Alameda County Emergency Medical Services 2026 Field Manual - Rev3 - Summary of High-Quality CPR Components

Sep 23, 2026

Field manual for Alameda County Emergency Medical Services, Revision 3 (2026). Includes a detailed BLS-focused reference section summarizing high-quality CPR components for adults, children, and infants: scene safety, cardiac arrest recognition, activation of emergency response, AED use, chest compression/ventilation ratios, compression rate and depth, hand placement, chest recoil, minimizing interruptions, and defibrillation guidance. Also lists supporting abbreviations and provides a comprehensive EMS policy table of contents covering ambulance rerouting, patient care overview, and multiple emergency care topics.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages178

Reading Time7 h 29 min

AccessFree to download

Summary of High-Quality CPR Components for BLS Providers

Scene safety

Recognition of cardiac arrest

Activation of emergency response system

Compression-ventilation ratios

Compression rate and depth

Hand placement

Chest recoil and minimizing interruptions

Defibrillation

Table of Contents

Ambulance Rerouting Criteria

General Policies TOC

Adult Policies TOC

Adult Policy Topics (selected)

2026 FIELD MANUAL ALAMEDA COUNTY EMERGENCY MEDICAL SERVICES 1 000 SA N L EAN DR O BL VD . | SU I TE 2 00 | SA N L EAN DR O , CA 9 4577 P HONE : 5 10 . 618 . 20 50 | W EB : [em s . ac go v. o r g | E m a il:](em s . ac go v. o r g | E m a il:) [a l coe m s @ ac go v. or g](a l coe m s @ ac go v. or g) | Summary of High-Quality CPR Components for BLS Providers | | | | | --- | --- | --- | --- | | Component | Adults and
Adolescents | Children (Age 1 Year to Puberty) | Infants
(Age Less Than 1 Year, Excluding Newborns) | | Scene safety | Make sure the environment is safe for rescuers and victim | | | | Recognition of
cardiac arrest | Check for responsiveness
No breathing or only gasping (ie, no normal breathing)
No deﬁnite pulse felt within 10 seconds
(Breathing and pulse check can be performed simultaneously in less than 10 seconds) | | | | Activation of emergency response system | If you are alone with no mobile phone, leave the victim to activate the emergency response system and get the AED before beginning CPR
Otherwise, send someone and begin CPR immediately; use the AED as soon as it is available | Witnessed collapse
Follow steps for adults and adolescents on the left
Unwitnessed collapse
Give 2 minutes of CPR
Leave the victim to activate the emergency response system and get the
AED
Return to the child or infant and resume CPR; use the AED as soon as it is available | | | Compressionventilation ratio without advanced airway | 1 or 2 rescuers
30:2 | 1 rescuer
30:2
2 or more rescuers
15:2 | | | Compressionventilation ratio
with advanced airway | Continuous compressions at a rate of 100-120/min
Give 1 breath every 6 seconds (10 breaths/min) | | | | Compression rate | 100-120/min | | | | Compression depth | At least 2 inches (5 cm)* | At least one third AP diameter of chest About 2 inches (5 cm) | At least one third AP diameter of chest About 1½ inches (4 cm) | | Hand placement | 2 hands on the lower half of the breastbone (sternum) | 2 hands or 1 hand (optional for very small child) on the lower half of the breastbone (sternum) | 1 rescuer
2 ﬁngers in the center of the chest, just below the nipple line
2 or more rescuers
2 thumb–encircling hands in the center of the chest, just below the nipple line | | Chest recoil | Allow full recoil of chest after each compression; do not lean on the chest after each compression | | | | Minimizing interruptions | Limit interruptions in chest compressions to less than 10 seconds | | | | Deﬁbrillation | Attach and use AED/ Deﬁbrillator as soon as available | Minimize interruptions in chest compressions before and aftershock | Resume CPR beginning with compressions immediately after each shock | *Compression depth should be no more than 2.4 inches (6 cm) . Abbreviations: AED, automated external deﬁbrillator; AP, anteroposterior; CPR, cardiopulmonary resuscitation. TABLE OF CONTENTS AMBULANCE REROUTING CRITERIA .................................................................. v EMERGENCY MEDICAL SERVICES-STAFF [DIRECTORY................................ vi](DIRECTORY................................ vi) GENERAL POLICIES TAB GENERAL POLICIES TOC ...................................................................................... 1 AN OVERVIEW OF PATIENT CARE POLICIES ..................................................... 2 ACUTE CORONARY SYNDROME (ACS) ........................................................ 3 ACUTE CORONARY SYNDROME (ACS) STEM I ............................................. 4 ASSAULT | ABUSE | HUMAN TRAFFICKING | DOMESTIC VIOLENCE ............... 5 BURN PATIENT CARE ............................................................................................ 9 BURN PATIENT CRITERIA .................................................................................... 11 CARDIOPULMONARY RESUSCITATION (CPR) .................................................. 12 AD

FAQs

What are the key steps to recognize cardiac arrest for BLS providers?

Check for responsiveness and confirm no breathing or only gasping, plus no definite pulse within 10 seconds. Breathing and pulse checks can be performed simultaneously in less than 10 seconds.

How should emergency response and AED use be handled during CPR?

If alone without a mobile phone, leave the victim to activate emergency response and get the AED before starting CPR. Otherwise, send someone and begin CPR immediately, using the AED as soon as it is available.

What compression rate, depth, and ventilation targets are recommended for CPR?

Use 100-120 compressions per minute. Provide at least 2 inches (5 cm) depth for adults/adolescents; pediatric and infant targets specify age-appropriate chest depth. For advanced airway, deliver continuous compressions with 1 breath every 6 seconds (10 breaths/min).

What guidance is given to minimize interruptions during chest compressions?

Limit interruptions in chest compressions to less than 10 seconds. When defibrillation is performed, minimize interruptions before and after the shock and resume CPR immediately beginning with compressions.

Sep 23, 2026

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