AHA Guidelines for CPR: Staying Updated with Best Practices in CPR

Learn the most recent CPR guidelines in this article. These CPR guidelines represent the gold standard for cardiopulmonary resuscitation, encompassing evidence-based techniques and best practices to ensure effective and standardized CPR delivery. They are developed and regularly updated by esteemed organizations such as the American Heart Association (AHA) and the International Liaison Committee on Resuscitation (ILCOR). Their objective is to provide healthcare professionals, first responders, and the general public with the latest, scientifically supported information on CPR to enhance survival rates during cardiac emergencies.

Updated as of October 2025: The latest AHA and ILCOR CPR guideline updates introduce new recommendations and refinements based on the most recent research in resuscitation science. These updates focus on improving survival outcomes through enhanced systems of care, refined CPR techniques, integrated opioid response protocols, and a unified Chain of Survival applicable to all age groups.

‍

Adult CPR Guidelines

Cardiopulmonary Resuscitation (CPR) is a critical life-saving skill that can be performed by anyone. The 2025 American Heart Association (AHA) Guidelines for CPR and Emergency Cardiovascular Care (ECC) include the following major updates for adult resuscitation:

‍

Unified Chain of Survival

A single Chain of Survival now applies to all cardiac arrests in adults, children, and newborns, whether in-hospital or out-of-hospital. The links remain early recognition and activation, high-quality CPR, rapid defibrillation, advanced life support, and post-arrest care.

‍

High-quality CPR refinements

• Perform compressions on a firm surface at a rate of 100–120 per minute with a depth of at least 2 inches (5 cm).
• Minimize interruptions, keeping pauses under 10 seconds.
• For trained professionals, during respiratory arrest with a pulse but no breathing, give one breath every 6 seconds (about 10 breaths per minute).
• The routine use of mechanical CPR devices is not recommended unless manual compressions are not feasible.

‍

Opioid-related emergency response

A new algorithm guides the management of suspected opioid overdose. Recognize signs such as slow or absent breathing, pinpoint pupils, and cyanosis. Administer naloxone if available and integrate CPR and defibrillation as needed.

‍

Defibrillation and ALS updates

• For atrial fibrillation, an initial synchronized cardioversion energy of 200 J or higher is reasonable.
• The benefit of double-sequential defibrillation in refractory VF or pulseless VT remains uncertain.
• Vasopressin offers no advantage over epinephrine alone outside of clinical trials.
• Temporary transvenous pacing is reasonable for adults with persistent, unstable bradycardia that does not respond to therapy.

‍

Systems and ethics focus

The new ethics chapter highlights the principles of beneficence, non-maleficence, respect for autonomy, and justice. It emphasizes fairness and addressing health inequities. The AHA also stresses community education, bystander CPR training, and continuous quality improvement in resuscitation systems.

‍

Pediatric CPR Guidelines

Pediatric CPR differs from adult CPR because infants and children have unique physiological needs. The 2025 American Heart Association (AHA) Guidelines for CPR and Emergency Cardiovascular Care (ECC) outline key updates and refinements to ensure effective pediatric resuscitation.

• The 2025 AHA Guidelines unify the Chain of Survival for all ages, including pediatric patients.
• For children, perform compressions at least 2 inches (5 cm) deep or one-third of the chest diameter.
• For infants, compress about 1.5 inches (4 cm) deep at a rate of 100–120 compressions per minute.
• The 2-finger technique is no longer recommended; use the heel of one hand or the two-thumb encircling hands technique.
• Maintain a 30:2 compression-to-ventilation ratio for single rescuers and 15:2 for two rescuers.
• Minimize interruptions in compressions to less than 10 seconds.
• Children aged 12 years and older can now be trained to perform CPR and use an AED.
• Use feedback devices and video-assisted dispatch to improve CPR quality.
• For newborns not requiring immediate resuscitation, delay cord clamping for at least 60 seconds (previously ~30 seconds).
• Pediatric cardiac arrest survivors should receive physical, cognitive, and emotional evaluation within the first year after arrest.

What is CPR?

CPR, short for Cardiopulmonary Resuscitation, is a crucial life-saving technique that aims to sustain blood circulation and oxygenation in individuals experiencing cardiac arrest. During sudden cardiac arrest, the heart stops effectively pumping blood, and breathing ceases. CPR involves a combination of chest compressions and rescue breaths, if trained to do so, to maintain the flow of oxygen-rich blood to vital organs, particularly the brain, until professional medical help arrives.

Importance of the CPR Guidelines

1. Evidence-Based Approach: The CPR guidelines are meticulously crafted based on the latest scientific research and clinical studies. They reflect evidence-driven insights and expert consensus, ensuring that the techniques recommended are rooted in proven effectiveness.
2. Consistency and Standardization: The guidelines promote uniformity in CPR practices, minimizing variations in techniques across different providers and settings. By following standardized protocols, responders works cohesively and optimize outcomes for patients.
3. Adaptation to Changing Knowledge: As medical knowledge advances, the CPR guidelines are continuously updated to incorporate new findings. This dynamic approach allows for the integration of cutting-edge discoveries into life-saving procedures.
4. Real-Time Relevance: Regular updates ensure that the guidelines remain relevant to the contemporary challenges and scenarios faced by healthcare professionals and lay rescuers alike. This adaptability ensures that CPR techniques align with current medical trends and technologies.
5. Training and Education: The guidelines serve as a cornerstone for CPR certifications and education programs. By adhering to the latest guidelines, instructors instills the most current and effective skills in CPR trainees.

Who Should Perform CPR?

Anyone is capable to perform CPR. Cardiopulmonary Resuscitationis a vital life-saving technique that is performed by anyone, regardless of their medical background or training. The earlier CPR is initiated, the better the chances of survival for the person in distress. Prompt action from a bystander significantly increase the likelihood of a positive outcome.

If you are untrained or unsure about performing rescue breaths, you can still help through hands-only CPR. This technique focuses solely on chest compressions and is an effective way to keep blood flowing to vital organs until professional help arrives.

By following the CPR Guidelines, how much can survival rates improve after a cardiac arrest?

Following the CPR guidelines, especially when combined with the use of an Automated External Defibrillator (AED) and prompt medical attention, significantly improves the chances of survival after a cardiac arrest. The American Heart Association (AHA) reports that immediate CPR, started within the first few minutes of cardiac arrest, double or even triple a person's chance of survival.

For each minute that passes without CPR and defibrillation, the survival rate decreases by approximately 7-10%. After 10 minutes without intervention, the chances of survival become very low. Therefore, early recognition of cardiac arrest, prompt activation of emergency medical services, and immediate initiation of high-quality CPR, along with using an AED, are crucial for increasing the likelihood of survival.

Specific Techniques and Considerations for Infant CPR

Infants (birth to 1 year) require specialized CPR techniques due to their smaller size and fragile anatomy. Quick and effective response is essential to improve survival outcomes. Follow these updated recommendations from the 2025 AHA Guidelines:

• Compression Depth: Compress the chest about 1.5 inches (4 centimeters), approximately one-third of the chest’s anterior–posterior diameter.
• Compression Technique: The two-finger technique is no longer recommended. Use the heel of one hand or the two-thumb encircling hands technique for better control and consistent depth.
• Compression Rate: Maintain a rate of 100–120 compressions per minute, allowing full chest recoil between compressions.
• Single Rescuer: Use a 30:2 compression-to-ventilation ratio when performing infant CPR alone.
• Two-Rescuer CPR: When two rescuers are available, switch to a 15:2 ratio, performing pulse and rhythm checks after every cycle.
• Use of Feedback Devices: Utilize real-time audio and visual feedback devices to ensure proper compression rate, depth, and recoil during resuscitation.
• AED Use: Apply an AED as soon as available. Use pediatric pads or a manual defibrillator when possible; if unavailable, standard adult pads may be used as a last resort.

What is the correct CPR Steps Based on CPR Guidelines 2025?

The 2025 American Heart Association (AHA) CPR Guidelines emphasize early recognition, high-quality chest compressions, rapid defibrillation, and minimizing interruptions in CPR. Below are the updated CPR steps for adults based on the latest recommendations:

1. Check the Scene and Victim

Ensure the environment is safe before approaching. Check the person for responsiveness by tapping their shoulder and shouting. If unresponsive, immediately call for help.

2. Activate Emergency Response System (Call 911)

If alone, call 911 and get an AED (Automated External Defibrillator) if available. Use a mobile phone’s speaker mode to stay on the line with the dispatcher for real-time guidance.

3. Check for Breathing and Pulse (for trained rescuers)

Quickly assess for normal breathing and pulse for no more than 10 seconds.

• If there is no pulse or only gasping, begin CPR immediately.
• If breathing normally but unresponsive, place the victim in the recovery position and monitor closely.

4. Start Chest Compressions

Begin high-quality chest compressions:

• Place the heel of one hand on the center of the chest (lower half of the sternum), with the other hand on top.
• Compress at least 2 inches (5 cm) deep at a rate of 100–120 compressions per minute.
• Allow full chest recoil after each compression and minimize pauses to less than 10 seconds.

5. Provide Rescue Breaths (If Trained)

After every 30 compressions, give 2 rescue breaths:

• Open the airway using the head tilt–chin lift technique.
• Seal your mouth over the victim’s and blow for about 1 second per breath, watching for chest rise.
• If untrained, continue hands-only CPR (compressions only).

6. Use an AED as Soon as Possible

Turn on the AED immediately when available and follow its voice prompts:

• Attach the pads to the victim’s bare chest.
• Ensure no one touches the victim while the AED analyzes the rhythm.
• Deliver a shock if advised, then resume CPR immediately for another 2 minutes before the next rhythm check.

7. Continue CPR

Alternate 30 compressions and 2 breaths, following AED prompts, until:

• The person shows signs of life (movement, breathing).
• Emergency responders take over.
• You are too exhausted to continue.

8. Place in Recovery Position (If Breathing)

If the victim regains breathing but remains unresponsive, roll them onto their side into the recovery position to maintain an open airway and prevent aspiration.

‍

Ensuring Safety During CPR

The American Heart Association (AHA) emphasizes the importance of safety during CPR. Before starting CPR, check the surroundings for hazards and ensure personal protective equipment (PPE) if available. Position the person in distress carefully and use proper compression and ventilation techniques. Communicate and coordinate with others present to delegate tasks effectively.

If using an AED, ensure the area is clear. Avoid excessive force and monitor the person for signs of life. Manage rescuer fatigue and never endanger yourself while providing CPR. Safety is paramount for both the rescuer and the victim during CPR.

‍

Systems of Care, Education, and Ethics

The 2025 Guidelines introduce a new ethics chapter emphasizing four key principles: beneficence, non-maleficence, respect for autonomy, and justice, including efforts to address inequalities in social determinants of health. Systems changes now focus on lay rescuer training, public education campaigns, and community CPR awareness, as only about 41% of adults experiencing out-of-hospital cardiac arrest receive bystander CPR. Continuous monitoring and quality improvement of resuscitation systems are also prioritized.

For post-cardiac arrest survivors, the guidelines stress integrated care, rehabilitation, and long-term support. These updates aim to strengthen system-wide and community-level approaches to cardiac emergencies.

‍

Why these changes matter?

‍Bystander intervention rates remain critically low, and streamlining the chain of survival helps simplify response. Updated protocols for choking and opioid overdose reflect evolving public health needs. However, with only about 1.4% of 760 recommendations supported by Level A evidence, many updates still rely on limited but evolving research.

How often are CPR Guidelines Updated?

CPR guidelines are reviewed and updated every 5 years by organizations like the American Heart Association (AHA) and the International Liaison Committee on Resuscitation (ILCOR) to ensure that the techniques and recommendations are based on the most current scientific evidence and research in resuscitation science. The update frequency varies depending on new research findings and advancements in the field.

How can the public stay informed about the current CPR Guidelines?

To stay informed about the current CPR guidelines, the public should regularly check the official websites of reputable organizations like the American Heart Association (AHA) or ILCOR, attend CPR training courses, follow healthcare providers' updates, and keep an eye on news, media, and social media channels. Reputable mobile applications, online forums, and communities also provide valuable information on CPR guidelines. Staying updated ensures individuals are prepared to respond effectively and provide the best care in emergencies.

‍

What Role Do CPR Guidelines Play in the Structure of a CPR Test?

CPR guidelines strictly define the structure of a CPR test, outlining precise actions and standards for participants to follow. The test rigorously evaluates adherence to these guidelines, including specific criteria such as compression depth, rate, and the integration of AED use. Mastery of these guidelines is paramount for passing, as they ensure candidates are prepared to respond effectively during real-life cardiac emergencies. Ultimately, successful completion of the CPR test leads to CPR certification, validating one's ability to perform life-saving techniques according to established protocols.

‍

Encouraging CPR Education for Children as Young as 12

The 2025 CPR Guidelines emphasize training younger populations, especially those aged 12 years and older, to perform CPR. Studies show that children around this age can effectively deliver compressions with proper guidance. Teaching CPR at schools or through community programs helps build early confidence and preparedness.

Encouraging young teens to learn CPR creates a new generation of lifesavers who can act quickly in emergencies, whether at home, in school, or in public spaces. The AHA supports age-appropriate, hands-only CPR training for 12-year-olds to ensure they understand when and how to help until professional responders arrive.

‍