The American Heart Association (AHA) recently released a Cardiopulmonary Resuscitation and Emergency Cardiovascular Care guideline update. The 2025 release saw new recommendations regarding adult and pediatric basic life support, adult and pediatric advanced life support, post-cardiac arrest care, and more.

The following rundown summarizes some of the major new updates published in the 2025 edition of the cardiopulmonary and emergency cardiovascular care guideline. Refer to the full text version of the guideline update for the most thorough explanation of these and other recommendations.

Summary of Key Changes in the 2025 Update

Systems of Care

  • New recommendations regarding the generation of a system of care for optimal postresuscitation recovery for cardiac arrest survivors are provided.
  • Recommendations were added supporting public access and the use of naloxone and defibrillation.
  • New recommendations were also added regarding immediate and delayed debriefing following CPR events, and on in- and out-of-hospital resuscitation team compositions.
  • A selection of recommendations were consolidated that focuses on community initiatives for improving lay rescuer response to out-of-hospital cardiac arrest (OHCA).
  • A selection of recommendations were consolidated regarding the use of early warning systems and rapid response or medical emergency teams to prevent in-hospital cardiac arrest (IHCA), with an added recommendation on the use of safety huddles to prevent IHCA.

Neonatal Life Support

  • New recommendations on topics such as ventilation corrective steps, timing of pulse oximeter placement, and positioning for chest compression, which may have been already commonly performed, were added following review of the latest evidence.

Pediatric Basic Life Support

  • A new recommendation was added regarding infants and children in cardiac arrest; CPR compressions should be minimized and pauses in chest compressions should be less than 10 seconds.

Adult Basic Life Support

  • New recommendations were published on the reasonable adjustment of a bra, rather than removal, and regarding CPR for adults with obesity. 
  • A new recommendation was added on the use of mechanical CPR devices in situations where delivery of high-quality manual compressions may be challenging or dangerous.

Pediatric Advanced Life Support

  • New recommendations were published based on the growing monitoring data available to drive best practices following cardiac arrest.
  • The guidelines now include information on predicting neurologic outcomes following cardiac arrest.

Adult Advanced Life Support

  • New recommendations were added regarding vector change and double sequential defibrillation, nonvasopressor medications, adjuncts to CPR, and the initial management of bradycardia.

Post-Cardiac Arrest Care

  • The neuroprognostication section now includes predictors of favorable outcome; neurofilament light chain was added as a serum biomarker.
  • A new recommendation states that treatment to suppress myoclonus without an EEG correlate is not recommended in adult survivors of cardiac arrest.
  • New recommendations focus on structured assessment and treatment/referral for emotional distress after medical stabilization and before hospital discharge for cardiac arrest survivors and their caregivers.

Cardiac Arrest Due to Special Circumstances

  • Two new recommendations were added regarding adults and children with life-threatening asthma.
  • Two new recommendations each were added regarding treating life-threatening hypothermia and hyperthermia in adults and children.
  • New recommendations on LVADs and toxicology of opioid overdose were added. 

Education Science

  • New recommendations were made involving rapid-cycle deliberate practice being incorporated as part of BLS or ALS training, gamified learning elements for resuscitation training for health professionals and lay rescuers. A trio of recommendations were made regarding virtual and augmented reality for use in training opportunities. 
  • A recommendation on encouraging CPR training in children younger than 12 was made. 
  • A pair of recommendations on cognitive aids during resuscitation was made that favors cognitive aid for professional use and to avoid using them by lay rescuers. 

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