What Changed in the 2025 CPR Guidelines?

If you learned CPR a few years ago and you've heard that things changed, the useful news is how little of it moved. You aren't starting over, and most of what you can already do is still exactly right.

Three things changed in a way that matters to someone doing CPR. Here they are, with what they were before, and why.

Most of it didn’t change

That's the bulk of what you know, and none of it moved. The changes below are specific and small — which is what you'd expect from guidance that gets revised rather than rewritten.

The age-by-age numbers

One table, because these are the values people most often mix up between age groups. Each lesson also carries its own numbers, so you never need this page in an emergency.

The only row that surprises people is the last ratio one: the two-rescuer change to 15 and 2 applies to children and babies, never to adults.

Infant compressions: thumbs, not fingers

Before: two fingers on the breastbone.

Now: two thumbs side by side, with your hands wrapping around the baby's chest — or the heel of one hand if you can't wrap.

Why: two fingers were found to press too shallowly to move blood reliably. The thumb technique gets better depth and better circulation, and it turns out to be easier to sustain as well. The current infant technique in full has the depth and the breaths with it.

This one also reaches choking, since infant chest thrusts use the same hands — the infant choking lesson carries the same update.

Pulse checks are gone

Before: check for a pulse at the neck before starting compressions.

Now: don't. If someone is unresponsive and not breathing normally, that's enough — start.

Why: finding a pulse is unreliable even for trained rescuers, and every second spent looking is a second nobody is doing compressions. The test was cut back to the things a person can actually determine under pressure. What that test looks like now is its own short lesson.

Adults call sooner than they used to

This is the change most likely to be half-remembered, so it's worth having both halves.

For an adult: call 911 immediately. Speaker on, phone down, compressions starting at nearly the same moment. The old advice — five cycles of CPR first if you were alone — is gone, because an adult in cardiac arrest usually needs a defibrillator, and the fastest way to get one is to make the call now.

For a child or a baby: that rule didn't change. If you have a phone, it's the same — call and compress together. If you're genuinely alone with no phone, give about two minutes of CPR before you leave to call, because a child's emergency usually starts with breathing and those two minutes of oxygen are often the thing that helps most.

So the honest summary is that one rule changed and its sibling didn't. The adult sequence and the child sequence each state their own version, deliberately.

An upper limit on speed

Worth including because people still teach it as "at least 100": the rate is 100 to 120 a minute, with a ceiling as well as a floor. Compressing faster than that gives the heart too little time to refill between pushes, so you move less blood rather than more — and the same logic applies to depth, which is why that has an upper bound too.

Strictly speaking this one arrived in 2015 rather than 2025. It's here because it's still the most commonly out-of-date number people carry, and because a page about what changed should be accurate about when.

This page isn’t a course

It's a summary of what moved, written so you can check one thing quickly. The lessons linked throughout teach the current technique properly, and they're where to go if you want the whole sequence rather than the diff.

Guidelines get revised on their own schedule and certifications expire on theirs, and the two aren't connected — a valid card doesn't mean the guidance behind it's the newest, which is exactly why a page like this exists.

Burns and bleeding have their own updates

One thing to know so you don't go looking in the wrong place: CPR guidance and first aid guidance are different publications on different cycles. The first aid guidelines were revised in 2024 and cover burns, bleeding, allergic reactions and the rest. Those lessons are current against that document rather than this one.

Put it into practice

Training scenario:

You run the safety training for a mid-sized care company and you're refreshing the slide deck you use with new staff. It was built four years ago. You’ve got thirty people booked in on Monday, most of them recertifying, and at least three of them have been doing this longer than you have and will notice anything that looks wrong. You’ve got an afternoon.

Walking it through:

Three slides, maybe four. The infant compression slide needs new hands. Any slide with a pulse check on it loses that step. The adult call-timing slide changes, and if you’ve got a child slide it keeps its rule. Everything about hand placement, depth for adults, the cycle and the reasoning stays as it's — which is most of the deck.

The one they'll argue about is the pulse check. It feels like a lowering of standards to somebody who was taught it as the mark of doing this properly, and the answer isn't that it stopped mattering — it's that it was never reliable, including for them, and the seconds it costs come out of compressions. Said that way it lands as information rather than as a correction of their training.

And the useful thing to say at the top of the session is the same thing at the top of this page: almost none of what you know has changed. Thirty people who arrive braced to be told they've been doing it wrong will listen better once they know they mostly haven't.