American Heart Association

AHA updates CPR guidelines with new choking and overdose protocols

October 24, 2025

AHA's 2025 CPR and emergency cardiovascular care (ECC) guidelines deliver significant updates aimed at improving survival in cardiac and respiratory emergencies. Key changes include new choking protocols: for conscious children and adults, rescuers should alternate 5 back blows and 5 abdominal thrusts until the obstruction clears or the patient becomes unresponsive. For infants, the recommendation shifts to alternating 5 back blows and 5 chest thrusts using the heel of 1 hand—abdominal thrusts remain contraindicated due to injury risk. Additionally, neonatal care guidance now advises delaying umbilical cord clamping for at least 60 seconds to enhance blood health and iron levels.

The guidelines also introduce a public access algorithm for suspected opioid overdose, emphasizing naloxone administration and recognition of hallmark signs such as respiratory depression and cyanosis. Other notable changes include reverting to a single chain of survival for all cardiac arrests, endorsing CPR and defibrillation training for children aged 12 and older, and promoting community engagement through media campaigns and instructor-led programs to increase bystander CPR rates.

Key takeaways:

• Choking: Alternate 5 back blows and 5 abdominal thrusts (children/adults); 5 back blows and 5 chest thrusts using the heel of 1 hand, until foreign object is expelled or infant becomes unresponsive (infants).
• Opioid overdose: New algorithm with naloxone guidance for public use.
• Cardiac arrest: Unified chain of survival; CPR and defibrillation training recommended for ages ≥12.
• Neonatal care: Delay cord clamping ≥60 seconds for most term/preterm infants.

Source:

(2025, October 22). American Heart Association. Updated CPR guidelines tackle choking response, opioid-related emergencies and a revised Chain of Survival: American Heart Association Guidelines. https://newsroom.heart.org/news/updated-cpr-guidelines-tackle-choking-response-opioid-related-emergencies-and-a-revised-chain-of-survival