AHA Guidelines

2020 Guideline Changes

Click here for full AHA 2020 Guidelines.

+AHA / Coronavirus(COVID-19)

Click here for current AHA Guidance


  • New Chain of Survival for In-Hospital Cardiac Arrest (IHCA):
  • A different chain of survival will be used to prevent and improve outcomes of IHCA. The IHCA Chain of Survival is: Surveillance and protection, recognition and activation of the emergency response system, immediate high-quality CPR, rapid defibrillation, and advanced support and post arrest care.
  • Team Resuscitation:
  • Provides a customizable approach for activation of the EMS and cardiac arrest management to better match the rescuers’ clinical setting. Instead of focusing on a single-rescuer algorithm, team resuscitation teaches how to modify the BLS sequence based on the type of arrest, its location and who is nearby.
  • Rescue Breaths with an Advanced Airway in Place:
  • There is only one rate once an advanced airway is in place. One breath every six seconds for all ages. Compressions and breaths are performed asynchronously after the placement of an advanced airway.
  • Out-of-Hospital Cooling:
  • Is not recommended at this time.

+ADULT CPR Changes

  • Cardiac Arrest in Pregnancy:
  • Do not delay providing chest compressions for a pregnant woman in cardiac arrest. High-quality CPR can increase the mother’s and the infant’s chance of survival. If you do not perform CPR on a pregnant woman when needed, the lives of both the mother and the infant are at risk.

    Perform high-quality chest compressions for a pregnant woman in cardiac arrest as you would for any victim of cardiac arrest. Use an AED for a pregnant woman in cardiac arrest as you would for any victim of cardiac arrest. If the woman begins to move, speak, blink, or otherwise react, stop CPR and roll her onto her left side.

  • Rescue Breaths, Yes:
  • Rescue breaths are recommended for trained rescuers providing CPR; maintain the current ratio of 30 compressions to 2 breaths. (unchanged from 2015)
  • Compression Rates:
  • The recommended rate is 100 to 120 compressions per minute (unchanged from 2015).
  • Compression Depth:
  • The recommended compression depth is at least 2 inches (5 cm) but not greater than 2.4 inches (6 cm) (unchanged from 2015)

+PEDIATRIC CPR (Child and Infant)

  • Infant Compressions::
  • For infants, single rescuers (whether lay rescuers or healthcare providers) should compress the sternum with 2 fingers or 2 thumbs placed just below the nipple line (mammary line).

For infants, if the rescuer is unable to achieve guideline-recommended depths (at least one third the diameter of the chest), it may be reasonable to use the heel of 1 hand.

  • Rescue Breathing:
  • For infants and children with a pulse but absent or inadequate respiratory effort, it is reasonable to give 1 breath every 2 to 3 seconds (20-30 breaths/min)
  • Compression Rates:
  • The recommended rate is 100 to 120 compressions per minute (as opposed to ‘at least’ 100 compressions).(unchanged from 2015)
  • Compression Depth:
  • For adolescents, a maximum compression depth not greater than 2.4 inches (6 cm) is recommended.


Use of Aspirin for Chest Pain:

  • Aspirin for Adults With Nontraumatic Chest Pain

    While awaiting the arrival of emergency services, first aid providers may encourage alert adults experiencing nontraumatic chest pain to chew and swallow aspirin, unless the person experiencing pain has a known aspirin allergy or has been advised by a healthcare provider not to take aspirin.

  • Repeat Doses for Anaphylaxis:
  • When a person does not respond to an initial dose of epinephrine and EMS is not expected to arrive within 5 to 10 minutes, consider a repeat dose.

+Stroke Recognition

Stroke Recognition

To recognize a possible stroke, first aid providers can use the signs of weakness in the face (eg, droop), arm, or grip on one side of the body or speech disturbance and should activate emergency services as quickly as possible if any of these signs are present.

The F.A.S.T. acronym can be helpful in recognizing a stroke:

F—Facial drooping

A—Arm weakness

S—Speech difficulty

T—Time to call 9-1-1