United States<unk>  Emergency Medical Services in the United States are generally identified with Emergency Medical Technicians-Basic (EMT-B). EMT-B is the highest level of healthcare provider that is limited to the<unk>  protocol; higher medical functions use some or all of the Advanced Cardiac Life Support (ACLS) protocols, in addition to<unk>  protocols. However, the American Heart Association's<unk>  protocol is designed for use by laypeople, as well as students and others certified first responder, and to some extent, higher medical function personnel.<unk>  for Healthcare Providers Course According to the American Heart Association, in order to be certified in<unk> , a student must take an online or in-person course. However, an online<unk>  course must be followed with an in-person skills session in order to obtain a certification issued by The American Heart Association. Chain of survival The American Heart Association highlights the most important steps of<unk>  in a "five-link chain of survival." The chain of survival includes early recognition of an ongoing emergency, early initiation of CPR by a bystander, early use of a defibrillator, and early advanced life support once more qualified medical help arrives. Qualified bystanders with training in<unk>  are encouraged to perform the first three steps of the five-link chain of survival. High Quality CPR High quality cardiopulmonary resuscitation (CPR) and early defibrillation using an automated external defibrillator (AED) are the most important aspects of<unk>  to ensure a victim survives. CPR involves a rescuer or bystander providing chest compressions to a victim in a supine position while also giving rescue breaths. The rescuer or bystander can also choose not to provide breaths and provide compression-only CPR. Depending on the age and circumstances of the victim, there can be variations in the compression to breath ratio given. Europe European Resuscitation Council According to 2015 guidelines published by European resuscitation council, early initiation of resuscitation and coordination of lay people with medical personnel on helping an unconscious person is very helpful in increasing the chance of survival of the victim. When a person is unconscious and is not breathing normally, emergency services should be alerted and cardiopulmonary resuscitation (CPR) and mouth-to-mouth resuscitation (rescue breaths) should be initiated. High quality CPR is important. An adequate ratio of high quality chest compressions and rescue breaths are crucial. An automated external defibrillator (AED) machine is essential during resuscitation. Defibrillation during the first 3 to 5 minutes during resuscitation can produce survival rates as high as 50 to 70%. Placing AEDs in public places where there is one cardiac arrest in five years is cost-effective. Although the adult CPR sequence can be safely used in children, a modified sequence of<unk>  that entails less forceful chest compression is even more suitable in children. United Kingdom Adult<unk>  guidelines in the United Kingdom were published in 2015 by the Resuscitation Council (UK), based on the 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations (CoSTR) published in November 2005. The newest guidelines for adult<unk>  allow a rescuer to diagnose cardiac arrest if the victim is unresponsive and not breathing normally. The guidelines also changed the duration of rescue breaths and the placement of the hand on the chest when performing chest compressions. These changes were introduced to simplify the algorithm, to allow for faster decision making and to maximize the time spent giving chest compressions; this is because interruptions in chest compressions have been shown to reduce the chance of survival. It is also acknowledged that rescuers may either be unable, or unwilling, to give effective rescue breaths; in this situation, continuing chest compressions alone is advised, although this is only effective for about 5 minutes. For choking, the guidelines in the United Kingdom first call for assessing the severity of the situation. If the victim is able to speak and cough effectively, the obstruction is mild. If the victim is unable to speak or cough effectively, or is unable to breathe or is breathing with a wheezy sound, the airway obstruction is severe. It is then recommended to perform back blows until the obstruction clears. If the victim becomes unresponsive, CPR is started. Other countries The term<unk>  is also used in some non-English speaking countries (e.g. in Italy) for the education of first responders. Terms with similar meanings for similar skill sets are also common. * Spain: SVB (soporte vital<unk> o) * Belgium: aide médicale urgente ("emergency medical assistance")/ EHBO (eerste hulp bij ongelukken, "first aid") * Brazil: SBV (Suporte<unk> o de vida) * France: PSE 1 & PSE 2 (Premiers Secours en Equipe niveaux 1 & 2), "First Aid as part of a team," level 2 includes stretchering and teamwork, (former CFAPSE before 2007 Certificat de Formation aux Activités des Premiers Secours en Equipe, "Training certificate for first aid teamwork") * Poland: Podstawowe zabiegi resuscytacyjne/ KPP (Kwalifikowana pierwsza pomoc) * Portugal: SBV (Suporte<unk> o de Vida) * Germany: Lebensrettende Sofortmaßnahmen<unk>  * Romania: SVB (support vital de bază) * Netherlands:<unk>  ("first aid" is referred to as EHBO (Eerste hulp bij ongelukken)) * Turkey: TYD (temel yaşam desteği,<unk> ")
Basic life support
Life support
Advanced trauma life support
Advanced cardiac life support
First aid
Euthanasia device
Rescue vehicle
Liver support system