EMS Continuing Education Home | Login | My Account |
CEH Continuing Education Hours
Fast. Efficient. Effective.
First Responder
Level 1
EMT Basic
Level 2
EMT Intermediate
Level 3
Level 4

Continuing Education and Instant Certificates Online

Customer Support
Contact Us
My Account
My Certificates
My Courses
Online Help
Technical Support

How Do I...?
    Take A Course
    Print My Certificate
    Contact Instructors
    Know When I Passed

EMS Resources

Cardiology: Circulation

Level 4

Circulation EMT Refresher Course EMSNeeds.com Continuing Education

Overview | Assessment | Treatment | Roles


Circulation Refresher Course

In this Circulation course you will earn 2 CE hours. This course is accredited for all levels since all EMS personnel are technically First Responders.

At the end of this course you will be able to:

  • List the reasons for the heart to stop beating.
  • Define the components involved in the circulatory system.
  • Describe the technique of external chest compressions on an adult patient.
  • Describe the technique of external chest compressions on an infant.
  • Describe the technique of external chest compressions on a child.
  • List the steps of two-rescuer adult CPR.
  • List the steps of child CPR.
  • Respond to the feelings that the family of a patient may be having during a cardiac event.

References for content used by permission are on the left side under "EMS Resources." A technical :word: when clicked instantly accesses the EMS glossary online.

There are four sections: Overview, Assessment, Treatment, and Roles. Take the section tests in order by clicking the Take Test button. Your results are saved if you are interrupted. Then do the next section—no lost time or effort with mini-test sections!

EMS Course Levels


Over 600,000 patients die each year from cardiovascular diseases; half of these deaths occur outside the hospital, with sudden death (collapse) being the first sign of cardiac disease in 50% of the cases. Cardiopulmonary Resuscitation (CPR), which will be covered in this module, is the major determinant of survival in cardiac arrest.

Review of the Circulatory System

The function of the circulatory system is to deliver oxygen and nutrients to the tissues and remove waste products from the tissues. Components of the anatomy include the heart, arteries, capillaries, veins, and blood.

  • The heart has an atrium (to receive blood) and a ventricle (to pump blood) with valves that prevent backflow of the blood.
  • Arteries carry blood away from the heart to the rest of the body. There are four major arteries:

    • Carotid in the neck where pulsations can be palpated on either side.
    • Femoral in the thigh where pulsations can be palpated in the groin area (the crease between the abdomen and thigh).
    • Radial in the lower arm where pulsations can be palpated at palm side of the wrist thumb-side.
    • Brachial in the upper arm where pulsations can be palpated on the inside of the arm between the elbow and the shoulder.

  • Capillaries are tiny blood vessels that connect arteries to veins and are found in all parts of the body. They allow for the exchange of oxygen and carbon dioxide.
  • Veins are the vessels that carry blood back to the heart.
  • Blood is the fluid of the circulatory system that carries oxygen and carbon dioxide.


  • Atrium - area of the heart that receives blood from the veins of the body on the right side and blood from the lungs on the left side.
  • Cardiopulmonary Resuscitation (CPR) - a combination of artificial ventilation and external chest compressions to oxygenate and circulate blood when the patient is in cardiac arrest.
  • Ventricle - area of the heart that pumps blood to the lungs on the right side on the left side pumps blood to the body.
Emergency Stop


To understand and assess circulation emergencies, review the physiology. As the left ventricle contracts, it sends a wave of blood through the arteries. The pulse can be felt anywhere an artery passes near the skin surface and over a bone by the four major arteries (carotid, femoral, radial, brachial).

If the heart stops contracting, no blood will flow. The body cannot survive when the heart stops. When the patient has lost a pulse, they are in cardiac arrest.

  • Organ damage begins quickly after the heart stops.
  • Brain damage begins 4-6 minutes after the patient suffers cardiac arrest.
  • Brain damage becomes irreversible in 8-10 minutes

External chest compressions are used to circulate blood anytime that the heart is not beating. External chest compressions are combined with artificial ventilation to oxygenate the blood. The combination of artificial ventilation and external chest compressions is called cardiopulmonary resuscitation (CPR).

Reasons for the Heart to Stop Beating

  • Sudden death and heart disease.
  • Respiratory arrest, especially in infants and children.
  • Medical emergencies (stroke, epilepsy, diabetes, allergic reactions, electrical shock, poisoning, etc.).
  • Drowning, suffocation, congenital abnormalities.
  • Trauma and bleeding.

Regardless of the reason, the First Responder's emergency medical care of cardiac arrest is CPR.


Cardiopulmonary Resuscitation

Cardiopulmonary Resuscitation (CPR) is a combination of artificial ventilation and external chest compressions to oxygenate and circulate blood when the patient is in cardiac arrest. External chest compressions are administered by depressing the sternum to change the pressure in the chest. This causes enough blood to flow to sustain life for a short period of time.

If you do not see the videos, download this free Flash plugin below.

Get Flash plugin


Roles and Responsibilities

The Chain of Survival and the EMS System

Weak links in the chain lower survival rates. Therefore, early access, public education and awareness, and rapid recognition of a cardiac emergency are essentials. Rapid notification before CPR is started means phone first. This gives 911 prearrival instructions and dispatcher directed CPR. Early CPR may have been performed by general public, family members, or bystanders. First Responders may use early defibrillation and advanced cardiac life support (ACLS).

CPR is only effective for a short period of time and cannot sustain life indefinitely. It must be started as early as possible. Effectiveness decreases the longer you are doing CPR. In many cases the patient needs to be defibrillated to survive. CPR increases the amount of time that defibrillation will be effective.


Search for Courses
About EMSNeeds

Terms & Conditions
Privacy Policy
Home | About Us | Site Map | Privacy Policy | Contact Us | Resources | CEU-Training
The purpose of this site is to support Pre-Hospital Emergency Medical Care Personnel or EMS
Personnel who need continuing education hours (CEH) to renew, refresh, recert, or maintain their certification.
Website Hosted By Expert Data Solutions, Inc.
©2008 EMSNeeds.com