Cardiac arrest & ACLS
Also known as: ACLS · CPR · post-arrest care · resuscitation
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2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
American Heart Association (AHA) · 2025
The AHA's comprehensive resuscitation guidelines for lay rescuers and health care professionals, published in Circulation in October 2025 and organized into multiple parts covering basic and advanced life support across age groups. It replaces the 2020 edition as the US reference standard for CPR and emergency cardiovascular care.
European Resuscitation Council Guidelines 2025
European Resuscitation Council (ERC) · 2025
The ERC's Europe-wide resuscitation guidelines, approved by the ERC Board and General Assembly in 2025 and published in the journal Resuscitation, built on the evidence evaluation work of ILCOR. They are issued as a set of chapters covering the full spectrum of cardiac arrest prevention and treatment.
- The guidelines are structured as separate chapters including epidemiology, systems saving lives, adult basic and advanced life support, paediatric and newborn life support, post-resuscitation care, special circumstances, education, ethics, and first aid. source
- The ERC notes it has published European resuscitation guidelines since 1992, with updates on a roughly five-year cycle since 2000. source
US vs EU key differences
- Unusually for this atlas, the two documents are in lockstep on currency: both the US and European resuscitation guidelines were reissued in 2025 and both are built on the same ILCOR 2025 Consensus on Science with Treatment Recommendations evidence base. source
- Structure differs even where the science does not: the 2025 AHA guideline reorganises around the Utstein Formula for Survival and consolidates previously separate chains into a single six-link Chain of Survival plus a new Newborn Chain of Care, while the European guidelines remain a set of parallel chapters covering epidemiology, systems, BLS/ALS, special circumstances, post-resuscitation care, education, ethics and first aid. source
- Core basic life support numbers have converged: European guidance specifies compressions of at least 5 cm but not more than 6 cm at 100–120 per minute with a 30:2 ratio for trained rescuers, and the 2025 AHA guideline states at least 2 inches (5 cm) while avoiding more than 2.4 inches (6 cm), at the same rate and ratio. source
- The 2025 AHA guideline downgraded routing patients to specialised cardiac arrest centres from Class 2a to Class 2b after a recent randomised trial showed no survival benefit. source
What changed recently
- US2020 → 20252025-10-22
The 2025 edition replaces the four separate 2020 Chains of Survival with a single unified six-link chain spanning adult, paediatric and in-hospital arrest, and adds first-time guidance for choking in responsive adults using alternating back blows and abdominal thrusts. It also advises against routine mechanical CPR devices, reserving them for situations where manual compressions are unsafe or impractical, and extends delayed cord clamping in newborns to at least 60 seconds.
- EU2021 → 20252025-01-01
The 2025 ERC guidelines supersede the 2021 edition, folding CPR-quality and technology guidance into the individual chapters instead of treating it separately and strengthening the message to call emergency services for any unresponsive person before assessing breathing. Advanced life support adds emphasis on effective ventilation and correct pad placement, positions extracorporeal CPR as an option in specialist centres when conventional CPR fails, and addresses sedation for CPR-induced consciousness.
source ↗curation confidence 90%
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