Inside a Canadian Red Cross CPR course — a session-by-session walkthrough.

Most people walking into their first CPR course don't really know what to expect. They've seen chest compressions on television, vaguely understand there's a manikin involved, and have noticed those AED boxes on the wall at the airport without ever pressing the button. Beyond that — fuzzy.

This is the article we wish someone had handed us before our own first course. We'll walk through what genuinely happens in a Canadian Red Cross CPR class — session by session — what the certification levels mean, and which one matches your circumstances. By the time you finish reading, signing up should feel like a known quantity instead of a leap of faith.

What CPR training is actually for

Cardiopulmonary resuscitation is the bridge between cardiac arrest and definitive medical care. When the heart stops circulating blood effectively, brain cells start dying within minutes from oxygen deprivation. CPR — done well, started immediately, continued without significant interruption — keeps oxygenated blood reaching the brain. It doesn't typically restart the heart on its own; an AED (automated external defibrillator) often does that. But CPR buys the time the AED, or the paramedics, need to do their job.

The numbers are stark: in out-of-hospital cardiac arrests, survival rates roughly double when bystander CPR is started before EMS arrives. They roughly halve for every minute that effective CPR is delayed. The intervention is conceptually simple. The skill is in doing it correctly and continuously when adrenaline is high, the patient is someone you know, and bystanders are looking to you for direction.

That's what a CPR course is built to produce. Not memorized procedure — embodied, practised, automatic response.

The three certification levels

Canadian Red Cross — and broadly speaking, the other recognized Canadian providers — offer CPR training at three levels. The actual chest compression and AED technique is identical across them. What changes is the breadth of who you're trained to resuscitate.

Level A — adults only

Covers adult CPR, adult choking, and AED use on adults. Runs about four hours. Practical in environments where children and infants aren't part of the population — some adult-services workplaces, some restricted-access facilities. Less common now than it once was; most workplaces opt for Level C as a small additional investment that significantly broadens the certificate's usefulness.

Level C — adult, child, and infant

The most-requested standalone CPR level in Saskatchewan and across Canada. Covers everything in Level A and adds child and infant resuscitation and choking, plus paediatric AED considerations. About five hours in length. This is the CPR level built into our Standard First Aid course and our Emergency First Aid course, and it's the right standalone level for most workplace contexts, parents and caregivers, schools, coaches, lifeguards, and anyone whose responsibilities span people of different ages.

Level HCP — Healthcare Provider

The professional level, built for clinical roles. Includes everything in Level C, with the additions that distinguish team-based clinical resuscitation: two-rescuer CPR coordination, bag-valve mask ventilation, and pulse checks. About six hours. Increasingly, what used to be called HCP is now delivered as BLS for Healthcare Providers, which is the standard required by the Saskatchewan Health Authority and most clinical employers.

If you're not in a clinical role and you're picking a level on your own initiative, Level C is almost always the right answer. If you're a healthcare worker, your employer or program will tell you whether they want HCP or BLS specifically — and the practical content is closely related.

The Level C course, session by session

Here's what a typical five-hour CPR Level C course looks like at our Saskatoon training centre. Real pacing depends on class size and the rhythm of the day, but the structure follows this pattern reliably.

Session one — framing and emergency scene management (about 45 minutes)

The day starts seated. You'll get your course materials, the instructor will introduce themselves and the class, and the first content block is the framework that runs through everything else: how to take charge of an emergency calmly when you have no idea yet what's happening.

This part of the course is often underrated by students before they take it, and rated highly afterward. The technical mechanics of CPR are simple enough to describe. The hard part of an emergency is the first thirty seconds — the part before you've started doing anything, when your brain is processing what's happening in front of you and deciding what to do. Emergency Scene Management is the rehearsed sequence that bridges that gap:

• Scene safety — making sure you're not about to become the second casualty
• Identifying the situation — what's happening, how many patients, what's the immediate threat
• Checking responsiveness and breathing — the rapid assessment that tells you whether CPR is what's needed
• Activating EMS — when to call, who calls, what to say to dispatch
• Directing bystanders — turning the people around you from passive observers into useful resources (calling 911, finding the AED, clearing space, controlling the scene)

You'll use this framework dozens of times over the course of the day, in every scenario from a simulated cardiac arrest to a choking emergency. By the end, the sequence runs almost automatically — which is exactly what you want when a real emergency happens.

Session two — adult CPR (about 75 minutes)

The manikins come out. Each student gets their own (no shared mouthpieces; individual pocket masks for ventilation practice), and the next stretch is hands-on adult CPR mechanics:

• Compression depth — about 5 to 6 centimetres (2 to 2.4 inches) for adults. Less than this and the heart isn't being effectively squeezed; more than this and you risk causing additional injury
• Compression rate — 100 to 120 per minute. The pop song "Stayin' Alive" lands almost exactly in this range, and yes, your instructor will probably hum it at least once
• Recoil — letting the chest come fully back up between compressions. This is the most-cheated part of compressions because it feels efficient to lean on the chest; it actually reduces effectiveness significantly
• Ratio of compressions to breaths — 30:2 in single-rescuer adult CPR
• Pocket mask technique for delivering effective breaths

You'll start in short bursts and build up to full two-minute cycles. The two-minute cycle is significant: it's the recommended duration before a rescuer swap if multiple rescuers are available, because two minutes of good CPR is roughly where rescuer fatigue starts measurably degrading the compressions. Doing two minutes yourself on a manikin is also the first time most people realize how physically demanding it is — by the 90-second mark, your arms and shoulders are burning. That's normal, expected, and entirely the point.

Session three — AED training (about 45 minutes)

If CPR is the bridge, the AED is what crosses it. Modern AEDs are designed to be safe and effective in the hands of any bystander. They talk you through every step, won't deliver a shock unless it's appropriate, and are physically simple to use. The CPR course's job is to make you familiar enough with the device that you reach for it without hesitation when it matters.

In the AED block, you'll learn:

• How to turn on a real AED and follow its voice prompts
• Where to place the pads on an adult — typically the upper-right chest and lower-left side, but the device shows you with diagrams
• How to keep CPR going while the AED is being readied and applied — minimizing interruptions to compressions is one of the highest-impact things you can do
• What happens when the AED says "shock advised" versus "no shock advised"
• What to do immediately after a shock (it's CPR — every time, regardless of what you think happened)
• Special situations — wet patients, hairy chests, transdermal medication patches, implanted pacemakers and defibrillators, paediatric versus adult pads

You'll run a full simulated cardiac arrest from collapse through AED arrival through shock delivery through ongoing CPR. The first time through, almost everyone fumbles something — the pads go on slightly wrong, or you forget to clear the patient before the shock. By the third repetition, it feels like a sequence rather than a panic. That's the goal: enough repetitions that the order of operations is muscle memory.

Session four — child and infant CPR (about 60 minutes)

Smaller bodies, slightly different mechanics, identical principles. Out come the child and infant manikins, and the next block adjusts the techniques:

• Child compression depth — about 5 centimetres (2 inches), or roughly one-third the depth of the chest
• Infant compression depth — about 4 centimetres (1.5 inches)
• Hand position changes — one-handed compressions for children if you're a smaller rescuer; two fingers (lone rescuer) or two-thumbs-encircling-hands (preferred when CPR is delivered to an infant by a single rescuer with appropriate technique) for infants
• The compression-to-breath ratio stays 30:2 for single-rescuer paediatric CPR, but changes to 15:2 for two-rescuer paediatric CPR
• Breath size — significantly less air for infants and small children. You should see the chest rise, but you're not blowing into an adult lung
• AED modifications for small bodies — paediatric pads where available; front-and-back placement on infants where adult pads would otherwise touch

The infant CPR practice is where the course tends to get quiet. Practising chest compressions on a doll-sized manikin makes the real-life scenario tangible in a way that's hard to ignore — and that emotional weight is part of the training value. You want to be prepared for the emotional reality of paediatric resuscitation, not just the technical reality. Talking about it in the room, with classmates and an instructor, is itself a kind of preparation.

Session five — choking, scenarios, and skill check (about 75 minutes)

The last stretch of the day pulls everything together. Three threads:

• Choking management — conscious and unconscious, all ages. Standard back-blows-and-abdominal-thrusts for older infants and adults; modified techniques for pregnancy and significant obesity; specific infant technique with back blows and chest thrusts
• Integrated scenarios — the instructor sets up situations and you work through them from scene safety to handover to EMS. "You walk into the staff room at the end of your shift and find a colleague slumped over a table." "A customer at your business starts choking during their meal." You handle the whole thing, including the parts that aren't strictly CPR — calling 911, managing bystanders, decisions about whether and how to move the patient
• Skill check — the instructor formally evaluates your demonstrated competence on the practical components. There's also a brief written knowledge check. The standard is 75% on the written and visible competence on each practical skill

Pass, and you walk out with a Canadian Red Cross CPR Level C certificate, valid for three years across Canada. The digital certificate is in your email within hours; the printed wallet card follows by mail.

What CPR training won't teach you (and why that's the right design)

It's worth being honest about what's not in a CPR course, because the omissions are deliberate:

• Drug administration. No epinephrine, no IV access, no naloxone administration techniques beyond the most basic (some advanced courses do include naloxone)
• Advanced airway management. No intubation or laryngeal mask airways. Your airway tools are: head-tilt, chin-lift, pocket-mask ventilation
• Cardiac rhythm interpretation. The AED reads the rhythm and decides whether to shock. You don't need to recognize ventricular fibrillation on an ECG
• Diagnosis. CPR training teaches you to recognize that someone needs CPR, not to figure out why

This isn't training-by-omission. The interventions that actually improve outcomes in out-of-hospital cardiac arrest — high-quality chest compressions, early defibrillation, minimal interruptions to compressions — are what the course doubles down on. Adding more complex skills would dilute that focus without improving real-world results for lay rescuers.

The skill-decay problem

One thing worth being honest about: CPR skill decays measurably within 3 to 6 months of certification if not practised. This is well-documented in resuscitation research. The certificate is valid for three years, but actual physical and procedural competence — especially compression rate and depth, and the smooth integration of AED use into ongoing CPR — degrades faster than that.

The practical implications:

• If you have any way to practice between certifications — workplace refresher days, community CPR events, even at home on a firm cushion — take it
• Mental rehearsal counts for something. Watching a brief CPR demonstration video every few months keeps the sequence fresh even without physical practice
• If your role makes you the likely first responder in an emergency — daycare worker, gym staff, school nurse, oilfield medic — consider annual rather than three-year renewal cycles. Some employers fund this; many will if asked

What surprises people most

Across many groups, the same observation comes up at the end of the day: students expected to learn techniques and instead learned a process. The techniques are simple; the process is what binds them together into something usable under pressure.

A real cardiac arrest involves adrenaline, fear, an unconscious person you might know, bystanders watching, the possibility that nothing you do will be enough. The CPR technique itself can be learned in fifteen minutes. The integrated response — scene assessment, activation, compressions, AED, sustained effort, handover — is what takes the full five hours to embed.

That integrated response is the actual product of CPR training. The certificate is just the credential.

If you're ready to register

We run CPR Level C courses at our Saskatoon training centre weekly, with weekend and evening sessions to accommodate shift workers. Private CPR sessions for groups of six or more can also be delivered onsite at workplaces, schools, and community organizations throughout Saskatchewan. See our CPR/AED course page for current dates, or request a private session.

And if you've read this and decided you want the broader curriculum — fractures, head injuries, sudden medical emergencies, environmental injuries — alongside your CPR training, our Standard First Aid with CPR/AED course is the natural next step. CPR Level C is built into it.