It had been 5 years since the American Heart Association (AHA) and the International Liaison Committee on Resuscitation (ILCOR) last gave the CPR guidelines a full update. ILCOR is the scientific governing body that sets the new standards, and the American Heart Association is the liaison to ILCOR for the United States. That is how we get our new guidelines roughly every 5 years, so we can keep you up to date with the latest information.
In October 2025, the AHA released its 2025 Guidelines for CPR and Emergency Cardiovascular Care, the first full update since 2020. After more than three decades teaching CPR, I can tell you this update matters more to the layperson than most. Here are the 5 changes you should know about.
- A new way to help a choking victim. This is the headline change. For a conscious choking adult or child, the guidelines now recommend alternating 5 firm back blows with 5 abdominal thrusts (the technique many of us learned as the Heimlich maneuver) until the object comes out or the victim goes unresponsive. For infants, it remains 5 back blows and 5 chest thrusts, and never abdominal thrusts on an infant. If the victim becomes unresponsive, begin CPR.
- One Chain of Survival for everyone. The old separate chains for adults, children, in-hospital and out-of-hospital cardiac arrest have been merged into a single, unified Chain of Survival. The message for bystanders is simpler than ever: recognize the emergency early, call 9-1-1, start compressions, and get an AED. The chain now also emphasizes recovery for survivors and their caregivers after the event.
- Opioid-related emergencies get their own response. With opioid overdoses remaining a leading cause of cardiac arrest in younger adults, the guidelines now walk laypersons through it: if a person is unresponsive and not breathing normally, call 9-1-1, start CPR, and give naloxone (Narcan) if it is available. Naloxone is now sold over the counter, and it is a smart addition to any first aid kit.
- Rescue breaths are back in the spotlight. The 2025 update reaffirms that compressions with breaths give the best chance of survival, especially for children, drowning victims, and overdose victims, where the arrest usually starts with breathing failure. Hands-Only CPR is still recommended for bystanders who are untrained or unwilling, because any CPR beats no CPR. And as before, do not waste time checking for a pulse; if they are not breathing normally, begin CPR.
- Start training earlier, refresh more often. The AHA found that children as young as 10 to 12 years old can learn and perform effective CPR, and it continues to endorse self-directed, video-based learning as an effective way to train laypersons. It also recommends refreshing your skills well before your 2-year certification runs out. Online courses are perfect for this objective, since you can revisit the training as often as you like.
Our online CPR, AED and First Aid training has been updated to reflect the 2025 guidelines. The training is free, taking the test is free, and you only pay if you need a certificate. There has never been a better time to learn, or refresh, the skills that save lives.
