EMS News - AHA 2025 Guideline Updates

The American Heart Association (AHA) has released its 2025 updates to the Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) guidelines, introducing several important changes for both healthcare professionals and everyday responders. 

These evidence-based guidelines outline best practices that improve survival from cardiac arrest and other life-threatening cardiovascular emergencies.

A Quick Note for EMS Providers

These updates aim to streamline care, reduce variability in the field, and improve the chain of survival across diverse patient populations. 

Many of the changes emphasize consistency, simplified decision-making, and the continued integration of lay rescuers into time-critical care. 

At the same time, these updates are written to be accessible to the general public, who play a vital role in early recognition and CPR.

The 2025 release builds on the 2020 guidelines, refining previous recommendations and adding new guidance in areas that had not been previously addressed. 

Image from Circulation - AHA / ASA Journals

Below is a summary of several take-home messages and key updates that EMS Providers - and the public - should be aware of:

• Unified Chain of Survival: A single model now applies to all cardiac arrests, regardless of patient age or location, providing a consistent framework for recognizing emergencies and delivering timely interventions.

• Systems of Care: Greater focus on community preparedness, telecommunicator CPR (e.g., 911 Dispatchers), early warning systems, and health equity. 

• Remain in Place: It is recommended that resuscitation should be conducted where the patient is found, as long as high-quality cardiopulmonary resuscitation (CPR) can be administered safely and effectively.

• Position and Location of CPR: Quality chest compressions are improved by optimizing the rescuer’s hand placement, body mechanics (i.e., posture), and the patient’s position. When possible, CPR should be performed on a firm surface to maximize compression effectiveness. 

• Bariatric Patients: CPR for adult cardiac arrest patients with obesity should be provided by using the same techniques as for the average weight patient.

• Pediatric CPR: The two-thumb encircled or one-hand compression techniques are favored on the the two-finger method.

• Mechanical CPR: The routine use of mechanical CPR devices is not recommended for adults in cardiac arrest. However, mCPR may be considered in specific settings where the delivery of high-quality manual compressions may be challenging or dangerous.

• Assisted Ventilations: It is still considered reasonable for both professional rescuers and lay responders to give breaths - when they are willing and able to do so with an appropriate barrier device - to improve oxygenation during cardiopulmonary resuscitation at a ratio. of 30:2 for adults.

• Choking Response: the updated sequence begins with 5 back blows, followed by 5 abdominal thrusts for all patients (e.g., adults & pediatrics), and continuing to alternate until the object is removed or the person becomes unresponsive.

• Opioid Overdose Response: The guidelines reinforce the importance of rapid naloxone administration and recommends supporting public access to opioid emergency response kits. The BLS algorithm explicitly shows where naloxone fits for suspected opioid overdose during respiratory and cardiac arrest.

Additional updates covering resuscitation education, systems of care, and post-cardiac arrest management are provided in the Highlights of the 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

Image from Circulation - AHA / ASA Journals

Why These Changes Matter

Cardiac arrest remains a leading cause of sudden death. Even small improvements in CPR technique or response consistency can dramatically impact survival. The 2025 updates aim to:

• Improve clarity during high-stress emergencies
• Increase bystander willingness to act
• Standardize care across EMS, hospitals, and the community
• Enhance oxygenation and compression effectiveness
• Support faster opioid overdose interventions

For EMS providers, these recommendations reinforce strong fundamentals, situational awareness, and the life-saving importance of early naloxone access.

What You Can Do Next

Whether you are an EMS professional or a member of the public, you play a vital role in improving survival from cardiac arrest. Here are a few ways to stay prepared:

• Review the full AHA 2025 guideline highlights
• Refresh your CPR, AED, or First Aid training
• Make sure your workplace or community organization has access to naloxone and CPR equipment
• Share these updates with colleagues, friends, or family

EMS Education - Advisor: Basic Life Support (BLS)

 

The Advisor: Basic Life Support (BLS) program is a specialized certification pathway developed by the AHA for individuals who have successfully completed the cognitive portion of the HeartCode® BLS course but cannot physically perform the motor skills of CPR due to a disability.

Rather than demonstrating the physical actions (like chest compressions or AED pad placement), participants demonstrate competency by advising another person through those steps — showing they fully understand the why, when, and how of BLS.

Purpose & Importance

This program:

• Promotes inclusivity in lifesaving education by recognizing that knowledge is just as critical as physical ability.
• Allows people with physical disabilities to become certified in BLS and empowered to guide and direct others during a real cardiac emergency.
• Increases the number of trained individuals in a given community who can contribute during a medical crisis — even if they aren't able to perform CPR themselves.

Eligibility and Certification

To earn the Advisor: BLS certification card, participants must:

1. Pass the HeartCode® BLS Provider Course cognitive exam (the same as all BLS providers).

Successfully demonstrate their ability to verbally direct another person in performing:

• High-quality CPR
• AED use
• Basic resuscitation team skills

This is assessed by an AHA instructor, who ensures that the candidate can provide accurate, timely, and effective instructions that align with AHA guidelines.

The issued certification card is an Advisor: BLS card, which is distinct from the standard BLS Provider card — but still represents formal AHA-recognized certification.

Who Is It For?

This program is designed for:

• Individuals with physical disabilities that prevent them from completing hands-on CPR testing.
• Candidates who want to contribute to emergency preparedness in workplaces, schools, or communities, even if they cannot perform compressions themselves.

Impact and Accessibility

The Advisor: BLS program aligns with the AHA's commitment to diversity, equity, and inclusion in resuscitation science and training. By expanding the definition of who can be trained and certified, the program:

• Acknowledges the contributions and capabilities of persons with disabilities.
• Increases the total number of CPR-capable bystanders in society — a crucial factor in improving out-of-hospital cardiac arrest outcomes.
• Encourages organizations to embrace broader emergency readiness by including all capable team members.

Learn more about it here: https://newsroom.heart.org/news/new-program-developed-for-persons-with-disabilities-to-advise-others-on-cpr

EMS Education - Are You BLS Certified?

Are you a pre-hospital, in-healthcare or care facility professional, then it is likely you are required to maintain certification in Basic Life Support (BLS) through the American Heart Association (AHA). 

However, BLS certification is not just a regulatory requirement to remain in good standing with  an employer, it is a critical asset and an occupational necessity that ensures you can perform your job effectively.

Why is BLS Certification Important?

The knowledge and skills associated with being BLS certified means you are prepared to respond to life-threatening emergencies involving cardiac arrest, respiratory failure, and choking incidents across adult to infant populations.

Also, beyond enhancing your professional skills, BLS certification empowers you to be a valuable resource for your family, community, and the patients you serve.

What Does an AHA BLS Course Cover?

The American Heart Association BLS course covers a wide range of life-saving techniques, including:

• Cardiopulmonary Resuscitation (CPR)
• Safe & Effective Automated External Defibrillator (AED) use.
• Bag-Valve Mask (BVM) Ventilations
• Choking & Airway Obstruction Management
• Rescue Breathing
• And much more!

Who Needs BLS Certification?

All healthcare providers in patient-facing roles - whether in a hospital or pre-hospital setting - are required to hold a valid BLS certification card. 

This includes:

• Emergency Medical Technicians (EMTs)
• Paramedics 
• Registered Nurses (RNs)
• Certified Nursing Assistants (CNAs)
• Medical Doctors (MDs)
• Firefighters & Law Enforcement Officers (LEOs)

Who Should I Train With?

Choosing the right BLS certification course is essential to gaining the confidence and skills needed to respond to life-threatening emergencies. Look for a program that offers small class sizes to maximize hands-on learning and individualized instruction.

Experienced instructors with real-world expertise can provide valuable insights, ensuring that every student leaves feeling fully competent in their abilities.

Investing in quality training means staying certified, staying prepared, and continuing to make a difference in the lives of those you serve.

Conclusion

BLS certification is more than just a credential - it is a vital skill set that can mean the difference between life and death in critical situations.

Whether you are an EMT, nurse, physician, or first responder, staying up to date with your BLS training ensures you are always prepared to act swiftly and effectively when every second counts.

By maintaining your AHA BLS certification, you contribute to a safer workplace, enhance patient outcomes, and reinforce your commitment to providing quality care.

If your certification is nearing expiration or you have yet to obtain it, consider enrolling in a BLS course today. Your knowledge and readiness could save a life.

Recommended CPR Training Providers: 

Bethesda, Wales, UK: Active First Aid

Rawlins, Wyoming, USA: Brian Eveleth, DTAC LLC

Littleton, Colorado, USA: Colorado Cardiac CPR

International: Crossing Latitudes