CPR & AED techniques: how to save a life in the first 5 minutes.

Detailed guide to CPR & AED techniques

Knowing the steps is one thing - performing them well under pressure is another. Mastering CPR and AED techniques means understanding why each action matters and exactly how to deliver it for the best chance of survival.

High-quality chest compressions

Chest compressions are the most important action you can take. Each compression squeezes the heart and pushes oxygenated blood to the brain and vital organs. Quality matters more than anything else.

• Rate - 100 to 120 compressions per minute. The beat of "Stayin\' Alive" by the Bee Gees is a useful tempo cue.
• Depth - at least 5 cm but no more than 6 cm in an adult.
• Recoil - allow the chest to rise fully between compressions. Incomplete recoil reduces blood return to the heart.
• Position - heel of hand on the centre of the chest (lower half of the breastbone). Arms straight, shoulders directly over hands.
• Minimise interruptions - keep pauses under 10 seconds. Every pause loses circulation.

If you have help, swap rescuer every 2 minutes (about 5 cycles of 30:2). Compressions tire fast and quality drops within about 90 seconds in an unfit rescuer.

Effective rescue breaths

Rescue breaths refill the lungs with oxygen so the next chest compressions push oxygenated blood to the brain. If you are trained and willing, give 2 breaths after every 30 compressions using a CPR pocket mask or face shield.

• Open the airway with a head-tilt, chin-lift.
• Pinch the nose closed.
• Make a tight seal over the casualty's mouth (or use a pocket mask).
• Blow steadily for about 1 second. The chest should visibly rise.
• Take a normal breath in between, do not hyperventilate.
• If the chest does not rise, recheck the airway and try again. Do not delay compressions for more than 10 seconds.

If you are untrained, unwilling or unable to give rescue breaths, deliver continuous chest compressions only. This is far better than nothing and is the recommended approach for bystander CPR in adults.

Using an AED safely

Modern AEDs are designed for untrained members of the public. They will guide you through every step with clear voice and visual prompts. The most important skill is the confidence to switch it on and follow the prompts without hesitation.

1. Switch the AED on. Most have a single button or switch that triggers the voice prompts.
2. Bare and dry the chest. Cut or remove clothing. Wipe the chest dry. Shave dense chest hair where the pads sit (most AED kits include a razor).
3. Apply the pads. One upper-right (just below the collarbone), one lower-left (mid-axillary line, below the armpit). Pad placement is shown on the pads themselves.
4. Stand clear during analysis. "Do not touch the casualty." The AED is reading the heart rhythm.
5. Deliver the shock if advised. Make sure no-one is touching the casualty, then press the shock button when prompted (some AEDs are fully automatic and shock without a button).
6. Resume CPR immediately. Start chest compressions again the moment the shock is delivered. The AED will reanalyse every 2 minutes.

Special situations. Move the casualty out of standing water and dry the chest. Remove transdermal medication patches and wipe the area. For implanted pacemakers or defibrillators, place pads at least 8 cm away from the device. AEDs are safe and effective on pregnant women, drowning casualties and electrical-shock casualties (once the source is isolated).

CPR for children and infants

The DRSABCD sequence is the same for children (1 year to puberty) and infants (under 1 year), with three key adjustments:

• Start with 5 rescue breaths. In children and infants, cardiac arrest is most often caused by a breathing problem. Give 5 initial breaths before starting compressions.
• Compression depth - about one third of the chest depth (around 5 cm in a child, 4 cm in an infant).
• Compression technique - one or two hands on a child, two fingers (or two-thumb encircling) on an infant.

Use paediatric AED pads if available. If only adult pads are available, use them - an adult-pad shock is far better than no shock at all.

Recovery position

Once a casualty starts breathing normally on their own, place them in the recovery position to keep the airway open and allow vomit to drain. Roll them onto their side, support the head, bend the upper leg to stabilise, and continue to monitor breathing until paramedics arrive.

Workplace applications of CPR and AED

Different work environments present different cardiac-arrest risks - but the response is always the same. Knowing how to apply CPR and AED techniques in your specific workplace is essential for every Irish first aider.

Construction and manufacturing

High-physical-exertion environments increase the risk of sudden cardiac events. Combine that with the risk of crush injuries, falls and electrocution and the workplace first aider needs every link of the Chain of Survival close at hand. Mount AEDs near welfare areas and emergency assembly points, ensure every shift has a trained first aider, and run quarterly cardiac-arrest drills.

Healthcare and care homes

Older, frail and immunocompromised patients are at significantly higher risk of cardiac arrest. Confident, fast CPR and AED operation, combined with strict infection-control practice during rescue breaths, are everyday skills. Keep AED pads in date and verify the AED self-test daily.

Retail, hospitality and offices

Most out-of-hospital cardiac arrests in Ireland happen in everyday settings - shops, cafes, gyms, hotels and offices. A trained first aider, an accessible AED and a fully stocked first aid kit can turn any of these spaces into a place where someone walks out alive. Train every shift, register the AED with the National Ambulance Service and run drills twice a year.

Schools and creches

Children rarely have primary cardiac arrests, but choking, drowning, asthma attacks, anaphylaxis and trauma can all lead to respiratory arrest that progresses to cardiac arrest. Every school and creche needs trained staff confident in paediatric CPR, choking response and EpiPen administration.

Legal requirements for CPR and AED training in Ireland

Under Section 8 of the Safety, Health and Welfare at Work Act 2005 and the General Application Regulations 2007, every Irish employer must provide first-aid arrangements proportionate to the risk in their workplace. The HSA Guide to Workplace First Aid expects an appointed first aider on every shift, an accessible first aid kit, and a clear emergency action plan.

An accessible AED is not yet a universal legal requirement, but it is strongly recommended in any workplace with more than 50 employees, in any premises open to the public, in remote sites and in higher-risk environments. Where an AED is provided, employees expected to use it must be trained, the device must be maintained, and the casualty management procedure must be documented and rehearsed.

Our Online First Aid Course (Emergency First Aid at Work) covers the full DRSABCD sequence, high-quality CPR, AED operation, choking response, severe bleeding control with tourniquets, anaphylaxis with EpiPen administration, recovery position, shock, burns, fractures, stroke (FAST check) and incident reporting - everything an Irish workplace first aider needs to act with confidence under pressure.