The updated 2025 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) were recently published on October 22, 2025. This marks the first full revision of the guidance since 2020. Since the initial release of the publication in 1966, cardiac arrest remains a leading cause of mortality and morbidity in the United States (US) and worldwide, with millions of events occurring annually in the US alone.
The updated recommendations are aimed at improving survival rates and neurological outcomes following cardiac arrest, and making lifesaving interventions clear and more effective for both medical professionals and lay rescuers. In addition to updated guidance for adult CPR and ECC, the AHA also revised neonatal and pediatric resuscitation guidance in partnership with the American Academy of Pediatrics (AAP). Highlights of the 2025 updates are discussed below.
- Choking in children and adults: New guidance recommends alternating five back blows followed by five abdominal thrusts, until the object is expelled or the person becomes unresponsive. The response for choking adults was not included in the past, and only abdominal thrusts were advised for children.
- Choking in infants: Recommendations have been updated to alternate between five back blows and five chest thrusts using the heel of one hand, until the foreign object is expelled or the infant becomes unresponsive. Abdominal thrusts are not recommended due to the risk of injury.
- Chain of Survival: The new guidance consolidates the Chain of Survival that previously had different versions for adults, children, and infants as well as for in-hospital versus out-of-hospital cardiac arrests. There is now a single version for all cardiac arrests, regardless of age or location, that includes CPR with manual compressions and breaths, defibrillation, and advanced resuscitation.
- Infant chest compressions: New methods are recommended for infant compressions—either the two-thumb encircling hands technique or the heel of one hand procedure. The two-finger compression approach is no longer advised.
- Routine use of mechanical CPR devices: In the 2025 publication, the routine use of mechanical CPR devices is not recommended. Per the AHA, they do not consistently show a benefit over high-quality manual compressions in improving patient survival. However, the Guidelines note that mechanical CPR may be appropriate in specific situations where delivering high-quality manual compressions is difficult or poses a risk to healthcare professionals, such as during transport to a hospital, provided that interruptions in CPR are minimized.
- Lay-rescuer response: To further improve lay-rescuer response to out-of-hospital cardiac arrests, the 2025 Guidelines support media awareness and education campaigns, as well as instructor-led and expanded community training. The AHA reports that new scientific evidence shows that children 12 years of age or older can be taught effective CPR and defibrillation.
- Opioid overdoses: The 2025 Guidelines provide a new algorithm for treating individuals with a suspected opioid overdose, including public access instruction on when to use naloxone, a medication given to reverse or reduce the effects of opioids, with the clarification that standard CPR should not be delayed. Key overdose indicators are also highlighted.
The AHA has released new CPR and EEC training materials that reflect the 2025 guidelines. These updated resources will be translated into multiple languages for international use. For additional information on the AHA’s 2025 Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC), or for help coordinating the training required for your organization—contact us!
This blog was written by Beth Graham, Safety Partners’ Director of Quality, Research, and Training.
