Updated Guidelines for Advanced Cardiac Life Support

Clinical Takeaway

: Guideline changes were relatively minor, but a few important aspects are worth considering.

An overview of Adult Advanced Life Support: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Background

At the end of 2025, the American Heart Association (AHA) updated its 2020 guidelines on cardiopulmonary resuscitation (CPR), advanced cardiac life support (ACLS), and emergency cardiovascular care. Although the AHA had no substantive additions, a few relevant changes are worth mentioning.

Key Changes

Opioid overdose: Don’t delay CPR, even when naloxone administration is being considered.
CPR: Mechanical compression CPR devices are not recommended routinely for out-of-hospital cardiac arrest in adults. Manual CPR is recommended in most instances, except for rare circumstances (e.g., …

Reviewing Author

Daniel D. Dressler, M.D., M.Sc., M.H.M., F.A.C.P.

Disclosures

RoyaltiesMcGraw-Hill; Elsevier

Editorial BoardsMedical Clinics of North America; Caribbean Medical Journal International Advisory Panel

Leadership Positions in Professional SocietiesAmerican College of Physicians, 2027 Annual Meeting Committee