Updated 2025 CPR guidelines from the AAP and AHA include revisions to pediatric and neonatal resuscitation, reflecting new evidence and a unified chain of survival.
The American Academy of Pediatrics (AAP) and the American Heart Association (AHA) have released updated 2025 guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) in infants and children—the first comprehensive update since 2020. The new recommendations, jointly published in Pediatrics and Circulation, reflect the latest evidence on pediatric and neonatal resuscitation and were unveiled on October 22 during a global rollout tied to the 2025 International Liaison Committee on Resuscitation meeting in Rotterdam.1
The guidelines include new and revised recommendations across pediatric basic and advanced life support and neonatal resuscitation. Each chapter was co-led by AAP and AHA representatives and experts.
“Children are not little adults, and these guidelines offer specific recommendations that reflect the unique needs of children,” said Javier Lasa, MD, FAHA, FAAP, associate professor in critical care and cardiology at Children’s Health in Dallas and volunteer co-chair of the 2025 Pediatric Advanced Life Support Writing Group.
More than 7,000 out-of-hospital and 20,000 in-hospital pediatric cardiac arrests occur in the United States each year. To address these emergencies, the new pediatric basic and advanced life support sections are intended for both lay responders and health care professionals across community, prehospital, and clinical settings.
A major change is the creation of a single chain of survival that now applies to both adults and children, acknowledging the importance of prevention and preparedness before cardiac arrest occurs. The guidelines also emphasized early recognition of arrest, rapid emergency activation, and the initiation of high-quality CPR with strong focus on chest compressions.
For airway obstruction, the new recommendations specified:
The neonatal section introduces a new “chain of care,” outlining steps from prenatal preparation through postnatal recovery.
“The guidelines also observe that 1 out of every 10–20 newborns each year needs help transitioning from the fluid-filled environment of the womb to the air-filled room,” said Henry Lee, MD, FAAP, professor of pediatrics and neonatologist at the University of California San Diego. “It is essential that every newborn infant has a health care professional dedicated to facilitating that transition who is trained and equipped for the role using these recommendations.”
New recommendations highlight the importance of team readiness and the role of deferred cord clamping for 60 seconds or more—an increase from the prior 30-second standard—to improve outcomes. Skin-to-skin contact is encouraged immediately after birth when feasible. Effective lung ventilation remains the top priority for newborns needing resuscitation.
Updated ventilation guidance now recommends 30–60 inflations per minute, expanding from the prior range of 40–60 inflations. Several other practices, including pulse oximeter placement, chest compression positioning, and ventilation corrective steps, were reviewed and strengthened with the latest evidence.
Selected updates and highlights:
The new guidelines and training resources are available online for immediate use through the AHA’s Pediatric Advanced Life Support program and the AAP’s Neonatal Resuscitation Program, with additional translations planned.
For additional details related to these updated guidelines from the AAP and AMA, view each section below, courtesy of the AAP:
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