What You Really Need To Know
The AHA updated its guidelines based on new ILCOR research. Core CPR techniques stay the same. Here’s what’s changing:
- Choking in adults/children: Back blows are now recommended alongside abdominal thrusts
- Infant chest compressions: Two-finger technique is out; use the heel of one hand or the two-thumb encircling technique instead
- Infant choking: Alternate 5 back blows with 5 chest thrusts using the heel of the hand
- Soft surfaces: Start CPR immediately, even on beds or soft surfaces, rather than wasting time moving the patient
The theme across all updates: get people acting faster with techniques that work in real-world conditions. ProTrainings will have updated courses by March 2026.
2025 ECC Updates Are Here
New research is leading to changes in how we save lives during cardiac emergencies. The International Liaison Committee on Resuscitation (ILCOR) is a global group of experts who study what works best in resuscitation. Their latest findings led the American Heart Association to update its 2025 guidelines. The good news is these updates don’t make things more complicated; they focus on what actually works when emergencies happen in real life, not just in textbook conditions.
The AHA updates will affect anyone who learns CPR and First Aid, from workplace safety coordinators to parents who want to protect their families. Each change addresses a gap between what we’ve traditionally taught and what actually happens when someone’s life is on the line. ProTrainings’ courses will be updated to align with the new certification standards by March 1st, 2026.
Reemphasis for Current Guidelines
Although there are few true changes in the current CPR guidelines, several core practices have been strongly re-emphasized. Rescuers should continue to:
- Use the 30:2 compression-to-ventilation ratio
- Minimize time off the chest to under 10 seconds
- Deliver compressions at a rate of 100–120 per minute.
CPR with breaths remains the most effective method, with hands-only CPR reserved for rescuers who are untrained or uncomfortable giving breaths. Compression depth should stay at 2–2.4 inches for adults or one-third the depth of the chest for infants and children. As always, the AED should be used as soon as it is ready, with attention to correct pad placement.
The guidelines also highlight the importance of strong teamwork during resuscitation and emphasize closing the gap in CPR delivery between women and men—reassuring rescuers that the bra may remain in place, with AED pads placed underneath so they still contact bare skin.
The research also points to one consistent finding: bystander action saves lives. When someone nearby starts CPR before emergency services arrive, survival rates improve dramatically. The 2025 guidelines remove barriers and add options specifically to get more people acting sooner.
What’s Changing
The four changes we outline below are the most substantial ones from our perspective that everyone should know. They represent a subset of the full changes that were made to AHA’s guidelines.
Back Blows Join Abdominal Thrusts for Choking
Previous guidelines have emphasized abdominal thrusts (the Heimlich maneuver) as the primary technique for choking victims. The 2025 updates now incorporate back blows as well, aligning practices with international guidelines that have used this approach.
When someone is choking, you need to dislodge the obstruction. Having two complementary techniques increases your chances of success. Back blows still use pressure to force out the object, but they seem to be more effective with less concern for abdominal injuries with abdominal thrusts.
Infant Chest Compressions
Prior to 2025, rescuers learned the two-finger technique for infant chest compressions, pressing with two fingers on the sternum. When researchers studied real infant resuscitations and simulation data, they found that two-finger compressions consistently fell short of what’s needed to circulate blood effectively. The 2025 guidelines eliminate that approach entirely.
The new guidelines offer two alternatives: compress with the heel of one hand, or use the two-thumb encircling hands technique, where you wrap both hands around the infant’s chest and press with your thumbs. Both methods generate deeper, more effective compressions.
Infant Choking Response Clarified
The new guidelines also clarify the sequence for responding to a choking infant. Rescuers should alternate five back blows with five chest thrusts until the object is expelled or the infant becomes unresponsive. The chest thrusts should be delivered with the heel of one hand, not with fingers.
This isn’t a dramatic change from previous guidance, but the recommendation to use the heel of one hand aligns infant choking response with the updated compression technique. This reinforces that abdominal thrusts are not appropriate for infants. Their internal organs are still developing and positioned differently than those of older children or adults, making abdominal thrusts potentially harmful.
CPR on Soft Surfaces
Traditional teaching emphasized firm surfaces because they provide the resistance needed for effective chest compressions. Firm surfaces remain ideal, but the 2025 guidelines recognize that perfect conditions don’t always exist, and attempting to create them can waste time the patient doesn’t have. Just keep in mind that you will need to push harder to get the same depth for adequate compressions.
An elderly patient who is in cardiac arrest found in bed, someone who collapses in a bathroom too small to maneuver in, a responder who simply doesn’t have the physical strength to move the victim alone; these scenarios all benefit from this clarified guidance. Start CPR immediately, even if conditions are suboptimal, rather than delaying care to achieve the ideal setup.
What These Changes Mean for Your Training and Practice
At ProTrainings, we’re actively working to integrate these guidelines into our training materials, ensuring that what you learn reflects the most current evidence-based practices, because understanding these updates goes beyond simply learning new techniques. The real value lies in grasping the reasoning behind them.
When you understand why back blows complement abdominal thrusts, you develop the kind of adaptive thinking that makes you effective in actual emergencies. You’re not just memorizing steps anymore. You’re understanding principles that help you make good decisions when conditions don’t match what you practiced.
That’s why ProTrainings makes all of our online learning materials and videos easy to access and freely available. It’s also why we encourage our students to sign up for our weekly reminder emails, where we review key concepts to keep you prepared.
If you’re pursuing CPR and First Aid certification or recertification, these updates will shape your learning experience.
For instructors, these updates offer a teaching opportunity that extends beyond technique demonstration. You can help students understand that emergency response protocols evolve continuously as we gather more evidence about what works. You can explain how these changes remove barriers that prevented people from acting confidently in the past. You can emphasize that flexibility and adaptation aren’t signs of confusion in emergency medicine, but rather signs of maturity and sophistication.
While these updates apply to everyone who learns CPR and First Aid, advanced healthcare providers have additional guidance and expectations outlined in the full 2025 guidelines. We’ll have updated courses for instructors and students by March 1st, 2026. As we get closer to launch, we’ll provide additional updates about what to expect.
Looking Ahead
Technology has transformed how research gets shared and analyzed. Studies from hospitals, EMS systems, and resuscitation registries around the world can be synthesized faster than ever before. That accelerated learning means guidelines will continue to evolve to save more lives.
We know many of you pursue CPR training because your job requires it. Our goal at ProTrainings goes beyond checking a compliance box. We want you to leave with genuine skills and the confidence to use them. When the moment comes, hesitation costs lives. Training that builds real competence builds the confidence to act.