Heart & Stroke Foundation 2025 Guidelines
- Grace. T
- Oct 23
- 4 min read
Updated: Nov 11
Heart & Stroke Foundation 2025 Guidelines: Key Updates at a Glance
Published: October 2025 | Source: Heart & Stroke Foundation of Canada – Guidelines for CPR & ECC 2025
💡 Overview
The Heart & Stroke Foundation of Canada’s 2025 Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) bring forward a major scientific update to resuscitation science. These new standards—developed alongside ILCOR (International Liaison Committee on Resuscitation)—introduce clearer ethical frameworks, improved systems of care, and a greater focus on recovery, equity, and education for healthcare professionals across Canada.
🔍 Section Highlights and Rationales
🧭 1. Ethics and Equity
New chapter on resuscitation ethics: Defines the core principles of beneficence, non-maleficence, autonomy, and justice.
Equity in care: Healthcare professionals and institutions are urged to address social determinants that create inequities in cardiac outcomes.
Shared decision-making: Encourages advanced care plans and portable orders for life-sustaining treatment (POLSTs).
Rationale: This chapter helps professionals navigate complex ethical decisions with clarity. It reduces moral distress and promotes fair care for every patient.
🏥 2. Systems of Care
Unified Chain of Survival: Applies to all age groups and settings.
Safety Huddles (New): Regular team briefings to prevent in-hospital cardiac arrest.
Naloxone Access (New): Public distribution and legal immunity for lay rescuers.
Code Team Structure: Defined roles and simulation-based training recommended.
On-Scene Resuscitation: Prioritize ROSC before transport.
Post-Arrest Recovery: Integrate rehabilitation and long-term follow-up.
Rationale: A strong, coordinated system saves more lives and supports patients beyond initial resuscitation.
👶 3. Neonatal Life Support
Deferred Cord Clamping (≥ 60 sec): Improves iron status and reduces mortality in term and preterm infants.
Cord Milking (New): May benefit non-vigorous term and late preterm infants.
Video Laryngoscopy: Improves intubation success.
Laryngeal Mask: Alternative airway for ≥ 34 weeks gestation if mask ventilation fails.
Rationale: Updated practices prioritize oxygenation and developmental outcomes through gentle, evidence-based care.
🧒 4. Pediatric Basic Life Support
High-quality CPR: Minimize interruptions (< 10 seconds).
Compression Technique: Use heel-of-one-hand or two-thumb encircling hands for infants; the two-finger technique is no longer recommended.
Foreign-Body Airway Obstruction (FBAO): Alternate five back blows and five abdominal thrusts for children; use back blows and chest thrusts for infants.
Rationale: These changes simplify training and improve confidence for both professionals and lay rescuers.
👩⚕️ 5. Adult Basic Life Support
Naloxone Integrated: Now part of the BLS algorithm for suspected opioid overdose.
New Adult FBAO Algorithm: Start with five back blows → five abdominal thrusts.
Compression-to-Ventilation Ratio: Continue 30:2 until advanced airway placement.
Defibrillation Pads: Adjust bra position instead of removal to reduce barriers to defibrillation.
Mechanical CPR: Not recommended routinely; only when manual compressions are unsafe or impractical.
Rationale: Streamlined protocols and gender-inclusive guidance encourage faster bystander CPR and improved outcomes.
🧠 6. Advanced Life Support (Adult & Pediatric)
Early Epinephrine: For non-shockable pediatric arrests.
ETCO₂ Monitoring: ≥ 20 mmHg linked to better ROSC; avoid ending CPR based on ETCO₂ alone.
Adult ALS Updates: Epinephrine after failed defibrillation; IO only if IV fails.
Cardioversion: ≥ 200 J initial energy for AF and flutter.
Rationale: Timely drug delivery and precise monitoring improve neurological outcomes after cardiac arrest.
❤️🔥 7. Post-Cardiac Arrest Care
MAP Target: ≥ 65 mm Hg to avoid hypotension.
Temperature Control: Maintain 32–37.5 °C for at least 36 hours.
Routine Imaging: CT and Echocardiography for etiology and complication assessment.
Mental Health: Evaluate survivors and caregivers for emotional distress before discharge.
Rationale: Extending care beyond ROSC promotes neurological recovery and psychological healing.
🧬 8. Special Circumstances
ECLS for Refractory Asthma or Hypothermia.
Pregnancy: Begin resuscitative delivery within five minutes of arrest.
Opioid Toxicity: Administer naloxone without delaying CPR; provide education and “take-home” kits upon discharge.
Rationale: Case-specific guidance improves survival while preserving ethical decision-making and safety for rescuers.
🏁 Conclusion
The 2025 Heart & Stroke Guidelines represent a transformative shift in Canadian resuscitation practice. From ethics to education, these updates call on healthcare professionals and nursing students to lead with compassion, inclusivity, and evidence-based skill. At Saving Grace Medical Academy, the commitment is to translate these standards into practical, hands-on training. This empowers students to save lives with confidence and grace.
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Author - Saving Grace Medical Academy Ltd
Grace. T
Medical Content Writer
