vinegar for at least 30 seconds as soon as possible. After rinsing, immerse area in hot water (as hot as patient tolerates) or apply a heat pack for 20 minutes to reduce pain.

CPR Summary of Steps

Memorize this — it's the part you'll be tested on.
  1. Perform 30 chest compressions
  2. Open airway
  3. Give 2 breaths
  4. Repeat 30 compressions and 2 breaths cycle