CPR - Cardiopulmonary Resuscitation and Updated Guidelines 2025

Summary

Each year, approximately 350,000 people in the U.S. experience an out-of-hospital cardiac arrest – when the heart suddenly stops beating – which results in death 90% of the time, according to the Association’s statistics.[1]  By giving someone CPR you can double or even triple their chances of survival. Learn CPR and become part of the Nation of Lifesavers™.

The “2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC),” published in October, 2025 in the Association’s flagship journal, Circulation. It marks the first full revision of lifesaving resuscitation guidance since 2020. Among the updates are expanded recommendations for managing choking and suspected opioid overdose, in addition to other lifesaving interventions.

Cardiac Arrest vs. Heart Attack:

What is Cardiac Arrest? CARDIAC ARREST occurs when the heart malfunctions and stops beating unexpectedly. Cardiac arrest is an “ELECTRICAL” problem.

What is a Heart Attack? A HEART ATTACK occurs when blood flow to the heart is blocked. A heart attack is a “CIRCULATION” problem.

Learn more about what each of these mean and what actions to take here.

What is CPR?

• New guidance on choking in conscious children and adults recommends alternating five back blows followed by five abdominal thrusts, until the object is expelled or the person becomes unresponsive.
• Guidance for choking in infants has been updated to alternate between five back blows and five chest thrusts using the heel of one hand, until the foreign object is expelled or the infant becomes unresponsive.
• The guidelines provide a new algorithm for treating individuals with suspected opioid overdose, including public access guidance on naloxone use.
• The systems of care volunteer writing group elected to revert to a single chain of survival for all forms of cardiac arrest, whether adult or pediatric, in- or out-of-hospital.
• Evidence shows that children 12 years old or older can be taught effective CPR and defibrillation.
• To improve lay-rescuer response to out-of-hospital cardiac arrests, the guidelines recommend support for media campaigns, instructor-led training and community training.

Additional Details:

The 2025 CPR guidelines provide an extensive review of the latest science, translating it into clear, lifesaving recommendations that empower people to act when every second counts.

Out-of-hospital cardiac arrests caused by respiratory emergencies or asphyxia occur in more than 9% of adults and 39% of children in the U.S.[2] New guidance on choking recommends alternating five back blows followed by five abdominal thrusts for conscious children and adults, until the foreign object is expelled or the person becomes unresponsive. Choking guidance for adults was not included in the previous guidelines, and earlier guidance for children called for performing abdominal thrusts only. For infants, rescuers should alternate between five back blows and five chest thrusts using the heel of one hand, until the foreign object is expelled or the infant becomes unresponsive. Abdominal thrusts are not recommended for infants, due to the risk of injury.

The guidelines also provide updated recommendations for treating people experiencing a suspected opioid overdose, which is the cause of 80% of all drug overdose deaths worldwide.[3] According to the World Health Organization (WHO), opioid use can lead to death because opioids affect the part of the brain that regulates breathing. Signs of an opioid overdose include:

• Slow, shallow or no breathing
• Choking or gurgling sounds
• Drowsiness or loss of consciousness
• Small, constricted pupils
• Blue or grey coloring of the skin, lips or nail beds

For the first time, the guidelines provide public access instruction on when to use naloxone, a medication used to reverse or reduce the effects of opioids.

“The American Heart Association’s 2025 CPR guidelines represent gold standard science. It reflects a rigorous examination of the most up-to-date evidence that guides how resuscitation is provided for critically ill patients,” said Ashish Panchal, M.D., Ph.D., volunteer chair of the American Heart Association Emergency Cardiovascular Care Science Committee, physician and professor of emergency medicine at The Ohio State University. “As the science continues to evolve, it’s important that we continue to review new research specific to the scientific questions considered of greatest clinical significance that affect how we deliver life-saving care.”

Together with the American Academy of Pediatrics, the Association co-developed the pediatric and neonatal guidelines that help protect the youngest and most vulnerable lives. These chapters were co-led by volunteer experts from both organizations, with writing groups evenly balanced between their members, resulting in a unified set of recommendations that reflect the shared expertise, dedication and vision of both organizations.

Alongside major changes to choking recommendations for infants, the neonatal guidelines provide further direction for treating newborns. For most term and preterm infants not needing immediate resuscitation, delaying umbilical cord clamping for at least 60 seconds – up from the previously recommended 30 seconds – has been shown to improve a newborn’s blood health and iron levels.

“We’re proud that these guidelines will be jointly published in the American Heart Association journal Circulation and the American Academy of Pediatrics journal Pediatrics. This action underscores our joint commitment to advancing pediatric and neonatal resuscitation — together,” said Javier Lasa, MD, FAHA, FAAP, American Heart Association and American Academy of Pediatrics volunteer and co-chair of the 2025 Pediatric Advanced Life Support Writing Group and associate professor in critical care and cardiology at Children’s Health in Dallas.

Further updates offer suggestions for increasing lay rescuer intervention in a cardiac emergency, noting that only approximately 41% of adults experiencing cardiac arrest outside of the hospital receive CPR before emergency medical services arrive.[4] Early CPR could double or triple a person’s chance of survival. New recommendations include:

• Consolidating the chain of survival into one chain, which highlights the importance of doing compressions and breaths, especially in children and infants. Previously, there were separate chains of survival for adults, infants and children experiencing a cardiac emergency, and for cases of in-hospital and out-of-hospital cardiac arrest.
• Aligning with new scientific evidence that suggests children 12 years old or older can be taught effective CPR and defibrillation.
• Further improving lay rescuer response to out-of-hospital cardiac arrests, by recommending the use of media awareness and education campaigns, increased instructor-led training and expanded community training.

Full News Release: Updated CPR guidelines tackle choking response, opioid-related emergencies and a revised Chain of Survival - American Heart Association Guidelines - Spanish news release - 2025 CPR Guidelines Highlights​

How to lower your risk for cardiovascular disease

• Know your numbers and follow the American Heart Association’s Life’s Essential 8™
  • Health Behaviors: Eat better, be active, quit tobacco, get healthy sleep.
  • Health Factors: Manage weight, control cholesterol, manage blood sugar, manage blood pressure.

Please consult with your physician or healthcare team about what is best for your health.

Helpful Links:

• Statements & Guidelines | Statistics
• Embargo and Recording Policies
• Images | General B-roll and Animations
• Association Newsroom | @HeartNews 

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.   

For Media Inquiries and American Heart Association Expert Perspective:214-706-1173; AHAcommunications@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721)

heart.org and stroke.org