Understanding the 2025 RCUK Resuscitation Guideline Updates:

In December of 2025, the Resuscitation Council UK released their new national Resuscitation Guidelines, marking one of the most significant and important updates in many years.
Among the most important revisions are those concerning airway management as well as the jaw thrust manoeuvre, as further detailed in the Safety Training Awards (STA) Technical Notice (15 December 2025).

Under the new guidance, first aiders and lifesavers are now expected to be trained and assessed on opening the airway using the jaw thrust technique where a spinal injury is suspected. The RCUK has clarified that keeping an open airway takes precedence over strict immobilisation, given that the head and neck are moved carefully.

When do these changes come into effect?

The STA confirms there will be a transition period starting on the 1st of January 2026, with full implementation by the 1st of April 2026. All regulated First Aid at Work (FAW), Emergency First Aid at Work (EFAW), and Aquatic Rescue Awards will require training providers to integrate the updated jaw thrust technique into practical assessments by these dates.

Training organisations regulated by STA, Ofqual, or RLSS UK should review their lesson plans, make sure the appropriate CPR manikins are used, and brief instructors on the updated expectations.

Why does the jaw thrust manoeuvre matter?

The jaw thrust is the recommended method for opening an airway when a spinal injury is possible; for example, after a fall, diving accident, or road collision.
It allows first aiders to lift the tongue away from the back of the throat without tilting the head, which helps to keep optimal spinal alignment.

Under the RCUK 2025 guidance, airway management is now seen as the priority intervention, since oxygen deprivation is immediately life threatening.
This subtle shift means that airway competence and confidence are a key part of every accredited first aid qualification.

How should training providers adapt to these changes?

Updated CPR Manikins for Realistic Airway Practice:

With airway management now being a mandatory assessment aspect, instructors need CPR manikins that can replicate real jaw movement, as well as resistance. The Prestan Jaw Thrust Manikin allows trainers to teach both standard head-tilt-chin-lift, as well as jaw thrust techniques, included with realistic anatomical landmarks and feedback indicators.

For those who already own a Prestan adult CPR manikin, or series 2000 manikin, upgrading is very straightforward, using the Prestan Jaw Thrust Head Assembly, which swaps directly onto compatible Prestan Adult Manikins.

These upgrades make sure your training stays compliant with the RCUK 2025 airway assessment criteria.

Key Differences from Previous Guidance

Aspect	2021 Guidelines	2025 Guidelines
Airway vs Spine Priority	Equal priority	Airway takes priority
Jaw Thrust Use	Optional for advanced rescuers	Expected training standard.
Assessment	Often demonstrated verbally	Must be practised and assessed using manikins

Automated External Defibrillator (AED) Guidance Updates

The updated resuscitation guidelines additionally place renewed importance on immediate defibrillator use. Rescuers should apply an AED as soon as it becomes available, without delay. Additionally, when performing resuscitation after a drowning or in wet environments, first aiders should dry the chest, as fast as possible, before placing pads to ensure proper pad adhesion and reduce the risk of arcing.

Training centres and workplaces should make sure AEDs are readily and easily accessible, visible, and accurately equipped with additional essentials such as scissors, razors, and wipes. The Defibrillator AED Prep Kit contains all these items, supporting compliance with the latest guidance. For new installations, the Mediana A15 HeartOn AED is a simple, voice-guided device ideal for both trained and untrained rescuers.

CPR on Soft Surfaces

The RCUK 2025 guidance recognises that in real world situations, such as healthcare or care home settings, a casualty could collapse onto a soft surface, such as a bed.
Rescuers are now advised to begin CPR immediately, rather than delaying to move the casualty. If possible, they should increase the compression depth to compensate for mattress softness.

To prepare learners for this reality, trainers can use CPR manikins with feedback sensors to help them monitor and adjust compression depth and rate. Training mats can also help to simulate real life conditions while protecting CPR manikins from damage during practice.

Anaphylaxis Protocol Update

Another important change to the first aid for anaphylaxis section is the confirmation that a second dose of adrenaline may be given approximately five minutes after the first, only if symptoms do not improve or worsen. This reflects current Resuscitation Council UK anaphylaxis guidance and brings workplace and first aid teaching in line with clinical practice.

For first aid instructors and course providers, including adrenaline auto injector trainer pens in their sessions is advised to teach safe and confident use of devices such as EpiPen or Jext trainers.

Drowning and Rescue Breaths

Another notable update addresses resuscitation following drowning. First aiders should begin with five rescue breaths before starting chest compressions. This prioritises oxygen delivery to a casualty who has suffered a hypoxic cardiac arrest, where breathing failure occurs before heart stoppage.

Once the casualty is moved to a safe, dry area, rescuers should use an AED as soon as possible. To train effectively for these scenarios, first aid instructors should make sure they have realistic water rescue or CPR manikins and AED trainers that replicate automated prompts, preparing trainees for high pressure, outdoor situations; where it may be cold and/or wet.

Paediatric Basic Life Support (BLS) Changes

The paediatric resuscitation section of the guidelines confirms that trained responders should perform 15 chest compressions followed by 2 rescue breaths (15:2 ratio), keeping the same ratio as in previous paediatric and infant guidance, but with reinforced emphasis on the accurate hand positioning and compression depth.

The guidelines also restate the two thumb encircling technique as the preferred method for infant CPR when two rescuers are present. To meet this new focus, instructors can use child CPR manikins and infant CPR manikins, making sure that learners practise the appropriate technique for different age groups.

Casualty Modesty & Bra Guidance for AED Use

An important clarification in the RCUK 2025 guidelines addresses the removal of bras, especially underwired types, when applying AED pads as best practice. Underwired bras can obstruct pad placement and increase the risk of burns or sparks during defibrillation.

Rescuers are advised to remove or cut through clothing (including bras where necessary) to make sure that the AED pads are applied directly to clean, dry skin. For safe and respectful pad placement, the AED Prep Kit includes scissors, razors, wipes, and gloves; all of which are essential for fast, professional intervention. This clarification supports both effective treatment and dignity management in emergencies. To assist with bra removal in your training sessions for CPR manikins, we recommend the Prestan female accessory, which acts as a bra on both male and female CPR manikins.

Renewed Focus on the ABCDE Assessment Framework

The ABCDE approach (Airway, Breathing, Circulation, Disability, Exposure) is, again, highlighted as the most important foundation of structured casualty assessment for both first aiders and lifesavers. The RCUK 2025 update stresses consistency between clinical and layperson assessments, helping rescuers prioritise life threatening problems in order.

Why does this matter to first aiders?

Even if your certificate for first aid is still valid, these updated guidelines will affect how medical emergencies should be seen and managed. First aiders who trained before these updates may not yet have covered:

• The newly structured assessment (ABCDE) approach;

• The updated CPR and rescue sequence modifications;

• Higher importance on chest compression quality, using AEDs and emergency call strategy;

• The updated first aid responses for life threatening conditions.

The HSE Recommends Annual Refreshers

Under the Health and Safety (First Aid) Regulations 1981, employers must make sure that first aid provision is adequate and appropriate to their specific workplace risks. While first aider certificates are valid for three years, the HSE strongly advises that qualified first aiders should undertake an annual refresher training session to keep optimal competence.

An annual refresher helps a first aider to:

• Reinforce their practical skills for emergencies;

• Stay up-to-date with new guidance and the best first aid practice;

• Boost their confidence further in responding to an emergency under pressure;