Interim CPR Guidelines - National Safety Council

First Aid Technical Bulletins

In light of the COVID-19 pandemic, NSC First Aid subject matter expert Robb Rehberg released four Technical Bulletins for First Aid instructors, dated May 4, April 21, April 13, March 30 and March 16.

May 4 Bulletin: Updated Guidance on First Aid and CPR Training


In light of the continuing health crisis, NSC is providing the following updated guidance related to first aid and CPR training. This information replaces all previously issued guidance and directives regarding first aid and CPR training that were issued in the March and April Technical Bulletins.

NSC is aware that the loosening of social distancing restrictions in certain areas of the country may make it possible to conduct first aid and CPR training. All instructors are to observe the following until further notice:

1. Teaching First Aid and CPR in a Classroom Environment:

  • Classroom-based First Aid and CPR courses may only be conducted where permitted by local government/public health officials. Prior to scheduling or conducting any class, instructors must ensure current state and local public health policies permit gatherings such as a classroom-based first aid and CPR classes. NSC instructors may not conduct classroom-based classes in areas where prohibited by social distancing orders.
  • If classroom-based courses are permitted, instructors must first consider the appropriateness and urgency of conducting classroom-based training, and should consider if other options, such as NSC First Aid, CPR and AED Online course, might be more appropriate.

    By using the online course option, customers can complete the First Aid, CPR, & AED Online course, and then must complete skills testing within 90 days with an NSC instructor who is also authorized as a skills tester. For additional information on becoming authorized as a skills tester, go to https://safety.nsc.org/skill-tester-registration-form.
  • Instructors must follow any additional directives from local government or health officials that are relevant to classroom-based training.
  • Prior to the class, and immediately before beginning class, instructors should communicate with course participants and encourage them not to attend training if they have any known medical condition or illness, or signs or symptoms consistent with an illness. Instructors should offer students the opportunity to speak discreetly prior to the start of class, should they have any questions or concerns about their health status as it relates to class participation.
  • Instructors and course participants may not participate in classroom-based training if they are sick or have a fever.
  • Individuals who are immunocompromised should not attend first aid or CPR classes at this time.
  • Face coverings (which cover the mouth and nose) must be worn by instructors and course participants at all times during the course.
  • Instructors must ensure adequate training space to accommodate the following:
    • Students must be seated at least 6 feet apart during the class.
    • CPR manikins must be spaced at least 6 feet apart for skills practice.
    • In smaller training facilities, instructors should limit class sizes to ensure these distancing requirements are followed.
  • For CPR skills practice, the student to manikin ratio must be 1:1. Students may not share manikins.
  • Rescue breathing:
    • Lay rescuers (Adult Only, Adult and Child, Infant and Child, and Adult/Infant/Child CPR): There will be no modifications to the sequence of CPR skill steps, and providing breaths in between compressions will still be included. However, students will not administer breaths to the manikin. Instead, students should be instructed to simulate breaths by performing a head-tilt/chin-lift and verbally saying “breath – breath” when breaths would normally be performed. At no time should students place their mouth on the manikin.
    • BLS for Health Care and Professional Rescuers: Students will follow the same guidance as lay rescuers (above). A bag mask must be used to ventilate the manikin for skills practice involving rescue breathing and two-rescuer CPR.
  • Students will still complete first aid skills with a partner as usual. Exam gloves must be worn at all times for skills practice, and must be disposed of once skills practice has been completed.
  • Instructors should ensure that there are proper hand-washing facilities available during class. At a minimum, hand sanitizer must be available to students during class.
  • Proper hand-washing must occur before and after breaks, and after glove removal.
  • Lined trash receptacles should be available for glove disposal. Trash receptacles should either be lid-less, or have a hands-free means of opening the lid (such as a foot pedal).
  • All training equipment, including CPR manikins, AED training units, and other first aid and resuscitation devices, should be thoroughly cleaned and decontaminated after each use in accordance with manufacturer’s recommendations. All classroom surfaces must be decontaminated /disinfected immediately after training.

2. NSC First Aid, CPR & AED Online Course Skills Testing
Due to the current COVID 19 crisis, we are temporarily changing the policy regarding skills testing following the completion of NSC First Aid, CPR & AED Online course. Effective immediately, the deadline for completing skills testing for individuals who have completed the First Aid, CPR & AED Online course has been temporarily extended from 45 days to 90 days.

3. Temporary Extension of Expiration Dates for First Aid and CPR Completion Cards
In light of the continuing health crisis and the difficulty in providing training to individuals with current first aid and CPR cards, NSC is extending the expiration dates of all first aid and CPR completion cards by 120 days. Ultimately, the acceptance of this extension is at the discretion of the individual employer or regulatory agency.

Chapters, training centers and instructors who have additional questions or concerns about teaching first aid courses with regard to COVID-19 are encouraged to contact the NSC First Aid Department at [email protected].

April 21 Bulletin: Extension of Expiration Dates for First Aid, CPR

[email protected].

In light of the continuing health crisis and the difficulty in providing training to individuals with current first aid and CPR cards, NSC is extending the expiration dates of all first aid and CPR completion cards by 120 days. Ultimately, the acceptance of this extension is at the discretion of the individual employer or regulatory agency.

This policy will be re-evaluated on or before May 31 and may be extended as needed.

April 13 Bulletin: Interim CPR Guidelines for First Aid


The American Heart Association recently released interim guidelines for rescuers responding to victims of cardiac arrest with suspected or confirmed cases of COVID-19. As a result of these interim guidelines, all NSC instructors are advised to share the following information to current and past course participants regarding response to cardiac arrest in victims with suspected or confirmed cases of COVID-19:

Lay Rescuers

Adults:

  • Wear personal protective equipment (PPE) if available
  • At a minimum, perform compression-only/hands-only CPR (continuous compressions, no breaths)
  • Rescuers and/or victims should wear a face mask or cloth that covers the nose and mouth while compressions are performed, as this may help reduce the risk of transmission
  • AEDs should still be used whenever available

Children:

  • Wear personal protective equipment (PPE) if available
  • Perform chest compressions and consider rescue breaths, if willing and able
  • If unwilling or unable to perform rescue breaths, rescuers and/or victims should wear a face mask or cloth that covers the nose and mouth while compressions are performed, as this may help reduce the risk of transmission
  • AEDs should still be used whenever available

Health Care and Professional Rescuers (Out-of-Hospital)

  • Ensure PPE is used at all times
  • Limit the number of personnel in the room during the resuscitative effort
  • When using a bag-mask, attach a HEPA filter before ventilating, if available, and ensure a tight seal
  • Consider using mechanical CPR devices for qualifying patients when available and if trained
  • Adults: Give CPR in cycles of 30 compressions and 2 breaths using a bag-mask with a HEPA filter and tight seal, OR continuous compressions with passive oxygenation using a non-rebreather mask covered by a surgical mask
  • AEDs should still be used as soon as possible

Chapters, training centers and instructors who have additional questions or concerns about teaching first aid courses with regard to COVID-19 are encouraged to contact the NSC First Aid Department at [email protected].

March 30 Bulletin: Skills Testing Deadline Extended


Due to the current COVID 19 crisis, we are temporarily changing the policy regarding skills testing following the completion of NSC’s First Aid, CPR & AED Online course. Effective immediately, the deadline for completing skills testing for individuals who have completed the First Aid, CPR & AED Online course has been temporarily extended from 45 days to 90 days.

This policy change will be effective through June 30, 2020 and will be extended as needed.

March 16 Bulletin: Instructor Guidance Regarding COVID-19


Cases of novel coronavirus, or COVID-19, have surpassed 125,000 worldwide, according to the Center for Systems Science and Engineering at Johns Hopkins University, with more than 1,200 cases in the United States. The National Safety Council is committed to sharing relevant resources to help keep our members, our instructors and the public informed about this rapidly developing situation.

In light of the current situation, NSC advises all first aid instructors to follow the recommendations issued by the Centers for Disease Control and Prevention and the World Health Organization. NSC has created an online resource that contains links to these recommendations, as well as other important information on COVID-19. Please visit nsc.org/coronavirus for more information.

In addition, NSC advises chapters, training centers, and instructors to observe the following when teaching first aid and CPR classes, effective immediately:

  • Instructors are urged to follow local guidelines and recommendations from health officials regarding public gatherings. In some situations, it may be best to postpone training. If training must be postponed, instructors should make reasonable accommodations for rescheduling the class.
  • Prior to the class date, and immediately before beginning class, instructors should communicate with course participants and encourage them not to attend training if they have any known medical condition or illness, or signs or symptoms consistent with an illness. Instructors should offer students the opportunity to speak discreetly prior to the start of class, should they have any questions or concerns about their health status as it relates to class participation.
  • Course attendees who are experiencing flu-like symptoms should not participate in class, and should be encouraged to seek the advice of their health care professional.
  • Individuals who are immunocompromised should not attend first aid or CPR classes at this time.
  • All training equipment, including CPR manikins and other first aid and resuscitationdevices, should be thoroughly cleaned and decontaminated after each use inaccordance with manufacturer’s recommendations.
  • All instructors and course participants should practice proper hygiene before and afterclasses, and before and after breaks in the class, including hand washing for at least 20 seconds.

CPR Instruction:

  • Whenever possible, use a 1:1 student-to-manikin ratio.
  • Manikins should be placed at least 3 feet apart during CPR training inaccordance with social distancing recommendations.
  • If possible, students should use a pocket mask with a one-way valve forproviding ventilations during CPR skills practice.
  • If a pocket mask is not available, students should simulate breaths only. Mouth-to-mouth ventilations should not be performed on manikins at this time, even withface shields.
  • Students in Basic Life Support for Health Care and Professional Rescuer classesmust use a pocket mask with one-way valve. Students should also be using bagmasks during two-rescuer practice scenarios. Bag masks should bedecontaminated after each use.

First Aid Instruction:

  • As a reminder, preventing disease transmission is the first skill in the NSC firstaid curriculum. Students should be practicing the application and removal ofexam gloves as the first skill.
  • Personal protective equipment, such as examination gloves, should be used forall hands-on skills practices.

The above guidance should be followed at least until April 30, 2020. NSC will notify chapters, instructors, and training centers if this time frame must be extended.

Finally, in light of the current situation and its impact on the availability of training courses, NSC is recommending that regulatory agencies and employers consider extending the acceptance of NSC first aid and CPR cards up to 60 days past the expiration date. Ultimately, this decision is at the discretion of the individual employer or regulatory agency. Chapters, training centers and instructors who have additional questions or concerns about teaching first aid courses with regard to COVID-19 are encouraged to contact the NSC First Aid Department at [email protected].