28/10/2025
🚑 2025 RCUK Resus Guidelines: What’s New?
The Resuscitation Council UK has released its 2025 updates. Here’s what every responder, clinician, and instructor should know:
🧠 Education
• CPR now begins in schools from age 4–6, with annual refreshers
• Training should be role-specific and tech-enhanced (feedback devices, VR, hybrid models)
• Gamified and rapid-cycle learning encouraged
• Faculty development and “train-the-trainer” programmes emphasised
📊 The Numbers
• ~115,000 out-of-hospital cardiac arrests (OHCA) per year in the UK
• ~43,000 receive attempted resuscitation
• Bystander CPR in 60–73% of cases
• Public AED use remains under 10%
• 30-day survival around 9–10%; higher (≈30%) in the Utstein subgroup
❤️ Basic Life Support (BLS)
• Call 999 before checking for breathing
• Compression-only CPR acceptable for untrained rescuers
• 100–120 per minute, 5–6 cm depth, minimal interruptions
• Early defibrillation remains critical
💉 Advanced Life Support (ALS)
• No changes to drug intervals or doses
• Focus on ventilation quality and correct pad placement
• Team debriefs and performance feedback encouraged
• CPR-induced consciousness should be recognised and managed appropriately
🩺 Ethics
• Person-centred discussions and advance planning highlighted
• Family presence should be offered where feasible and supported
• Decisions to stop resuscitation must consider reversible causes and patient values/wishes
• Ethical simulation and debriefing recommended to build decision-making confidence
🌍 Systems Saving Lives
• Strengthened first responder and AED networks
• Mandatory CPR education for schoolchildren and learner drivers
• Support for lay rescuers after the event encouraged
• Continuous data-driven system improvement promoted
👶 Paediatrics & Newborns
• Assess heart rate, breathing, and tone – not skin colour
• Adrenaline every 4 minutes (no interval change)
• Sodium bicarbonate removed from newborn protocols
• Out-of-hospital births (including ambulance settings) now explicitly covered in NLS guidance
• Early use of supraglottic airways and two-person airway management encouraged
🧊 Post-Resuscitation Care
• Maintain systolic BP > 100 mmHg (MAP ≥ 60–65)
• Prevent fever (≤ 37.5 °C) for 36–72 hours
• Treat seizures with levetiracetam or valproate
• Prognosticate ≥ 72 hours post-ROSC using multimodal assessment
• Emphasise early rehab, psychological support, and family follow-up
🚨 First Aid – Brand New Chapter
• First aid is officially recognised as the first link in the chain of survival
• Includes choking, severe bleeding, anaphylaxis, asthma, overdose, heat illness, hypothermia, and more
• Accessible, inclusive training promoted across communities, schools, workplaces, and remote environments
🕒 Implementation
• Guidelines take effect January 2026
• Update your teaching materials, algorithms, and scenario training now
Paramedics, instructors, first responders — time to refresh your slides, drills, and practice.
Qualsafe
