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News
The European Resuscitation Council's 2025 guidelines bring significant updates to pediatric CPR — from mandatory two-thumb compressions in infants to capnography as a new standard. Key drug changes include levetiracetam replacing phenytoin as second-line for status epilepticus and atropine being largely dropped. The goal: faster, cleaner emergency response for kids.
The European Resuscitation Council (ERC) has released its 2025 pediatric resuscitation guidelines, and they come with meaningful changes designed to simplify and sharpen emergency care for children. The updates touch everything from chest compression technique to post-resuscitation targets — and clinicians are being urged to update their equipment and team protocols accordingly.
One of the biggest shifts: the two-thumb encircling technique is now mandatory for infant chest compressions in all situations, replacing the previously acceptable two-finger method for solo rescuers. Trained providers should use a 15:2 compression-to-breath ratio, while those only trained in adult BLS should default to 30:2. Continuous waveform capnography is now a defined standard for every advanced airway procedure — not just for confirming tube placement, but for monitoring CPR quality and detecting impending return of spontaneous circulation (ROSC).
On the medication front, levetiracetam is now the preferred second-line agent for status epilepticus, bumping phenytoin. Atropine has been largely retired except for specific indications. Post-ROSC, blood pressure targets have been raised to above the 10th percentile, and oxygen should be titrated to SpO₂ 94%–98% immediately after ROSC.
Key Takeaways:
Why it matters: These guidelines affect not just hospital teams but also family physicians and pediatricians who may be first responders in an emergency. Updating office equipment and running regular simulation drills on these new protocols could make a critical difference in outcomes for pediatric patients.
