Resuscitation Council UK Unveils Ground-breaking 2025 Guidelines

The Resuscitation Council UK (RCUK) has released its comprehensive 2025 Resuscitation Guidelines, marking the most substantial update in over 15 years. These new standards are set to revolutionise first aid and basic life support training across the UK, with full implementation expected by January 2026. Awarding bodies are currently reviewing the updates, and training providers will begin incorporating the new content once approved.

A primary focus of the new guidelines is the emphasis on speed in emergency response. Individuals finding someone unresponsive are now advised to shout for help and call 999 immediately using a speakerphone while simultaneously opening the airway and checking for normal breathing. This proactive approach aims to facilitate faster recognition of cardiac arrest by call handlers.

The guidelines also place increased importance on recognising agonal gasps – irregular, gasping breaths that can occur in the early stages of cardiac arrest, indicating an urgent need for CPR.

Key Changes in Adult and Paediatric Resuscitation

  • Earlier 999 Calls: For adults, the updated guidance stresses calling 999 as soon as unresponsiveness is established, even before confirming abnormal breathing. For children and infants, if alone, perform CPR for two minutes before calling 999, as paediatric cardiac arrests are often due to a lack of oxygen.
  • AED Pad Placement: New research highlights the critical role of correct defibrillator pad placement. The apical pad (left side of the chest) should now be placed directly below the armpit, with its centre aligned with the mid-axillary line, to ensure the electrical current passes effectively through the heart's ventricles. The guidelines also include new advice for female casualties.
  • CPR on Soft Surfaces: In healthcare or residential settings, if an unresponsive person is found on a bed, the new guidance advises against wasting time moving them to the floor. Instead, pillows should be removed, and compressions should be adjusted for the soft mattress, as immediate CPR is paramount.
  • Paediatric Updates: Significant changes have been introduced for paediatric resuscitation. The compression-to-breath ratio for those trained in paediatric life support is now 15:2 for babies, children, and adolescents. Initial rescue breaths remain crucial for children, with five recommended to be given first. The two-thumb encircling technique is now the recommended method for infant chest compressions, replacing the two-finger method. Infant choking guidance now includes chest thrusts after back blows. For infants and small children (under 25 kg), one defibrillator pad should be placed mid-chest to the left of the sternum, and the other between the shoulder blades.

Workplace First Aid: HSE and HSA Introduce Vital Revisions

Both the Health and Safety Executive (HSE) in the UK and the Health and Safety Authority (HSA) in Ireland have introduced significant updates to their workplace first aid guidance, emphasising a more holistic approach to employee well-being.

UK: HSE Integrates Mental Health and Clarifies Training Requirements

The HSE's updated guidance, particularly the third edition of 'First aid at work: Guidance on regulations (L74)', implemented amendments in early 2024. While not changing legal compliance requirements, these updates provide clearer direction for employers.

Related training: If you are looking to qualify as a trainer in this area, see moving and handling trainer qualifications or explore online first aid training courses for nationally recognised UK and Ireland qualifications.

  • Mental Health Integration: A notable change requires employers to consider employees' mental health in their first aid needs assessments. This marks a departure from previous guidance that primarily focused on physical first aid, acknowledging the importance of addressing both mental and physical health emergencies. Employers may find it beneficial to have individuals trained to identify and understand mental ill-health symptoms.
  • Terminology Update: The term 'catastrophic bleeding' has been updated to 'life-threatening bleeding' to enhance clarity and align with contemporary medical terminology. From October 2025, new qualifications and syllabi will include life-threatening bleeding management as a core part of first aid training.
  • Simplified Training Provider Selection: The HSE has streamlined guidance on selecting first aid training providers, aiming to make the process clearer for employers. Employers are responsible for ensuring their chosen provider is competent, with appropriate content, suitable trainers, and robust quality assurance systems.
  • Blended Learning: The 2024 guidance explicitly accepts blended learning for workplace first aid training, provided employers conduct due diligence to ensure suitability, accessibility, adequate support, identity fraud prevention, sufficient classroom time, and appropriate assessment of e-learning components.
  • AED Guidance: While not a legal requirement, the HSE's 2025 update strongly advises AEDs in higher-risk environments and expects first aid needs assessments to consider defibrillator access, maintenance, and visibility as best practice.

Ireland: HSA Aligns with PHECC FAR Standard

The Health and Safety Authority (HSA) in Ireland released updated Guidelines on First-Aid at Places of Work in December 2024. These guidelines aim to enhance workplace safety and ensure employees have access to necessary first aid resources and training.

  • PHECC First Aid Response (FAR) Standard: The guidelines now reflect the Pre-Hospital Emergency Care Council (PHECC) First Aid Response (FAR) training standard. This update ensures occupational first-aiders are equipped with the most current and comprehensive training available. As of September 1, 2017, the HSA only recognises the PHECC FAR education and training standard for occupational first aid in workplaces.
  • Digital Certification: As of March 1, 2025, the only valid certificate for a PHECC approved Responder level course is a Digital Certificate.
  • First-Aid Kit Contents: Significant updates have been made to the contents of first-aid kits to ensure they are well-stocked for various workplace injuries and emergencies.
  • AEDs: Updated information on the use and maintenance of Automated External Defibrillators (AEDs) is now included, recognising their crucial role in sudden cardiac arrest.
  • Training Validity: Occupational first aid certification in Ireland is valid for two years, after which recertification training is required. There are no mutual recognition agreements for occupational first aid certificates from other countries; training must be completed in Ireland to be valid.

These updates across both the UK and Ireland underscore a commitment to improving first aid provision and ensuring that qualifications meet the highest standards of care. Employers and first aiders are encouraged to familiarise themselves with these changes to maintain compliance and enhance their ability to respond effectively in emergencies.

For comprehensive and up-to-date first aid training that aligns with the latest UK and Irish guidance, consider Abertay Training. Visit https://www.abertaytraining.co.uk for more information on their courses and how they can help your organisation meet its first aid obligations.