CPR & Resuscitation Guidelines 2025 & Updates

CPR and Resuscitation Guidelines: 2025 & 2026 Updates

The 2025 guidelines, issued by the American Heart Association (AHA), European Resuscitation Council (ERC), and Resuscitation Council UK (RCUK), introduced major updates on early intervention, simplified education, and emergency responses, including choking, opioid overdoses, and pediatric care.

The 2026 guidelines primarily enforce mandatory adoption of the 2025 updates, with no new “2026-branded” protocols. This marks the legal and clinical implementation of the latest standards in the UK, US, and international practice.

CPR & Resuscitation Standards: 2025–2026 Combined Guide

Key 2025 Updates

  • Choking Response (Adults & Children): Escalating approach: encourage coughing, then 5 back blows, then 5 abdominal thrusts until the object is expelled.
  • Infant Choking: Alternate 5 back blows with 5 chest thrusts using the heel of one hand.
  • Opioid Overdose: Public access to and use of Naloxone strongly recommended.
  • Recognition First: Call emergency services immediately; assess breathing while waiting.

Adult BLS:

  • Compressions at 100–120/min, depth 5–6 cm (2–2.4 in).
  • Compression-only CPR for untrained/unwilling lay rescuers; 30:2 for trained responders.
  • Female patients: Pad placement over bra is acceptable.
  • Obesity: Standard CPR techniques apply.

Paediatric & Newborn:

  • Children 12+ can be trained in CPR and AED use.
  • New 7-link newborn chain of care from prenatal to post-resuscitation follow-up.
  • Both compression-first or ventilation-first approaches accepted for children.

System & Education:

  • ERC & RCUK recommend training children as young as 4–6 years.
  • Guidelines recognise psychological impact on lay rescuers and advise support after events.

Key 2026 Updates & Mandatory Implementation

Implementation Dates:

  • UK Standardisation: All courses, manuals, and materials must comply with RCUK 2025 Guidelines by Jan 2026.
  • Instructor Certification: AHA instructors must complete science updates by Feb 28, 2026 to maintain certification.

Protocol Shifts:

  • Emergency Contact First: Call emergency services immediately before checking breathing.
  • Airway Over Spine: Jaw thrust now takes precedence over strict neck immobilisation in suspected spinal injuries.
  • Infant Technique: “Encircling two-thumb” method now preferred over two-finger compressions.
  • Bleeding Control: Tourniquets and haemostatic dressings are high-priority in training.
  • Medication Updates: Sodium bicarbonate removed from neonatal resuscitation; calcium chloride removed from paediatric cardiac arrest trolleys.

Stroke Management (Jan 2026):

  • Updated blood pressure targets (avoid <140 mm Hg after certain procedures).
  • New criteria for paediatric interventional treatments.


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Sources:

  1. https://newsroom.heart.org/facts/cpr-cardiopulmonary-resuscitation-and-updated-guidelines-2025
  2. https://www.resuscitationjournal.com/article/S0300-9572(25)00282-5/fulltext
  3. https://www.resus.org.uk/about-us/news-and-events/rcuk-publishes-guidelines-2025
  4. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001361

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