Hands-Only CPR: What the 2025 AHA Guidelines Mean for You

The 2025 American Heart Association Guidelines for CPR and Emergency Cardiovascular Care give lay rescuers a simple rule: if an adult is unconscious or unresponsive and is not breathing or is breathing abnormally (for example, only gasping), assume the person is in cardiac arrest.

Don’t let fear of hurting someone stop you. The 2025 guidelines note that chest compressions given to an unconscious person who turns out not to be in cardiac arrest “has not been associated with serious harm.”

The AHA describes Hands-Only CPR as two steps: call 911 and push hard and fast in the center of the chest at a rate of 100 to 120 compressions per minute until help arrives. The 2025 guidelines add these details:

1. 1Call 911 first. A lone responder should activate the emergency response system, then immediately begin CPR. Stay on the line and follow the 911 dispatcher’s instructions.
2. 2Position. When feasible, place the person on their back on a firm surface.
3. 3Hand placement. Put the heel of one hand on the center (middle) of the chest and the heel of your other hand on top of the first, so your hands overlap.
4. 4Push hard and fast. Compress at 100 to 120 per minute, to a depth of at least 2 inches (5 cm), while avoiding more than 2.4 inches (6 cm).
5. 5Let the chest come back up. Allow complete recoil between compressions, such as by not leaning on the chest.
6. 6Keep going until EMS takes over or an AED is ready to use.

The AHA released its updated guidelines in October 2025. Here are the points most relevant to members of the public, based on what the AHA has published:

• Compressions for everyone. “All lay rescuers should provide chest compressions for adults with presumed cardiac arrest.”
• Hands-Only CPR is still appropriate. A chest compression–only approach is appropriate if lay rescuers are untrained or unwilling to give breaths.
• Trained? Consider breaths. For lay rescuers trained in CPR, the guidelines say it is reasonable to give breaths in addition to chest compressions.
• One Chain of Survival. The AHA consolidated its guidance into one chain of survival, which highlights the importance of doing compressions and breaths, especially in children and infants.
• New choking guidance. For adults and children, the AHA recommends alternating five back blows followed by five abdominal thrusts until the object comes out or the person becomes unresponsive. For infants, alternate five back blows and five chest thrusts.
• Opioid emergencies. The guidelines include public instruction on when to use naloxone, a medication that can reverse or reduce the effects of opioids.
• Younger rescuers. The AHA notes that children 12 years old or older can be taught effective CPR and defibrillation.

An automated external defibrillator (AED) is a portable device that can check the heart’s rhythm and deliver a shock. The National Heart, Lung, and Blood Institute (NHLBI) explains that AEDs are found in many public places, such as airports, office buildings, gyms and shopping centers.

• “Even untrained people can use an AED in an emergency,” according to the NHLBI.
• AEDs “talk” to the user with step-by-step instructions.
• The device gives a shock if it detects a dangerous heart rhythm.
• Turn it on and follow its spoken instructions, and continue CPR as directed until EMS arrives.

Watching a video is a good start, but hands-on practice builds confidence. The AHA invites people to learn Hands-Only CPR at heart.org/cpr and to find classes at cpr.heart.org. Because breaths matter especially for children and infants, parents, teachers, coaches and caregivers may want a full course that includes them.

This article is general education, not personal medical advice or a substitute for a certified course.

At Republic EMS, Ltd., a licensed Texas EMS provider, resuscitation skills are part of everyday readiness: we conduct in-house AHA training in BLS, ACLS and PALS, along with mock codes. If you are a Paramedic or EMT who shares that commitment, we are hiring. Visit our job application page.