CPR and choking response guidelines change as new research becomes available. In October 2025, the American Heart Association released updated Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC), the first full revision of the guidelines since 2020. Among the changes were important updates to infant CPR techniques and choking response for infants, children, and adults.
If your school, workplace, restaurant, childcare center, health office, or other facility displays CPR and choking instructions, it’s worth checking that your reference materials reflect the current recommendations.
Infant CPR: The Two-Finger Technique Is No Longer Recommended
One of the biggest changes involves chest compressions for infants.
Previous CPR instruction commonly taught rescuers to perform infant chest compressions using two fingers on the sternum. Under the current American Heart Association guidelines, the recommended techniques are now:
- Two-thumb encircling hands technique, or
- Heel-of-one-hand technique
If the rescuer cannot physically encircle the infant's chest, the heel of one hand should be used.
The two-finger technique was removed because available evidence indicated that it may not consistently achieve adequate compression depth. Research reviewed for the updated guidelines supported the two-thumb encircling hands and one-hand techniques as more effective alternatives.
Choking Response Has Changed, Too
The updated guidelines also change the recommended response to severe choking.
Adults and Children
For a conscious adult or child with a severe airway obstruction, the current recommendation is to:
Give 5 back blows, followed by 5 abdominal thrusts.
Continue alternating between five back blows and five abdominal thrusts until the object is expelled or the person becomes unresponsive. The sequence begins with back blows. professional.heart.org
This is an important change in particular for children, because earlier AHA guidance called for abdominal thrusts without first giving back blows.
Infants Under 1 Year Old
For an infant with severe choking, rescuers should alternate:
5 back blows + 5 chest thrusts
The updated guidance specifies using the heel of one hand for the chest thrusts. Abdominal thrusts should not be used on infants because of the risk of injury. Continue the sequence until the object is expelled or the infant becomes unresponsive.
Why Updated CPR & Choking Reference Materials Matter
CPR and choking posters are not a replacement for hands-on CPR and first aid training. But clear reference materials can help reinforce the steps people have been taught and keep important emergency information visible in places where it may be needed.
Older CPR charts may still show the two-finger infant compression technique or choking instructions that no longer reflect current American Heart Association guidance.
That makes this a good time for schools, medical offices, childcare facilities, restaurants, workplaces, community centers, and other organizations to review the CPR and choking information they currently have posted.
ZoCo CPR & Choking Posters Have Been Updated
We have updated our ZoCo CPR & Choking First Aid Posters to reflect current guidance for infants, children, and adults.
The illustrated posters provide quick-reference information covering CPR, chest compressions, rescue breaths, and choking response in an easy-to-follow format. They are designed for display in classrooms, school health offices, workplaces, restaurants, childcare facilities, clinics, and other locations where emergency information should be readily accessible.
For anyone responsible for maintaining workplace, school, or facility safety materials, now is a good time to check older CPR and choking charts and replace information that no longer reflects current recommendations.
Shop CPR & Choking First Aid Posters
This article and ZoCo safety posters are intended as quick-reference educational resources and are not substitutes for certified CPR or first-aid training. In an emergency, call 911 and follow instructions from emergency personnel.