Heart & Stroke Foundation 2025 Guidelines
- Grace
- 2 days ago
- 4 min read
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 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, reducing moral distress and promoting 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, we remain dedicated to translating these standards into practical, hands-on training that empowers our students to save lives with confidence and grace.
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Author - Saving Grace Medical Academy Ltd
Grace. T
Medical Content Writer
