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From choking response to naloxone use: What’s new in CPR guidelines

The American Heart Association’s first CPR update since 2020 adds adult choking guidance, naloxone instructions and a unified chain of survival.
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For the first time since 2020, the American Heart Association has updated its CPR guidelines, introducing several key changes.

The new guidance includes updated recommendations for responding to choking incidents, opioid overdoses and cardiac arrest.

Previously, there was no specific guidance for helping an adult who is choking. Past recommendations for choking children called for abdominal thrusts only. The 2025 update now advises alternating five back blows and five abdominal thrusts until the object is expelled or the person becomes unresponsive — for both conscious adults and children.

The guidelines also provide detailed, step-by-step instructions for administering naloxone to someone suffering an opioid overdose.

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Another change unifies the “chain of survival” for all cardiac arrests, regardless of age or whether the event occurs in or out of a hospital. In previous guidelines, these chains differed for adults, children and infants, and by location.

The American Heart Association also now recommends that children as young as 12 can effectively learn CPR and use defibrillation equipment.

“The American Heart Association’s 2025 CPR guidelines represent gold standard science. They reflect a rigorous examination of the most up-to-date evidence that guides how resuscitation is provided for critically ill patients,” said Dr. Ashish Panchal, volunteer chair of the Association’s Emergency Cardiovascular Care Science Committee. “As the science continues to evolve, it’s important that we continue to review new research specific to the scientific questions considered of greatest clinical significance that affect how we deliver life-saving care.”The Association says a person’s chances of surviving a cardiac event at least double when CPR is performed.

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