New CPR Guidelines Transform Pediatric & Newborn Emergency Care

In a landmark collaboration, the American Academy of Pediatrics and the American Heart Association have jointly released comprehensive updated guidelines for pediatric and neonatal resuscitation, marking the first major revision since 2020. Published simultaneously in Circulation and Pediatrics on October 22, 2025, these evidence-based recommendations address the critical differences between adult and pediatric emergency care, with experts emphasizing that "children are not little adults." The guidelines cover three distinct areas: Pediatric Advanced Life Support, Pediatric Basic Life Support, and Neonatal Resuscitation, with writing groups evenly balanced between both prestigious organizations. The timing is crucial given the staggering statistics - more than 7,000 out-of-hospital and approximately 20,000 in-hospital cardiac arrests occur annually in American infants and children.

The pediatric guidelines introduce significant changes including a unified chain of survival applicable to both adult and pediatric cardiac arrests, while emphasizing prevention and preparedness. Key updates include modified choking protocols where infants now require alternating cycles of 5 back blows with 5 chest thrusts (eliminating abdominal thrusts), while children receive alternating back blows with abdominal thrusts. Compression techniques for infants have been refined, eliminating ineffective two-finger methods in favor of one-hand or two-thumbs-encircling techniques. The guidelines stress early recognition of cardiac arrest and immediate activation of emergency services, with high-quality CPR beginning with chest compressions remaining paramount. These recommendations serve as essential resources for both lay responders and healthcare professionals across community, prehospital, and facility-based environments.

For neonatal care, the guidelines establish a separate newborn chain of care framework extending from prenatal care through postnatal follow-up. Critical updates include extending recommended deferred cord clamping from at least 30 seconds to 60 seconds or more, while maintaining skin-to-skin contact with parents. Ventilation rates for newborns have been expanded to 30-60 inflations per minute from the previous 40-60 range. The guidelines highlight that 1 in 10-20 newborns requires assistance transitioning from womb to room environment, underscoring the need for properly trained neonatal clinical teams. The updated materials, available through the American Heart Association's Pediatric Advanced Life Support program and American Academy of Pediatrics' Neonatal Resuscitation Program, represent the most current science-backed resources for first responders and clinicians worldwide.