The recently released 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) mark the first comprehensive update since 2020. Developed by experts, with some sections chaired by physicians at Children's Hospital of Philadelphia (CHOP), the revised guidelines underscore the critical need for swift action in pediatric cardiac emergencies.
“In the 2025 American Heart Association Guidelines, the emphasis is on enhancing CPR and emergency care to improve outcomes from cardiac arrest. The guidelines stress performing high-quality CPR to save lives,” said Alexis Topjian, MD, MSCE, co-Chair of the Pediatric Advanced Life Support Guidelines and pediatric Critical Care Medicine attending physician at CHOP. “Training healthcare professionals and the public is vital. These updates aim to improve survival rates and improve recovery after cardiac arrest.”
In the latest guidelines, the focus remains on starting chest compressions immediately to boost survival rates after cardiac arrest. They also present new approaches for handling children with breathing issues from airway blockages, stressing the need for situation-specific actions. Additionally, they emphasize that children 12 and older are capable of learning CPR and defibrillation effectively and call for an immediate response to opioid overdoses.
Key highlights include:
Choking Response:
- Choking is a life-threatening emergency that requires swift and effective action.
- The guidelines highlight the importance of recognizing the signs of choking and knowing how to respond.
- For mild choking, encourage the person to cough forcefully to dislodge the object.
- In severe cases in which the person cannot breathe, talk, or cough, repeatedly performing 5 back blows followed by 5 abdominal thrusts until the object is expelled is crucial for adults and children.
- For infants, a combination of back slaps and chest thrusts is recommended. Prompt intervention can save a life.
Neonatal Guidelines:
- The updated neonatal guidelines emphasize a comprehensive newborn care approach, beginning with prenatal care and extending through postnatal recovery to ensure optimal health for infants and families.
- Anticipation and preparation by healthcare professionals, both individually and as teams, are crucial for effective newborn resuscitation.
- Most newborns can now be monitored during deferred cord clamping for at least 60 seconds – an increase from the previous recommendation of 30 seconds – and maintain skin-to-skin contact with a parent immediately after birth.
- Effective lung ventilation remains the top priority for newborns requiring resuscitation. It's now reasonable to ventilate newborns at 30–60 inflations per minute, expanding from the prior 40-60 inflations per minute guidelines
Opioid Crisis Response:
- Recognizing signs of an overdose, such as unresponsiveness, shallow breathing, or blue-tinted skin, is essential.
- Administering naloxone, an opioid reversal agent, can rapidly restore normal breathing.
- The guidelines highlight the importance of having naloxone readily available and training both healthcare professionals and the public in its use.
- Continuous monitoring and supportive care, including calling emergency services, are vital to ensure the individual's recovery and prevent further complications.
“Education is an essential link in the so-called ‘chain of survival’ from cardiac arrest,” said Aaron Donoghue, MD, MSCE, FAHA, FAAP, Chair of the Resuscitation Education guidelines and pediatric critical care and emergency medicine attending physician at CHOP. “The 2025 Guidelines aim to guide educators in the best methods to ensure that CPR trainees, both healthcare providers and laypeople, acquire skill and knowledge that enables them to perform effective CPR.”
Education highlights include:
- Feedback devices in CPR training lead to improved CPR performance in both healthcare providers and lay rescuers.
- Sociologic disparities in CPR training and willingness should be identified and addressed by supporting media campaigns and making community training initiatives easier to access.
- CPR training in schools should involve younger children as well as high school ages; this increases receptiveness and ease of learning at later ages.
- Technologies such as virtual and augmented reality along with gamified learning can enhance learner engagement.
Del Rios et al. “Part 1: Executive Summary: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.” Circulation. Online October 22, 2025. DOI: 10.1161/CIR.0000000000001372.
Donoghue AJ et al. “Part 12: Resuscitation Education Science: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.” Circulation. Online October 21, 2025. DOI: 10.1161/CIR.0000000000001374.
Topjian AA et al. “Part 8: Pediatric Advanced Life Support: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.” Pediatrics. Online October 22, 2025. DOI: 10.1542/peds.2025-074351.
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The recently released 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) mark the first comprehensive update since 2020. Developed by experts, with some sections chaired by physicians at Children's Hospital of Philadelphia (CHOP), the revised guidelines underscore the critical need for swift action in pediatric cardiac emergencies.
“In the 2025 American Heart Association Guidelines, the emphasis is on enhancing CPR and emergency care to improve outcomes from cardiac arrest. The guidelines stress performing high-quality CPR to save lives,” said Alexis Topjian, MD, MSCE, co-Chair of the Pediatric Advanced Life Support Guidelines and pediatric Critical Care Medicine attending physician at CHOP. “Training healthcare professionals and the public is vital. These updates aim to improve survival rates and improve recovery after cardiac arrest.”
In the latest guidelines, the focus remains on starting chest compressions immediately to boost survival rates after cardiac arrest. They also present new approaches for handling children with breathing issues from airway blockages, stressing the need for situation-specific actions. Additionally, they emphasize that children 12 and older are capable of learning CPR and defibrillation effectively and call for an immediate response to opioid overdoses.
Key highlights include:
Choking Response:
- Choking is a life-threatening emergency that requires swift and effective action.
- The guidelines highlight the importance of recognizing the signs of choking and knowing how to respond.
- For mild choking, encourage the person to cough forcefully to dislodge the object.
- In severe cases in which the person cannot breathe, talk, or cough, repeatedly performing 5 back blows followed by 5 abdominal thrusts until the object is expelled is crucial for adults and children.
- For infants, a combination of back slaps and chest thrusts is recommended. Prompt intervention can save a life.
Neonatal Guidelines:
- The updated neonatal guidelines emphasize a comprehensive newborn care approach, beginning with prenatal care and extending through postnatal recovery to ensure optimal health for infants and families.
- Anticipation and preparation by healthcare professionals, both individually and as teams, are crucial for effective newborn resuscitation.
- Most newborns can now be monitored during deferred cord clamping for at least 60 seconds – an increase from the previous recommendation of 30 seconds – and maintain skin-to-skin contact with a parent immediately after birth.
- Effective lung ventilation remains the top priority for newborns requiring resuscitation. It's now reasonable to ventilate newborns at 30–60 inflations per minute, expanding from the prior 40-60 inflations per minute guidelines
Opioid Crisis Response:
- Recognizing signs of an overdose, such as unresponsiveness, shallow breathing, or blue-tinted skin, is essential.
- Administering naloxone, an opioid reversal agent, can rapidly restore normal breathing.
- The guidelines highlight the importance of having naloxone readily available and training both healthcare professionals and the public in its use.
- Continuous monitoring and supportive care, including calling emergency services, are vital to ensure the individual's recovery and prevent further complications.
“Education is an essential link in the so-called ‘chain of survival’ from cardiac arrest,” said Aaron Donoghue, MD, MSCE, FAHA, FAAP, Chair of the Resuscitation Education guidelines and pediatric critical care and emergency medicine attending physician at CHOP. “The 2025 Guidelines aim to guide educators in the best methods to ensure that CPR trainees, both healthcare providers and laypeople, acquire skill and knowledge that enables them to perform effective CPR.”
Education highlights include:
- Feedback devices in CPR training lead to improved CPR performance in both healthcare providers and lay rescuers.
- Sociologic disparities in CPR training and willingness should be identified and addressed by supporting media campaigns and making community training initiatives easier to access.
- CPR training in schools should involve younger children as well as high school ages; this increases receptiveness and ease of learning at later ages.
- Technologies such as virtual and augmented reality along with gamified learning can enhance learner engagement.
Del Rios et al. “Part 1: Executive Summary: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.” Circulation. Online October 22, 2025. DOI: 10.1161/CIR.0000000000001372.
Donoghue AJ et al. “Part 12: Resuscitation Education Science: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.” Circulation. Online October 21, 2025. DOI: 10.1161/CIR.0000000000001374.
Topjian AA et al. “Part 8: Pediatric Advanced Life Support: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.” Pediatrics. Online October 22, 2025. DOI: 10.1542/peds.2025-074351.
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