New Pediatric CPR Guidelines Developed By Cincinnati Children’s Physician
Research By: Maya Dewan, MD, MPH
Post Date: November 18, 2025 | Publish Date:
Cincinnati physician is helping lead the way in emergency cardiovascular care internationally
Maya Dewan, MD, MPH, is a member of the Emergency Cardiovascular Committee and the Pediatric Emphasis Group of the American Heart Association (AHA) and was tapped this year to be an author of the new AHA CPR guidelines for CPR & Emergency Cardiovascular Care that were released in October. The updated guidelines include new information on pediatric CPR that will take effect in January 2026.
Dewan, director of the Division of Critical Care Medicine and attending physician in the pediatric ICU, focuses her research on cardiac arrest prevention and resuscitation system improvement. She also serves on the International Liaison Committee on Resuscitation, an international committee that reviews and synthesizes resuscitation science for organizations around the world, including the AHA.
“My favorite part of the new 2025 guidelines is the emphasis on teaching CPR to kids,” she said. “Children 12 and older can learn to perform effective CPR and use an AED, while younger children can start by learning how to recognize emergencies, call for help, and build confidence so they’re ready to act as future lifesavers.”
The guideline updates include:
For Anyone Performing CPR (Basic Life Support)
- Choking (Foreign Body Airway Obstruction): If a child is choking and cannot breathe or cough, alternate 5 back blows with 5 abdominal thrusts until the object comes out or the child becomes unresponsive. (In 2020, only abdominal thrusts were recommended.)
- Infant Chest Compressions: When giving CPR to an infant, rescuers can now use either two thumbs wrapped around the chest or the heel of one hand to push firmly in the center of the chest. The two-finger technique has been removed because it doesn’t achieve enough depth for effective compressions.
For Healthcare Providers (Advanced Life Support)
- Epinephrine Timing: For children in cardiac arrest with a non-shockable rhythm, give epinephrine as early as possible. (This replaces the previous “within 5 minutes” recommendation.)
- Monitoring and Physiology During CPR: A single CO₂ (ETCO₂) reading should not be used to decide when to stop resuscitation—some children survive even with low values. When an arterial line is available, aim to keep diastolic blood pressure ≥25 mmHg in infants and ≥30 mmHg in older children to improve outcomes.
- Post-Cardiac Arrest Care: After a child’s heartbeat returns, focus on maintaining blood pressure above the 10th percentile for age (previously 5th), and use multiple tests over time—not one test alone—to assess brain recovery. Ensure survivors receive physical, cognitive, and emotional follow-up within the first year.
Read the Basic Life Support guidelines that Dewan worked on in the AHA journal Circulation.
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Research By
My research focuses on using the electronic health record to increase situation awareness to aid in the prediction and prevention of deterioration in PICU patients.
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The Research Horizons blog features news and insights about the latest discoveries and innovations developed by the scientists of Cincinnati Children's. This blog does not provide medical advice, diagnosis, or treatment. Email researchnews@cchmc.org with questions or ideas.
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