CPR and first aid for the CCMA: the 2025 AHA numbers

First aid, emergencies and wound care sit in General Patient Care, the largest clinical subdomain of the NHA CCMA exam, and the CPR items reward knowing the current numbers rather than the ones in an older textbook. The American Heart Association published its 2025 Guidelines for CPR and Emergency Cardiovascular Care in October 2025, replacing the 2020 edition. This post gives the 2025 figures, following unit 12 of the free NHA CCMA course. It is a study aid, not clinical guidance or a substitute for a BLS course; your instructor, the provider, facility policy and state law decide what you do in a real emergency. If someone is in trouble in front of you, call 911 or activate your facility's emergency response first; this page is for the exam. No drug doses appear here.

What changed in 2025

• The four 2020 chains of survival were merged into one six-link chain, from recognition and emergency activation through recovery and survivorship.
• Adult and child choking care now starts with 5 back blows followed by 5 abdominal thrusts, repeated. The 2020 guideline began with abdominal thrusts alone.
• The two-finger infant compression technique was eliminated because it does not reach adequate depth.
• Naloxone was built into the adult BLS algorithm for suspected opioid-associated arrest.

Adult BLS

Make sure the scene is safe, check responsiveness, shout for help, activate the emergency response system and send someone for the AED. Check breathing and pulse together for no more than 10 seconds. An unresponsive adult who is not breathing or only gasping is treated as being in cardiac arrest; gasping (agonal breathing) is not normal breathing. Then start compressions. The sequence is C-A-B: compressions, airway, breathing.

• Rate 100 to 120 per minute.
• Depth at least 2 inches (5 cm), avoiding more than about 2.4 inches (6 cm).
• Heel of one hand on the lower half of the sternum, other hand on top, with full recoil after each compression.
• Ratio 30:2 with one or two rescuers, each breath over about 1 second with visible chest rise.
• Pauses as short as possible; compressors switch about every 2 minutes.

Lay rescuers who are untrained or unwilling to give breaths may do compression-only CPR.

Child and infant numbers

An infant is under 1 year (excluding newborns) and a child is 1 year to puberty; from puberty on, adult BLS applies.

The distractor to watch: 15:2 belongs to two-rescuer child and infant CPR only. Adult CPR stays 30:2 with two rescuers.

Choking

A choking person who can cough forcefully and speak is encouraged to keep coughing. Severe obstruction means hands at the throat, inability to speak, a weak or silent cough and bluish skin.

• Adult or child, conscious (2025 AHA): repeat cycles of 5 back blows and 5 abdominal thrusts until the object comes out or the person becomes unresponsive.
• Pregnant or obese person: chest thrusts replace abdominal thrusts.
• Infant under 1 year: 5 back blows with the infant face down along the forearm, head lower than the body, alternating with 5 chest thrusts on the breastbone just below the nipple line. No abdominal thrusts for infants.
• Becomes unresponsive: call EMS, lower the person to a firm surface and start CPR with compressions. Look in the mouth before breaths and remove an object only if you can see it. Never do a blind finger sweep.

The AED

Use the AED as soon as it arrives. Pads go on the bare chest in the anterolateral position (front and side of the chest) or anteroposterior (front and back), following the pictures on the pads. After a shock, or a "no shock advised" message, resume compressions immediately. For children under 8, use pediatric pads and a dose attenuator if available; if not, an adult AED may be used. Rhythm recognition itself belongs to the EKG subdomain, and how to calculate heart rate on an EKG is the starting point there.

The office emergency plan

Office emergency protocols assign each staff member a role and keep a crash cart in a central spot. In the AAFP's sample protocol the medical assistant is the runner: moves the patient, alerts staff, brings the equipment, takes initial vital signs and assists the code, while checkout calls 911 with the location and nature of the emergency. MAs keep BLS current.

Crash cart contents vary by practice, so the exam asks "commonly includes": oxygen and a bag-valve-mask, suction, airway adjuncts, a glucose meter, a pulse oximeter and an AED, with medications such as epinephrine, diphenhydramine, albuterol, dextrose, naloxone, aspirin and nitroglycerin. The matching the exam wants: epinephrine for anaphylaxis, naloxone for opioid overdose, dextrose or glucagon for severe hypoglycemia. Diphenhydramine is an allergic-reaction add-on, never the first-line drug for anaphylaxis. Carts are checked on a schedule set by facility policy.

Common first aid, as the exam asks it

Bleeding. Firm direct pressure with a sterile dressing or clean cloth until it stops. If the dressing soaks through, add another layer on top; removing it pulls off the clot. Call 911 for severe bleeding or bleeding that continues after about 10 minutes. A tourniquet is for life-threatening limb bleeding that pressure cannot control, placed 2 to 3 inches above the wound, not over a joint, with the time noted.

Burns. Cool with cool (not ice-cold) running water for several minutes. Never ice, butter or home remedies, since ice deepens the injury. Do not pop blisters, and cover loosely with a clean, dry, nonadherent dressing. Full-thickness burns, burns palm-size or larger, burns of the face, hands, feet, genitals or major joints, and chemical or electrical burns need urgent care. The most painful burn is partial thickness; a full-thickness burn is numb.

Sprains and strains. A sprain injures a ligament, a strain injures a muscle or tendon. Early care is rest, ice, compression and elevation: ice wrapped in cloth for about 15 to 20 minutes at a time, a wrap that is firm but not tight, and the part above heart level. Splint a suspected fracture in the position found, including the joints above and below.

Nosebleed. Sit up, lean slightly forward and pinch the soft part of the nose for 10 to 15 minutes. Tilting the head back is the wrong answer.

Hypoglycemia. Blood glucose below 70 mg/dL: shakiness, sweating, fast heartbeat, hunger, confusion. The rule of 15: 15 grams of fast-acting carbohydrate (4 oz of juice or 3 to 4 glucose tablets), wait 15 minutes, recheck, repeat if still below 70. Sugar by mouth only if the person is awake and can swallow; an unconscious person gets nothing by mouth, and glucagon is the treatment. "Diabetic shock" and "insulin shock" are older names for severe hypoglycemia, not for diabetic ketoacidosis, the high-sugar emergency.

Seizure. Stay with the person, ease them to the floor, roll them onto their side, cushion the head, and time it. Do not restrain, and put nothing in the mouth. Call EMS for a seizure over 5 minutes, repeated seizures, a first seizure, a seizure in water or during pregnancy, or injury.

Stroke and heart attack. The CDC's B.E. F.A.S.T. check for stroke: balance loss, eyes (vision change), face droop, arm drift, speech slurred, time to call 911. Note when symptoms started, because the most effective treatments generally must start within 3 hours. Chest pain or pressure lasting more than a few minutes, with cold sweat, jaw, back or arm pain, or shortness of breath, means call 911; women more often have less obvious symptoms such as unusual fatigue and nausea.

Anaphylaxis. Hives, facial swelling, throat tightness, wheezing, low blood pressure. Epinephrine given intramuscularly, thigh preferred, is first-line; antihistamines do not replace it. A person with an autoinjector self-administers it, a first aider may help, and EMS is activated every time. The IM technique is in injection angles, needle gauges and sites.

Shock and fainting. Pale, cool, clammy skin, rapid weak pulse, fast shallow breathing, low blood pressure, confusion. Call 911, lay the person on their back, raise the legs about 12 inches if there is no head, neck, spine or leg injury, keep them warm, give nothing by mouth. Fainting gets the same leg raise. That pale, sweaty, fast-pulse picture is the sympathetic response described in sympathetic vs parasympathetic nervous system.

Heat stroke. Heat exhaustion becomes heat stroke when mental status changes and the temperature climbs, typically above 104 F (40 C): call 911 and cool rapidly, with ice-water immersion the fastest method per the 2025 AHA.

Every one of these starts with the assessment habit EMS uses, in EMT patient assessment, step by step, and the numbers you record are the ones in vital signs normal ranges for the CCMA; the vital signs normal ranges checker is a quick reference for them.

How to study this unit

CPR numbers are a small table that has to be exact, and first aid is a long list of condition-to-action pairs. Drill the table until every cell is automatic, using the approach in how to memorize a list, a table or a formula sheet, and spread the first-aid pairs over several weeks; cramming vs spacing is the evidence. Unit 12 of the NHA CCMA flashcard course is built that way, and what's on the NHA CCMA exam shows how General Patient Care is weighted.