Paediatric Resuscitation & First Aid Updates

What the New RCUK Guidelines Mean for Parents, Schools and First Aiders

By Paul Markham – Green Box First Aid Training

Every five years, the Resuscitation Council UK (RCUK) releases updated release Paediatric Resuscitation & First Aid Updates based on the latest scientific evidence, clinical outcomes and best practice. The 2025 Guidelines represent one of the most significant updates we’ve seen, particularly for paediatric resuscitation and first aid.

At Green Box First Aid Training, we are already preparing to embed these updates into all relevant courses ahead of their full implementation from January 2026, ensuring our learners remain confident, competent and current.

Below is a clear breakdown of the key changes, what they mean in real-life emergencies, and how our training will support you.

Why These Changes Matter

In the UK, out-of-hospital cardiac arrest (OHCA) remains a major public health challenge. While paediatric cardiac arrest is thankfully rare (around 750–800 cases per year), outcomes rely heavily on early recognition, prompt action and effective first aid.

The updated RCUK guidance reinforces a simple truth:

Early intervention by trained bystanders saves lives.

Education: Start Early, Train Often

One of the strongest messages from the 2025 RCUK Guidelines is the importance of early and repeated resuscitation education.

Key recommendations include:

CPR and first aid education starting from age 4–6
Annual refreshers throughout school years
Engaging, hands-on learning using manikins, scenarios and real-world context
Training tailored to the environment and likely risks

This aligns perfectly with how we deliver training at Green Box First Aid Training — practical, relevant and confidence-building.

Adult Basic Life Support: Key Updates

Call 999 First

A major update for 2025 is the instruction to:

Call 999 immediately for any unresponsive person
Do this before assessing breathing

Emergency call handlers now play an even greater role in:

Identifying abnormal breathing
Coaching CPR
Directing callers to the nearest AED

CPR Quality Still Saves Lives

Chest compressions: 100–120 per minute
Depth: 5–6 cm
Minimise interruptions
Rescue breaths only if trained

Evidence continues to show that CPR with breaths significantly improves survival when the rescuer is trained to give them.

AED Use and Pad Placement Updates

AEDs should be used as soon as available
Adult pad placement should ensure the heart sits between the pads
If three shocks are unsuccessful, guidance now suggests adjusting pad position to improve current flow across the ventricles

These refinements will be clearly demonstrated on our updated courses using current training equipment.

CPR on a Bed: No Longer a Delay

Previous guidance discouraged CPR on soft surfaces. New evidence now shows:

It’s better to start CPR immediately on a bed than delay moving the casualty
Remove pillows and kneel beside the bed to improve compression depth

This is particularly relevant in care settings and home environments.

Drowning: Immediate Rescue Breaths

For drowning casualties, the guidance now clearly states:

Give 5 initial rescue breaths first
Then continue CPR as appropriate

This reflects the fact that drowning leads to cardiac arrest due to lack of oxygen, not a primary heart issue.

Paediatric Life Support: Preventing Arrest Comes First

In children, cardiac arrest is usually secondary to hypoxia rather than a heart problem.

The 2025 Paediatric Guidelines emphasise:

Early recognition of serious illness
Structured ABCDE assessment
Rapid management of airway and breathing problems

A new section on special circumstances (asthma, trauma, drowning, hypothermia) and improved post-resuscitation care strengthens the entire chain of survival for children.

Important Changes to Paediatric CPR

For those trained in Paediatric First Aid or Paediatric Basic Life Support:

5 rescue breaths first
CPR ratio: 15 compressions to 2 breaths
AEDs can be used on any age, including infants
Adult AEDs may be used if paediatric pads are unavailable

Infant CPR Hand Position

The thumb encircling technique replaces the two-finger method
This applies to CPR and choking chest thrusts

AED Pad Placement in Children

Front pad slightly left of centre
Back pad in the centre of the back
Aim is always to place pads either side of the heart

First Aid: Now a Core Part of RCUK Guidance

For the first time, First Aid has its own dedicated chapter, recognising it as the first and most vital link in the chain of survival.

ABCDE Approach

The primary survey now formally includes:

Airway
Breathing
Circulation
Disability
Exposure

Life-Threatening Bleeding

Given significantly higher priority
Direct pressure first
Tourniquets and wound packing introduced more routinely
Improvisation skills encouraged

Medical Emergency Updates

Hypoglycaemia

Now recognised beyond diabetes alone:

Includes fasting, severe illness and alcohol-related cases
Children unable to tolerate gel may receive ½ teaspoon of sugar under the tongue (if conscious)

Anaphylaxis

Second adrenaline dose should be given in the opposite leg
Nasal adrenaline sprays receive the second dose in the same nostril

Amputations

Wrap the body part in a damp cloth
Place in a waterproof bag
Store on ice (not directly in water)

What This Means for Our Training

At Green Box First Aid Training, we are:

Updating all relevant courses in line with 2025 Paediatric Resuscitation & First Aid Updates
Introducing changes progressively ahead of January 2026
Continuing to focus on practical confidence, not just theory

We’ll also be releasing updated downloads, infographics and learning resources to support our learners between courses.

Final Thoughts:

2025 Paediatric Resuscitation & First Aid Updates reinforce a powerful message

First aid is everyone’s responsibility — and everyone can make a difference.

Whether you’re a parent, teacher, childcare professional or workplace first aider, staying up to date saves lives.

If you’d like to train with confidence, using the most current UK guidance, Green Box First Aid Training is here to help.

To book now contact us for award winning courses

For more information see the Resuscitation Council’s Website