AHA 2025 Update

Highlights of the 2025 American
Heart Association Guidelines for
Cardiopulmonary Resuscitation and
Emergency Cardiovascular Care

Pediatric Basic Life Support

• The 2-finger technique for infant CPR is no longer recommended; heel-ofone-
  hand or 2-thumb encircling technique is preferred.
• For severe FBAO in children and infants, repeated cycles of back blows and
  thrusts are now recommended.

Pediatric Advanced Life Support

• Early epinephrine administration for nonshockable rhythms is
  emphasized.
• ETCO₂ and arterial pressure monitoring during CPR are recommended to
  guide resuscitation quality.
• EEG is recommended as part of multimodal neuroprognostication.

Adult Basic Life Support

• CPR for adults with obesity should follow standard techniques.
• Mechanical CPR devices are not routinely recommended but may be
  considered in specific challenging scenarios.

Adult Advanced Life Support

• Initial defibrillation energy ≥200 J is recommended for AF and atrial flutter.
• IV access is preferred over IO for drug administration during cardiac arrest.
• Head-up CPR is not recommended outside clinical trials.

Education & the Community

• Feedback devices are recommended for CPR training for both
  professionals and lay rescuers.
• Gamified learning, VR for knowledge acquisition, and scripted debriefing
  are newly supported.
• CPR training should begin in children <12 years to build early confidence.
• Cognitive aids are recommended for professionals but not for lay rescuers
  due to delays in CPR initiation.
• Public access to naloxone is now recommended alongside defibrillation
• access to reduce opioid-related deaths.
• Instructor-led CPR training, mass media campaigns, and CPR certification
  policies are encouraged to improve lay rescuer response.