CPR, AED, Rapid Transport, and Handoff
Key Takeaways
- Cardiac arrest care requires quick recognition, high-quality CPR, early AED use, and minimal interruptions.
- The AED is used as soon as available for an unresponsive patient with no normal breathing and no pulse, according to current CPR training.
- Airway and ventilation support must be coordinated with compressions so lifesaving actions do not compete with each other.
- Transport and handoff should communicate arrest timeline, CPR start time, AED analysis and shocks, ventilation method, and patient response.
Make Arrest Care Fast, Organized, and Easy to Handoff
A cardiac arrest scenario is one of the clearest examples of Patient Treatment and Transport. The EMR must recognize unresponsiveness, absent normal breathing, and pulselessness; start CPR; apply the AED as soon as it is available; manage airway and ventilations; request resources; and prepare a concise handoff.
The National Registry candidate handbook states the EMR exam is computerized adaptive testing with 90-110 items, including 30 unscored pilot items. You cannot know which item counts, so every arrest item deserves full attention. The safest answer usually follows current CPR training and avoids unnecessary interruptions.
CPR quality matters. Push hard and fast according to current training, allow chest recoil, minimize pauses, rotate compressors when possible, and avoid leaning. Ventilations should create visible chest rise without excessive force. If an AED arrives, turn it on, attach pads correctly, follow prompts, clear the patient for analysis and shock, then resume CPR promptly.
Airway actions should support CPR, not stop it unnecessarily. If vomit appears, clear the airway efficiently and resume care. If a BVM is used, coordinate breaths with compressions according to current CPR sequence and local protocol. If there are too few rescuers, prioritize the core sequence and request help.
| Arrest task | EMR priority | Handoff detail |
|---|---|---|
| Recognition | Unresponsive, no normal breathing, no pulse | Time found and initial condition |
| CPR | Start compressions quickly | Approximate start time and interruptions |
| AED | Attach and follow prompts | Number of analyses and shocks advised or delivered |
| Ventilation | Provide effective breaths with chest rise | Device, oxygen use, airway issues |
| Transfer | Continue care until relieved | Changes, response, and resources requested |
Pediatric arrest items use the same integrated exam logic but require size-appropriate pads, positioning, ventilation, and compression technique based on training. The exam will not put pediatrics in a separate content lane. It will embed the child or infant in a realistic treatment scenario.
Transport decisions can be tricky. EMRs often stabilize and support while awaiting additional EMS resources, but the exam wants the candidate to keep the chain moving. Do not abandon CPR to package too early, and do not withhold an AED because transport is coming. Communicate clearly when higher-level providers arrive so care continues without losing critical timeline information.
Team roles improve arrest care. One responder can compress, another can manage ventilations, another can prepare the AED, and another can record times or relay information. If only one or two responders are present, the priority is to start the core lifesaving sequence and add tasks as help arrives.
During handoff, avoid guessing about rhythm interpretation beyond the AED prompts. Report what the device advised, what rescuers did, and what changed in the patient. That keeps the EMR inside scope while preserving the timeline higher-level providers need.
An adult is unresponsive, not breathing normally, and has no pulse. What should the EMR do next?
The AED is analyzing the rhythm. What is the EMR's priority?
Which handoff statement is most useful after an AED arrest call?