Immediate Feedback Devices in CPR Training

Q. May I use feedback manikins or devices that let students know if their compression rate and depth is appropriate in EFR® courses?

A. Absolutely. At least one resuscitation council, the American Heart Association, recommends the use of quality CPR feedback devices to learn adult CPR based on research. Though CPR skill repetition is essential, there is speculation that the use of feedback devices may reduce mastery time as participants self-correct in response to the device’s real-time feedback. ILCOR Guidelines in recent years have re-emphasized compression rate, depth and recoil, which make these devices an interesting teaching aid for skill mastery evaluation.   

The important aspect of using manikins that provide immediate results on compression rate, depth and recoil in EFR courses is to do so in a reassuring way, so the competent-versus-perfect philosophy outlined in the EFR Instructor course is not compromised.

Keep in mind that CPR students often feel intimidated by the practical skills and can feel performance anxiety, particularly when they’re not able to achieve great feedback results right away. Unless a level of comfort and support is achieved by the instructor in the CPR classroom, the participant’s ability to learn and retain skills and be willing to offer them in an emergency can be severely reduced. However, used properly, compression feedback devices are a teaching tool that can effectively help EFR students bring their practical CPR skills in line with current compression rate, depth and recoil guidelines.

A variety of feedback devices are available, some built into the manikin, and others can be added to and used with existing manikins.

ILCOR Consensus March 2018

Emergency First Response courses keep pace with current research and treatment recommendations in emergency care. The most recent news indicates that no changes to CPR procedures are necessary in EFR courses.

After re-evaluation of science and research, the International Liaison Committee on Resuscitation (ILCOR) most recent Consensus on Science and Treatment Recommendations do not include any changes to bystander CPR.

ILCOR reaffirmed three areas of bystander treatment as published in the journal, Resuscitation 121 (2017) 201-214:

  • We continue to recommend that bystanders perform chest compressions for all patients in cardiac arrest. We suggest that bystanders who are trained, able, and willing to give rescue breaths and chest compressions do so for all adult patients in cardiac arrest.
  • We suggest a compression/ventilation (CV) ratio of 30:2 compared with any other CV ratio in patients with cardiac arrest.
  • We suggest that bystanders provide CPR with ventilation for infants and children less than 18 years of age with cardiac arrest. We continue to recommend that if bystanders cannot provide rescue breaths as part of CPR for infants and children under 18 years of age with cardiac arrest, they should at least provide chest compressions.

Congratulations to the new EFR Instructor Trainers in the Asia Pacific Region

We wish you the very best with your EFR business.

PADI Asia Pacific is delighted to announce the new EFR Instructor Trainers from 2018 and early 2019. Multiple programs have been conducted around the Asia Pacific region. Completing the course has enabled these new EFR Instructor Trainers to teach the wide variety of EFR programs. Not only at the Instructor level but also to help build up their own EFR instructional staff.

Jon-Jon SuarezLiu Dong HaiAroldo Valerio
Yuri SakamotoSamuel NortonYoung Hoon Park
Karl Singery Restuning SandiniChoong Kwon Ko
Shu Wei GohChien-Ming ChenYu Chan Won
Claire BakerHsien-Yin LinHong Sung Lee
Trevor NealMing Wei ChiJoon Sik Yu
Kenny RamdhonyKatie SpinkYoung Min Choi
Tan Jemmy TanjungLena NorrYang Hee Jo
Tam Kit FungMootoosamy Moorghen Sunil Kim
Ming Chau Roger ChanMarie-Emilie CangoJong Pil Yang
Weonsin SongPierre BritsDo Young Moon
Bryan BaileyScott RobertsSeul A Ha
Kookjae LeeRebecca WastallJin Suk Park
Xiaoyu PeiMark WastallKyung Yil Lee
Takuma YamamotoAleksei PermakiovSeung Mok Han
Wayne Hung Wei LiaoWayne BudgenKyung Lee
Selahattin AkinTroy MurrayHyukjoon Kim
Shubin YiLushan HeSu Young Kim
Kai WangJulian PirieChul Kwon Lee
Adi HaliemMonique RichardsKyung Ho Jung
Augusto AlparceJamie HullKyuchul Cho
Ketut CariasaMan Chung Leung Sung Won Kim
Ni Made JulianiSze Po FunHyunjae Park
Shaobin XieLijun TangJin Myung Kim
Lin QiaoKewalyn PrapansinSeung Mok Han
Seong Cheol KimJung Woo SeoSungkuk Kim
Jaewon KimJi Kyung JeongDeuk Hun Ahn
Jong Yul Kim Jae Jung Park Bastiaan van der Kuijl

This highly prized qualification allows these professionals to further expand their EFR businesses beyond diving markets.

We wish everyone the very best of success for the future.

Are you interested in growing your business? See all the upcoming EFR Instructor Trainer Courses.

How to Use the EFR Logos and Trademarks

Did you know as Emergency First Response Instructor Trainers you are allowed to use and reproduce the latest logos and images to promote your business?

The EFR logo is available to current and renewed EFR Instructors and registered EFR Centers offering EFR programs.

The word EFR and the EFR logo, which consists of a heart with a pulse line inside a box, with the words Emergency First Response, can be used on your promotional materials such as specifically printed brochures, or any interactive digital or broadcast media including web sites.

Some limitations you need to be aware of are:

  • The EFR logo cannot be placed on goods that you intend to sell (such as mugs or T-shirts). If you want to use the logo on staff shirts for example, you will need to get separate written authorization.
  • Websites and promotional material should clearly identify the EFR instructor who will be conducting any training.
  • You are not able to use EFR name or logo in internet domain names or email addresses.
  • It cannot be combined with other marks, symbols, language or be altered in any way. You need to follow the exact format, character, general appearance, type style, background and proportions of the logo/mark.

Guidelines and Terms of Use can be found on the EFR Instructor Site (PADI Members need to access via PADI Pros’ Site/Training Essentials/EFR/EFR Instructor Site) under Toolkit/General Forms. You can also view the EFR License Agreement.

Here you will find the current Trademark Usage Guidelines and specific advice on how to use and reproduce the latest logos and images appropriately, to promote your business successfully. By using the logo in this way you will ensure that you receive maximum exposure and at the same time remain within the license agreement regarding logo and trademark use.

PADI First Responder in Action – Dilshan Nanayakkara

Being PADI Professionals, we are all aware of the importance of Emergency First Response (EFR) courses and first aid training in general. The EFR course provides comprehensive first aid training to not only help us prepare for a variety of situations but to also help us properly care for an injured or ill person.

While some of us may think (and hope) that we will never have to use our EFR training in an emergency situation, others have already had to use their EFR skills to save lives. One of these heroic individuals is Sun Diving Center owner, Master Scuba Diver Trainer and Emergency First Response Instructor Dilshan Nanayakkara. Dilshan was able to use his EFR skills in full force to successfully resuscitate and save an unconscious civilian.

Dilshan Nanayakkara- Diver- Instructor- India

We asked Dilshan some questions about his courageous and brave efforts:

What were you doing before the incident?

I was taking a guest from my PADI Dive Center on a guided snorkelling tour at Jungle Beach, Sri Lanka. We arrived at the site on my dive center boat and snorkelled for around an hour. We then decided to go back to shore which is where I saw around 50 people, oddly gathering together on the beach.

What happened next?

I immediately knew something was wrong so I left my snorkelling gear on the beach and ran towards the crowd. When I reached the crowd I saw a man lying on the ground, lifeless, with his friends crying around him. I told everyone I was a trained Emergency First Responder and knew what to do. Instinctively, I first checked for his pulse – but there was not one. I suddenly started yelling “call for an ambulance!” and rolled the patient onto his side to open and check his airways. After this, I immediately gave him two rescue breaths and began CPR. The only thing running through my head at this point was “I need to save this guy’s life.” After the second round of CPR the patient started vomiting. Then finally after one deep breath, the patient miraculously started breathing again.

Did the ambulance then take over from you?

Unfortunately, Jungle Beach is a location that can’t be reached by ambulance. So I had to make a decision on the best (and fastest) way to get the patient to a hospital. I decided to drive him on my boat and meet the ambulance on the closest main road. From here, I was able to quickly tell the paramedics what I witnessed and what first aid I provided him. Overall, the whole experience ended in around 25 minutes but will remain a learning life experience for me, forever.

How is the patients’ health and recovery since the incident?

The patient’s family called me the night of the incident and told me that the doctors had successfully removed water from his lungs, which means he should get better. A week later the patient was able to be discharged from hospital.

Did your Emergency First Response (EFR) skills help you in this situation?

Yes and without these skills I might not have been able to save this man’s life. Therefore, I want to thank PADI for including the EFR course in the structure of the PADI Rescue Diver course. Without PADI, I wouldn’t have become an EFR Instructor or known how to help save this man’s life.

Why should everyone complete their Emergency First Response (EFR) course?

I think that the EFR course is one of the greatest courses that gives you the most important skills that you could ever learn as a human. I believe that this course is essential to both divers and non-divers as it will help them be prepared for any situation. We will never know when accidents are going to occur or when we might need to save another person’s life. Therefore, it’s imperative that we know how to help an injured or ill person and ultimately, how to save someone’s life, if ever needed.

Dilshan Nanayakkara- Diver- Instructor- India

Congratulations to Dilshan for not only putting your EFR skills to use under extreme circumstances, but for also effectively responding in a manner that was able to successfully save this man’s life.

Marketing your Emergency First Response Courses

Think back to your first CPR or first aid course and answer these three questions:

1) What made you enrol?

2) What made you choose that particular course?

3) Did you take other courses or go back for a refresher course from the same instructor or facility?

Chances are your answers are all very different, which makes a couple of important points. First, people have a wide variety of reasons for wanting to learn CPR and first aid procedures. This could range from wanting to know how to care for a family member through to being required to take a course by an employer. The second point is that in many regions there are a lot of training choices. Most people don’t have to look far to find a course that fits their schedule and budget. When training is easy to find, you need to figure out how to make your courses stand out. You need a marketing plan to keep your EFR courses full. Decide who your potential participants are and carefully craft your marketing message to appeal to each group. You also need to arrange your courses in a way that is convenient and attractive to potential participants.

Let’s break this down into three simple steps:

Potential participants: Everyone is eligible to complete first aid training, so the potential market is huge. Start by researching who may need CPR and first aid training in your local area to help you focus on specific groups. This training is often required for certain roles, such as child care, life guarding or commercial driving licenses. Also look towards anyone involved in organisations such as schools, universities or youth groups.

Developing a contact: You can reach out to these groups through various mechanisms – direct email, ads, social media, events, mail or phone calls can all be effective. Try to identify the decision maker as a point of contact and speak to them personally. For example in a business this may be the human resources manager, whilst in a sporting club it might be the chairperson or coach.

Highlight the benefits! Make sure you emphasise the huge advantages offered by your EFR courses. For example, the fact that you can offer dedicated paediatric first aid courses, AED training or separate secondary care. EFR course are based on internationally recognised medical guidelines and that you can offer flexible learning options.

Be ready to follow up your contacts with additional communications and information.

For more details on how to market your EFR courses, don’t forget to refer to your EFR Instructor Manual (page A20) or contact your EFR Instructor Trainer for guidance.

Business Development Opportunities with Emergency First Response

Does your local marketplace have a need for any first aid training that is not immediately available through the current suite of EFR courses? You may think the EFR programs cannot cover these gaps in the market but by using an alternate route, these gaps may well be filled to grow your first aid business.

To give you food for thought, here are some examples that might work well in your local marketplace:

  • EFR Distinctive Specialties
  • Recognised first aid training – in Australia / New Zealand


You might like to author an EFR Distinctive Specialty to expand your business. Once you have an idea for your EFR Distinctive Speciality, for instance Primary and Secondary Care at Festivals, Marathons, etc., simply download the EFR Distinctive Specialty Template and use it to write your own course outline. This template makes writing your own course a very simple process for you. If any particular local government requirements apply in your country, make sure you accommodate for these in your instructor-authored course outline.

Once you have written your EFR Distinctive Speciality, complete the EFR Distinctive Specialty Instructor Application Form and email both documents to us for review.

Your Regional Training Consultant will work with you to answer any questions you have and provide feedback, should your outline need revision. Once you are both satisfied with the Distinctive Specialty, the course outline and the application will be submitted to a review panel for consideration.

It’s that simple. EFR Distinctive Specialities are an excellent opportunity to add something unique, that prospective clients need or want, to your business model and will support your business plans for your EFR business growth.

RECOGNISED FIRST AID TRAINING – in Australia / New Zealand

Most workplaces in Australia look for Nationally Recognised Training in CPR and first aid, which must be conducted through a Registered Training Organisation (RTO). EFR Instructors in Australia with the additional credential called Cert IV TAE, can become a PADI RTO Trainer and deliver recognised first aid courses

In New Zealand, EFR courses are recognised by the New Zealand Qualifications Authority (NZQA) when conducted at a Private Training Establishment (PTE) and competency was assessed as assessed as meeting OSH/NZQA unit standard 6400, 6401, 6402 (or 6400, 26551, 26522 or equivalent / most recent unit standards).

 If you have any questions please contact us

Responders in Action

When Emergency Responders use their skills to care for an injured or ill person, it’s significant and worth sharing. In this newsletter we’d like to share a good news story from Vanuatu.

If you know of any Emergency Responders who have used their Emergency First Response skills in an emergency situation, or if you’ve used your training to help someone in need, please send the information describing the action to Emergency First Response by using the Responder in Action Report form found in the Appendix of your EFR Primary and Secondary Care Instructor Guide and email it to so the Emergency Responders involved will receive formal recognition for their efforts.

This good news story from Vanuatu is a great example:

Last March PADI Master Scuba Diver Trainer / EFR Instructor Wilfred ‘Wills’ Tileya # 330494 and PADI Divemaster / Emergency Responder Luaky Nabanga # 466304 (both working at PADI Five Star IDC Resort Big Blue # S36279 in Port Vila, Vanuatu) were going out for a night dive around 6:30pm, just after sunset.

Half way out at the channel they noticed a catamaran with four people waving franticly, trying to attract their attention. The Big Blue boat was the only boat out on the harbour. As they got closer, they noticed a person in the water face down and in distress.

Luaky grabbed him and managed to pull the man into the boat where he lay on the floor, breathing but unable to speak. The patient was put into the recovery position and returned to base, still unable to give his name. Wills called emergency services and tended to the patient, keeping him warm, until EMS arrived. He was treated on the scene and taken to hospital where he was released the following day.

Congratulations to Wills and Luaky – this person’s luck would have run out had you not spotted the emergency and responded in such an effective manner; well done!

Expand into Instructor Training

Are you an experienced EFR Instructor? Would you like to help new instructor candidates become EFR professionals? Training other professionals is a demanding but rewarding job.

Helping new EFR instructor candidates to gain instructor level knowledge and skill and then pass that on through positive coaching to their own students is the role of the EFR Instructor Trainer. As an EFRIT your own skills will also be polished as you role model instructor level teaching. You’ll also consider opportunities outside your normal market as you guide instructors considering work in a wide range of environments.

If you would like to be an EFR Instructor Trainer you will need to:

  • Be a current, authorised EFR Primary / Secondary Care Instructor
  • Be an EFR Care For Children Instructor
  • Have registered at least 25 EFR students, or
  • Have conducted at least 5 separate EFR courses


  • Successfully complete an EFR Instructor Trainer Course

For dates and locations of these courses CLICK HERE. Please note that additional locations are added throughout the year so if you don’t see one that is convenient for you, contact our Instructor Development team to see if one can be scheduled (bearing in mind each course is subject to a minimum number of participants).

Emergency First Response Manuals Go Digital

The first EFR digital student manuals are planned for release during 2018. With more and more people using their tablets, phones and computers the option for online and offline digital study materials is increasingly popular and in demand.

The manuals will be accessed through the Adobe Experience Manager (AEM) platform which offers a great online and offline experience across various platforms. It also offers the ability to search for key words so that a learner can quickly find information to review or jump back to a specific topic or course content. Updates are almost seamless and each time the user logs in the most current content is available.

Watch out for further information and announcements with exact launch date.