Emergency Procedures, First Aid & Basic Life Support

ACSM-EP ACSM Certified Exercise Physiologist

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1 Introduction & Exam Overview

The ACSM-EP Credential & Current Exam Facts Exam Blueprint, Cognitive Levels & Study Strategy

2 Foundations of Exercise Physiology

Bioenergetics & Energy Systems Cardiorespiratory Responses & Adaptations to Exercise Neuromuscular Physiology

3 Functional Anatomy & Biomechanics

Musculoskeletal Anatomy & Movement Terminology Biomechanical Principles

4 Preparticipation Health Screening & Risk Assessment

The ACSM Preparticipation Screening Algorithm & Medical Clearance Informed Consent & Health-History Questionnaire CV, Pulmonary, Metabolic & Musculoskeletal Risk Factors Clinical Reference Values

5 Health & Fitness Assessments

Selecting, Sequencing & Terminating Fitness Assessments Cardiorespiratory Fitness Testing Muscular Fitness, Flexibility & Neuromotor Assessment Anthropometric & Body Composition Assessment

6 Exercise Prescription Foundations: FITT-VP & Programming

The FITT-VP Framework & Training Principles Session Structure, Warm-Up/Cool-Down & Recovery Program Design, Overtraining & Injury Recognition

7 Cardiorespiratory Exercise Prescription

Prescribing CR Exercise & Intensity Methods ACSM Metabolic Equations & Caloric Expenditure

8 Resistance, Flexibility & Neuromotor Prescription

Resistance Training Prescription Flexibility, Neuromotor & Plyometric Prescription

9 Progression, Nutrition & Weight Management

Exercise Progression & Modification Energy Balance, Nutrition & Fuel Utilization Body-Composition Modification, Ergogenic Aids & Weight-Management Programming

10 Clients with Controlled Disease & Special Populations

Exercise for Controlled Cardiovascular, Pulmonary & Metabolic Disease Exercise for Arthritis, Osteoporosis, Obesity & Low-Back Pain Older Adults Children, Adolescents & Pregnant Clients Environmental Considerations: Heat, Cold, Altitude & Air Quality

11 Exercise Counseling & Behavior Modification

Communication Techniques & Group Exercise Leadership Behavior-Change Models & Theories Motivational Interviewing, Goal Setting & Adherence Health Literacy, Educational Resources & Stress Management Professional Standards, Mental Health & Referral (Scope of Practice)

12 Risk Management & Emergency Procedures

Risk Management, Legal & Professional Responsibilities Emergency Procedures, First Aid & Basic Life Support

Emergency Procedures, First Aid & Basic Life Support

Key Takeaways Explain This Topic AI

The current AHA standard for adult chest compressions is a rate of 100 to 120 per minute at a depth of at least 2 in (5 cm), avoiding depths greater than 2.4 in (6 cm).

Single-rescuer and two-rescuer adult CPR without an advanced airway uses a 30:2 compression-to-ventilation ratio.

The unified AHA Chain of Survival has six links: Recognition & Emergency Activation, High-Quality CPR, Defibrillation, Advanced Resuscitation, Post-Cardiac Arrest Care, and Recovery & Survivorship.

For a conscious, choking adult, rescuers alternate 5 back blows and 5 abdominal thrusts until the object is expelled or the person becomes unresponsive.

RICE (Rest, Ice, Compression, Elevation) is the standard initial first-aid protocol for exercise-related sprains and strains.

Last updated: July 2026

Emergency Response Systems: Roles & Activating EMS

Every facility's written EAP assigns roles before an emergency happens: who calls EMS, who retrieves the AED and first-aid kit, who meets EMS at the entrance and directs them to the scene, and who manages bystanders. Activating EMS means calling as soon as an emergency is recognized, not after first aid has already been attempted, and giving the dispatcher the exact location, the nature of the emergency, the number of victims, and the victim's condition; the caller stays on the line until told to hang up. In a witnessed collapse, activation and compressions happen in parallel — a second staff member calls 911 and retrieves the AED while the first rescuer begins compressions immediately; care never pauses for the phone call.

Recognizing & Managing Common Exercise-Setting Emergencies

Emergency Key signs Initial first aid

Hypoglycemia Shakiness, confusion, sweating, weakness, irritability If conscious and able to swallow, give fast-acting carbohydrate (juice, glucose tabs); activate EMS if unresponsive or not improving

Heat exhaustion → heat stroke Heavy sweating, dizziness, nausea, headache; heat stroke adds altered mental status, hot skin, and possible collapse Move to a cool area, remove excess clothing, cool actively (cold water immersion for suspected heat stroke); heat stroke is a medical emergency — activate EMS immediately

Hypothermia Shivering, slurred speech, confusion, loss of coordination Move to a warm, dry area, remove wet clothing, insulate, rewarm gradually; activate EMS for moderate-to-severe presentation

Syncope (fainting) Lightheadedness, pale/clammy skin, brief loss of consciousness Lay the client supine, elevate the legs, loosen restrictive clothing, monitor breathing and pulse; activate EMS if recovery is not rapid or an injury occurred

Sprains / strains Pain, swelling, bruising, limited motion RICE — Rest, Ice, Compression, Elevation

Bleeding Visible external hemorrhage Apply firm direct pressure with a clean dressing, maintain pressure, elevate if possible, use gloves under universal precautions

Choking (conscious adult) Universal choking sign (hands clutching throat), unable to speak, cough, or breathe Alternate 5 back blows and 5 abdominal thrusts until the object is expelled or the person becomes unresponsive

Cardiac arrest Unresponsive, no normal breathing (or only gasping), no definite pulse within 10 seconds Activate EMS, begin high-quality CPR immediately, apply the AED as soon as it arrives

The AHA Adult Chain of Survival

The current AHA Guidelines for CPR and Emergency Cardiovascular Care use a single, unified six-link Chain of Survival that applies to any cardiac arrest, adult or pediatric, in-facility or out-of-hospital:

Recognition & Emergency Activation
High-Quality CPR
Defibrillation
Advanced Resuscitation
Post-Cardiac Arrest Care
Recovery & Survivorship

An EP-C operates squarely inside the first three links: recognize the arrest and activate EMS immediately, start compressions without delay, and apply an AED the moment one is available rather than waiting for EMS to arrive. Early bystander CPR and early defibrillation are the two links most strongly associated with survival to discharge, which is why every fitness facility should maintain an accessible, well-signed AED.

High-Quality Adult CPR: The Numbers

BLS Parameter Current AHA Standard
Pulse/responsiveness check No more than 10 seconds; if no definite pulse, assume cardiac arrest
Compression rate 100–120 compressions per minute
Compression depth (adult) At least 2 in (5 cm); avoid depths greater than 2.4 in (6 cm)
Chest wall recoil Allow complete recoil between compressions — do not lean on the chest

Compression-to-ventilation ratio 30:2 (30 compressions : 2 breaths) for single-rescuer or two-rescuer CPR without an advanced airway

Rescue-breathing-only rate (pulse present, breathing inadequate) 1 breath every 6 seconds (10 breaths/min)

Compressor rotation Switch roles about every 2 minutes (~every 5 cycles of 30:2) to prevent fatigue-related depth decay

AED / defibrillation Apply and use as soon as it is available; minimize interruptions to compressions

For an untrained bystander, or a rescuer unwilling/unable to give breaths, compression-only (hands-only) CPR — continuous compressions at the same rate and depth with no pause for breaths — is an acceptable and effective alternative for a witnessed adult collapse. In all cases, the guiding principle is "push hard, push fast, allow full recoil, minimize interruptions."

EP Scope, Documentation & Legal Limits in an Emergency

An EP-C's emergency scope of practice is first aid, CPR, and AED use — not diagnosis or advanced medical treatment. Once EMS personnel arrive, the EP-C hands off care and gives a concise report: what happened, what actions were taken, and how the client responded. Every emergency, however minor, requires a same-day, objective incident report, and staff should also know the facility's building-wide evacuation plan (fire, gas leak, structural threat), which is distinct from the medical EAP covered in Section 12.1. Acting outside scope during an emergency — for example, assuming a collapse is "just dehydration" rather than activating EMS for an ambiguous presentation — creates the same negligence exposure discussed in Section 12.1, so when in doubt, the correct action is always to activate EMS and begin the appropriate first aid.