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Difficulty speaking indicates moderate to severe respiratory distress. Normal breathing allows full sentences, and mild distress may cause shortness of breath with exertion only. Respiratory failure is when breathing becomes inadequate or absent. EMRs must act quickly with oxygen and monitoring.

A BVM with oxygen reservoir at 15 L/min is essential for patients in cardiac arrest. Non-rebreathers and nasal cannulas require spontaneous breathing. Simple masks provide moderate oxygen but not ventilations. EMRs prioritize assisted ventilations in cardiac arrest.

Switching every 2 minutes (or after 5 cycles of 30:2) prevents fatigue and maintains compression quality. Longer intervals risk shallow compressions. EMRs practice smooth transitions to minimize interruptions and maintain effective CPR.

Patients with spinal injuries should be logrolled as a unit by several rescuers to maintain alignment while clearing the airway. Sitting or prone positioning risks further injury. Abdominal thrusts are inappropriate. EMRs practice logrolling to maintain spinal integrity and airway safety.

When the AED analyzes rhythm, no one should touch the patient to prevent interference. Compressions resume immediately after analysis unless the AED advises a shock. Clearing the patient ensures accuracy and rescuer safety. EMR training emphasizes this critical sequence.