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.


Adult CPR Guidelines

Cardiopulmonary Resuscitation (CPR) is a crucial life-saving technique that is performed by anyone, regardless of their medical training. The American Heart Association (AHA) provides these guidelines for performing adult CPR effectively:

  • Compression-only CPR for untrained responders: The 2020 AHA guidelines emphasized the use of hands-only CPR for untrained individuals. This means that if someone witnesses a cardiac arrest and is unsure or uncomfortable providing rescue breaths, they are encouraged to perform hands-only CPR by doing chest compressions at a rate of 100-120 compressions per minute until professional help arrives.
  • Change in compression depth: The recommended compression depth for adult CPR changed from a range of 2 to 2.4 inches (5 to 6 centimeters) to at least 2 inches (5 centimeters). The emphasis was placed on deeper compressions to ensure adequate blood flow during resuscitation.
  • Rhythm check before defibrillation: The guidelines advised a "rhythm check" (a quick check for a shockable rhythm) before each defibrillation attempt. This change aimed to reduce pauses in chest compressions during the resuscitation process.
  • Update on the use of feedback devices: The guidelines encouraged the use of real-time audio and visual feedback devices during CPR to help rescuers optimize compression depth, rate, and recoil.
  • Recognition of cardiac arrest and CPR initiation: There was a renewed emphasis on the early recognition of cardiac arrest and the importance of starting CPR immediately. The guidelines highlighted the importance of starting compressions within the first few minutes of cardiac arrest.


Pediatric CPR Guidelines

Pediatric CPR differs slightly from adult CPR due to the unique needs of infants and children. The AHA guidelines provide specific instructions for performing CPR on pediatric patients

  • Update on compression depth and rate: The 2020 AHA guidelines recommended a change in compression depth for pediatric CPR. For children, the guideline emphasized a compression depth of at least 2 inches (5 centimeters) but no more than 2.4 inches (6 centimeters). The compression rate for pediatric CPR remained the same at 100-120 compressions per minute.
  • Compression-to-ventilation ratio: The guidelines maintained an infant cpr ratio of 30:2 for a single rescuer providing CPR to children (except for newborns).
  • Single rescuer vs. two-rescuer CPR: The guidelines recognized the challenges of performing high-quality CPR with multiple rescuers. In specific situations, it was recommended to minimize interruptions in chest compressions and focus on high-quality compressions, even if the ratio of compressions to ventilations was not strictly 30:2.
  • Age-based classification: The guidelines provided clearer age-based classifications for pediatric CPR, categorizing children into different age groups, including infants (0 to 12 months), children (1 to 8 years), and adolescents (9 to 18 years).
  • Update on the use of feedback devices: Similar to adult CPR, the guidelines encouraged the use of real-time audio and visual feedback devices during pediatric CPR to optimize compression depth, rate, and recoil.
  • Compression depth in newborns: For newborns (birth to 1 month), the guideline maintained the recommendation for a compression depth of about 1.5 inches (4 centimeters).
  • Use of mobile devices for emergency dispatch: The guidelines explored the use of mobile devices equipped with video capabilities for emergency dispatch, allowing dispatchers to assess the situation remotely and guide bystanders in CPR and other life-saving interventions.


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.

Blood Pressure Category
Systolic (Upper)
Diastolic (Lower)
Health Risks
Less than 120 mm Hg
and Less than 80 mm Hg
Low risk of heart disease or stroke
Maintain healthy lifestyle (diet, exercise, no smoking)
120-129 mm Hg
and Less than 80 mm Hg
Doubled risk of cardiovascular complications
Make lifestyle changes (lose weight if overweight, increase physical activity, limit alcohol)
Hypertension Stage 1
130-139 mm Hg
or 80-89 mm Hg
Increased risk of heart attack, stroke, kidney disease
Lifestyle changes and potentially medication under doctor's guidance
Hypertension Stage 2
140 mm Hg or Higher
or 90 mm Hg or Higher
High risk; can lead to heart failure, vision loss, dementia
Medication required in addition to lifestyle changes as recommended by doctor
Hypertensive Crisis
Higher than 180 mm Hg
nd/or Higher than 120 mm Hg
Immediate danger of life-threatening complications
Seek emergency medical care immediately
Cardiac Arrest
Heart Attack
Sudden loss of heart function, leading to collapse
Blockage in a coronary artery, affecting blood flow to the heart muscle
Interruption of blood flow to the brain, leading to brain damage
Main Cause
Electrical malfunction of the heart
Blockage in coronary arteries
Blockage or rupture of blood vessels in the brain
Circulation Affected
Entire body
Heart muscle
Brain tissue
105Sudden collapse, unconsciousness, no pulse
Chest pain or discomfort, shortness of breath
Sudden numbness or weakness, confusion, trouble speaking or understanding speech/73
Emergency Response
Immediate CPR and defibrillation
Activate emergency medical services, chew aspirin
Activate emergency medical services, FAST assessment (Face, Arms, Speech, Time)
CPR, defibrillation
Thrombolytic therapy, angioplasty, stenting
Thrombolytic therapy, clot retrieval,
Long-term Management
Implantable cardioverter-defibrillator (ICD), medication management
Medication management, lifestyle changes, cardiac rehabilitation
Medication, rehabilitation, lifestyle changes
Dependent on prompt CPR and defibrillation, underlying health conditions
Dependent on extent of heart muscle damage, effectiveness of intervention
Dependent on severity of brain damage, rehabilitation progress
Risk Factors
Previous heart conditions, arrhythmias, electrolyte imbalances
Atherosclerosis, high cholesterol, hypertension, smoking, diabetes
Hypertension, diabetes, smoking, high cholesterol, atrial fibrillation

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) have distinctive anatomical and physiological characteristics, making CPR techniques different from those used for adults and older children. If an infant experiences cardiac arrest, quick and precise action is crucial. Follow these specific techniques and considerations for infant CPR:


  • Compression depth: For infants (birth to 1 year), the recommended compression depth is about 1.5 inches (4 centimeters).
  • Compression technique: Use two fingers (index and middle fingers) for chest compressions on infants to ensure proper depth and avoid causing harm to their delicate bodies.
  • Compression rate: The compression rate for infant CPR is the same as for pediatric and adult CPR, at 100-120 compressions per minute.
  • Single rescuer: For single rescuer CPR, the compression-to-ventilation ratio for infants is 30:2, meaning 30 compressions followed by 2 rescue breaths.
  • Two-rescuer CPR: In a two-rescuer scenario, it is recommended to perform continuous chest compressions at a rate of 100-120 per minute with a ventilation rate of 1 breath every 6 seconds (or 10 breaths per minute) without pauses for pulse checks. This approach helps maintain optimal blood flow during CPR.
  • Use of feedback devices: The guidelines encourage the use of real-time audio and visual feedback devices during infant CPR to ensure the appropriate compression depth, rate, and recoil.
  • Use of AED: For infants who experience sudden cardiac arrest, the use of an Automated External Defibrillator (AED) is rare. However, if an AED with pediatric capabilities is available, use it if needed.

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Blood Pressure Chart by Age

Age Group
Min Systolic/Diastolic
Normal Range
Max Systolic/Diastolic
1-12 months
Consult pediatrician if outside normal range. Cuff sizing is critical.
1-5 years
High BP in children may indicate underlying condition. Lifestyle factors.
6-13 years
Obesity, family history increase risk. Promote healthy habits early.
14-19 years
Adolescent rise normal. Rule out secondary causes if elevated.
20-24 years
Stressors, medications may impact. Start monitoring if high-normal.
25-29 years
Dietary changes, exercise for elevated readings. Birth control effects.
30-39 years
110/77 - 111/78
122/81 - 123/82
134/85 - 135/86
Monitor closely if readings increasing with age.
40-49 years
112/79 - 115/80
125/83 - 127/84
137/87 - 139/88
Lifestyle changes proven to reduce hypertension risk.
50-64 years
116/81 - 121/83
129/85 - 134/87
142/89 - 147/91
White coat effect common. Home monitoring advised.
65+ years
130+ Systolic Risk
Frailty, medications, conditions factored in management.

What is the correct CPR Steps Based on CPR Guidelines 2023?

The correct CPR steps based on CPR Guidelines 2023 are as follows:

  1. Check the scene and the victim. Make sure it is safe to approach the victim and that there is no danger to you or others. Also, check to see if the victim is unresponsive.
  2. Call 911. If the victim is unresponsive, call 911 before beginning CPR.
  3. Check for breathing and open airway. Position the victim on their back on a firm surface and check the breathing for 10 seconds. If possible, tilt their head back and lift their chin to open the airway.
  4. Begin CPR starting with chest compressions. Place the heel of one hand on the center of the chest, with the other hands on top, interlocking your fingers. Maintain a compression rate of 100 compressions per minute.
  5. After 30 chest compressions, use head tilt chin lift technique and give mouth to mouth breaths for about 1 second to make their chest rise.
  6. Repeat the CPR cycle. Continue giving 30 chest compressions and two rescue breaths.
  7. Use AED if available. Turn on the machine, and attach the pads during CPR. An automated External Defibrillator analyzes abnormal heart rhythms and send an electrical shock to get the heart to return to its normal rhythm.
  8. Put the victim in the recovery position.

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.


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.