What's Changed in AHA 2025 CPR Guidelines?

The American Heart Association (AHA) updates to the 2025 Guidelines for CPR and First Aid bring a few essential changes. An understanding of these changes allow you to keep your certifications current while also learning the most effective, up-to-date techniques.
At Help-A-Heart CPR, LLC our mission is to empower you with the knowledge and resources to act confidently in emergency situations. Listed below are a few of the changes in the 2025 AHA & ECC Guidelines as compared with 2020.

Key Changes In the AHA 2025 Guidelines

1. Chain of Survival
   The AHA has consolidated various chains of survival into a single six-link version, usable across adult, pediatric, and in-hospital scenarios. A separate seven-link Newborn Chain of Care has also been introduced.
2. Updated Terminology
   “Rescue breaths” are now referred to as “breaths” specifically for patients with a pulse but no breathing and “ventilations” when using a device.
   “Lay rescuer” replaces “bystander” or “layperson.”
   ROC (return of circulation) as opposed to ROSC (return of spontaneous circulation) are now clearly distinguished.
3. Neonatal Resuscitation
   Delay cord clamping at least 60 seconds for term/preterm babies
   Intact cord milking may be reasonable in non-vigorous newborns
   Clear oxygen and ventilation recommendations for different gestational ages
   T-piece resuscitators and supraglottic airways (SGA) are now more emphasized
4. Pediatric Basic Life Support (PBLS)
   Two-thumb encircling hands or one-hand technique preferred for infant compressions (2-finger method no longer recommended)
   Compression + breaths prioritized over compression-only
   Updated FBAO management: 5 back blows + 5 abdominal thrusts
5. Adult Basic Life Support (BLS)
   Back blows followed by abdominal thrusts for conscious choking victims
   Ventilations plus compressions are now recommended for all trained lay rescuers
   Positioning guidance: firm surface, step-stool for rescuer alignment, and prone CPR if supine delay is significant
   Real-time feedback devices are encouraged during CPR
6. Adult Advanced Life Support (ALS)
   Stronger recommendation for immediate cardioversion in unstable atrial fibrillation
   Double sequential defibrillation is acknowledged but not routine
   Head-up CPR not recommended outside of clinical trials
7. Stronger Focus on Systems of Care (SOC)
   The guidelines now stress the importance of community-wide preparedness: public access defibrillation, opioid overdose response programs, and structured EMS protocols.
8. Systems of Care: Detailed Updates
   Consolidated early warning and rapid response systems
   Expanded guidance on telecommunicator CPR
   Community education and app-based notification tools
   On-scene resuscitation is preferred over rapid transport in many OHCA cases
   Emphasis on ECPR (extracorporeal CPR) where applicable
   Structured support systems for cardiac arrest survivors
   Debriefing for emotional and performance review
9. Training and Quality Improvement
   Continued emphasis on debriefing, feedback devices, team training, and system-wide quality improvement

Why are these updates important?

As a healthcare provider or laymen rescuer, you are directly involved in the chain of survival. A knowledge of these various updates provide you with the following:

• The latest science-backed guidance
• Higher-quality CPR performance techniques
• Clearer protocols for special cases and pediatrics
  
• A framework for training and teamwork that saves lives

What do we do with this information?

• Update your knowledge with 2025 recommendations
• Use real-time feedback devices in your CPR practice
  
• Emphasize teamwork, structured debriefing, and system readiness
  
• Educate yourself and others about new BLS/ACLS/PALS protocols

Would you like to get cpr certified?

Here at Help-A-Heart CPR we can help you stay on top of any current science and guidelines in CPR and First Aid. Looking for CPR certification in San Antonio? Visit Help-A-Heart CPR, LLC at https://www.helpaheartcpr.com for American Heart Association and American Red Cross BLS, ACLS, PALS, and First Aid training courses designed for healthcare professionals and the community.