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The 2025 AHA guidelines turn one year old. The changes live in the hands, not the handout.
The American Heart Association published its 2025 CPR and ECC guidelines on October 22, 2025. A year later, the changes that matter most are the ones a student practices on a manikin.
October 19, 2026 · American Heart Association newsroom, 'Updated CPR guidelines tackle choking response, opioid-related emergencies and a revised Chain of Survival,' October 22, 2025; Circulation, 'Part 4: Systems of Care: 2025 American Heart Association Guidelines for CPR and ECC,' October 22, 2025; Circulation, 'Part 6: Pediatric Basic Life Support: 2025 American Heart Association and American Academy of Pediatrics Guidelines for CPR and ECC,' October 22, 2025
On October 22, 2025, the American Heart Association published the 2025 Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care in its journal Circulation. The pediatric and neonatal chapters were written with the American Academy of Pediatrics. It was the first full revision since 2020, and the AHA released updated training materials the same day. This Thursday, October 22, 2026, those guidelines turn one year old.
A year is long enough for the changes to reach every classroom in Fayette County and the rest of western Pennsylvania. It is also long enough for old habits to come back. Someone who last took a course in 2021 is still carrying the older version. The update does not live in a handout. It lives in what the hands do first.
Three changes show up most in the room. The four chains of survival from 2020 are now one six-link chain for adults and children, in and out of the hospital: recognition and activation, high-quality CPR, defibrillation, advanced resuscitation, post-cardiac arrest care, and recovery and survivorship. Its CPR symbol now shows compressions and breaths. Choking changed. For a conscious adult or child, the guidelines call for alternating five back blows and five abdominal thrusts until the object comes out or the person becomes unresponsive. For an infant, it is five back blows and five chest thrusts with the heel of one hand, and no abdominal thrusts. The previous guidelines had no adult choking guidance, and the child guidance used abdominal thrusts only. The AHA also noted evidence that children 12 and older can be taught effective CPR and defibrillation.
One more change is easy to miss. Two-finger compressions on infants are out. The pediatric chapter recommends one hand or the two thumb-encircling hands technique, because two fingers often do not reach proper depth. Michael Wystepek, MBA, RN, PHRN, teaches the new sequence until it is the one the hands reach for first.
Wystepek Ventures, LLC teaches the current AHA Heartsaver and BLS materials. This article is education, not a protocol and not legal advice. Follow your medical director, your employer's emergency plan, and the manuals in the room.