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Part 6: Pediatric Basic Life Support: 2025 American Heart Association and American Academy of Pediatrics Guidelines
Insights
The 2025 guidelines update pediatric cardiopulmonary resuscitation (CPR) and emergency cardiovascular care, introducing new techniques for chest compressions and foreign-body airway obstruction management to improve survival from cardiac arrest.
Area of Science:
- Pediatric Emergency Medicine
- Cardiovascular Care
- Resuscitation Science
Background:
- The American Heart Association and American Academy of Pediatrics developed these 2025 guidelines.
- This is the first comprehensive update since 2020 for pediatric basic life support and emergency cardiovascular care, excluding newborns.
- Guidelines incorporate evidence reviews from the International Liaison Committee on Resuscitation.
Purpose of the Study:
- To provide updated recommendations for lay rescuers and healthcare professionals.
- To improve survival rates for sudden cardiac arrest and acute life-threatening cardiopulmonary emergencies in children.
- To outline current best practices in pediatric resuscitation.
Main Methods:
- Structured evidence reviews by the International Liaison Committee on Resuscitation.
- Comprehensive review of existing guidelines and new literature.
- Focus on key updates in CPR techniques, defibrillation, and airway obstruction management.
Main Results:
- Revised chest compression technique for infants (1-hand or 2 thumb-encircling hands).
- Immediate use of automated external defibrillators (AEDs) with pediatric attenuators recommended for pediatric cardiac arrest.
- Updated protocols for foreign-body airway obstruction in infants and children.
Conclusions:
- The updated guidelines provide critical changes for pediatric resuscitation.
- New recommendations aim to enhance the effectiveness of CPR and emergency interventions.
- These guidelines are essential for improving outcomes in pediatric emergencies.
Abstract:
Codeveloped by the American Heart Association and the American Academy of Pediatrics, this publication presents the 2025 guidelines for basic life support during cardiopulmonary resuscitation and emergency cardiovascular care of the pediatric patient, excluding the newborn infant, and represents the first comprehensive update of treatment recommendations since 2020. Incorporating the results of structured evidence reviews from the International Liaison Committee on Resuscitation, these guidelines are for lay rescuers and health care professionals with recommendations designed to improve survival from sudden cardiac arrest and acute life-threatening cardiopulmonary problems. Existing guidelines remain relevant unless specifically updated in this publication. Topics reviewed include the initiation of cardiopulmonary resuscitation; pulse check; components of high-quality cardiopulmonary resuscitation; chest compression technique; support surfaces for cardiopulmonary resuscitation; opening the airway; coordination of shock and cardiopulmonary resuscitation; types of defibrillators or automated external defibrillators; defibrillator paddle or pad size, type, position; treatment of inadequate breathing with a pulse; and foreign-body airway obstruction. Key topics that are new, are substantially revised, or have significant new literature include the elimination of 2-finger chest compressions in infants due to ineffectiveness of achieving proper depth with a recommendation of 1-hand or 2 thumb-encircling hands technique; the immediate application and use of an automated external defibrillator with a pediatric attenuator if available for cardiac arrest; and in infants with severe foreign-body airway obstruction repeated cycles of 5 back blows alternating with 5 chest thrusts (no abdominal thrusts), and in children with severe foreign-body airway obstruction repeated cycles of 5 back blows alternating with 5 abdominal thrusts. Key Words: AHA Scientific Statements • cardiopulmonary resuscitation • chest compressions • defibrillator • foreign body airway obstruction • heart arrest • shockable rhythm • ventilation.
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