Çağdaş Yıldırım, Ayhan Özhasanekler, Elif Öztürk İnce, Gültekin Kadı, Gül Pamukçu Günaydın, Buğra İlhan, Yunus Emre Arık, Müge Günalp, Bülent Erbil, Cem Oktay
Anatolian Journal of Emergency Medicine - 2025;8(4):199-212
Cardiac arrest continues to be one of the most critical health emergencies worldwide, associated with high morbidity and mortality. Prepared in light of recent developments in resuscitation science, the 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care present new evidence-based recommendations aiming to increase survival rates. This review aims to examine the critical updates included in the guidelines, specifically under the headings of "Systems of Care," "Adult Basic Life Support," "Adult Advanced Life Support," "Cardiac Arrest in Special Situations," "Tachycardia Management," "Post-Cardiac Arrest Care," and "Resuscitation Education Science." In the Systems of Care section, which forms the foundation of the guidelines, it is emphasized that survival depends not only on medical interventions but also on educational efficiency and the quality of local implementation. The concept of the "Chain of Survival" has been expanded to include recovery and survivorship phases, and the importance of community-based interventions and the principle of equity has been highlighted. In the Adult Basic Life Support section, the term "lay rescuer" has been preferred over "bystander" terminology to encourage action, and the use of technology-assisted feedback systems has been recommended alongside early defibrillation and high-quality chest compressions. Evidence regarding airway management strategies and defibrillation techniques in Adult Advanced Life Support algorithms has been updated. In Tachycardia Management, current approaches to electrical cardioversion are summarized. The Cardiac Arrest in Special Situations section, which covers a substantial part of the guidelines, includes specialized management strategies for specific etiologies such as opioid toxicity, pregnancy, pulmonary embolism, and drowning. The integration of naloxone administration into standard resuscitation practices in opioid-associated arrests is strongly emphasized. Finally, the Post-Cardiac Arrest Care section focuses on the determinant effect of management after the return of spontaneous circulation (ROSC) on hospital discharge and long-term neurological outcomes. Targeted temperature management, hemodynamic stabilization goals, and multimodal neuroprognostication approaches are addressed as the cornerstones of this process. In conclusion, this review offers an up-to-date guide for clinicians by synthesizing the innovations introduced by the guidelines. Translating global standards into practice by supporting them with local data, such as in Turkey (e.g., the TROHCA study), will play a key role in improving cardiac arrest survival rates in our country.
