What’s New: AHA 2025 Guideline Highlights for Mechanical CPR & LUCAS
The AHA’s release of its 2025 Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) brings several important updates that users of mechanical CPR devices — including the LUCAS system — should know.
Here’s what these changes mean for first responders, hospitals, EMS services, and anyone involved in procuring or deploying automated/assisted CPR systems.
Key Guideline Changes Relevant to Mechanical CPR
1. Routine use of mechanical CPR devices is
not recommended
In the “Adult Basic Life Support” section, the AHA states that the “routine use of mechanical CPR devices is not recommended for adult cardiac arrest.”
What this means in practice:
Manual high-quality CPR remains the standard.
Mechanical devices should be reserved for specific circumstances where manual CPR is impractical, unsafe, or of poor quality.
EMS services and hospitals need to evaluate exactly when and how devices like LUCAS add value rather than assuming “automated is always better.”
2. Specified situations where mechanical CPR may be reasonable
While routine use is not the standard, there is acknowledgement that mechanical CPR devices may be reasonable in certain settings. For example:
During transport when it is difficult to maintain high-quality manual compressions (in ambulance, helicopter, or unusual terrain)
In situations where provider safety or physical conditions hamper effective manual compressions
In systems with protocols, training, and monitoring around mechanical CPR deployment
From commentary among EMS providers:
“The new guideline is that they are not recommended at all unless effective manual CPR cannot be performed, such as during transport (which itself is highly discouraged)…”
3. Integration into the “Chain of Survival” and system-of-care expectations
The 2025 Guidelines emphasize the importance of the unified Chain of Survival — prevention, recognition, high-quality CPR, defibrillation, advanced life support, post-arrest care — across in- and out-of-hospital settings.
This has implications for mechanical CPR device procurement and use:
Device deployment should be part of a system-wide plan, not as a standalone “silver bullet.”
Quality metrics (compression depth, rate, interruptions) remain critical whether manual or mechanical.
Training, protocols, debriefing, data capture (for both manual & mechanical) matter more than ever.
4. Implications for training, provider judgment & equipment procurement
The guidelines’ emphasis on context and provider judgment means:
Agencies must train crews not just on device operation, but on when not to use it versus when manual CPR should remain.
Procurement decisions should factor in systems of care, transport dynamics, terrain, manpower, quality monitoring and cost-benefit—not just device specs.
Post-event debriefing and review of mechanical CPR use will be more important to demonstrate that when LUCAS or similar devices are used, the decision was appropriate, supported, and audited.
What This Means for AEDPRO Customers & Partners
As a trusted partner in AED, CPR and resuscitation-equipment sales and service, AEDPRO is well positioned to help responder agencies interpret and implement these guideline changes.
For Purchasing / Equipment Decision-Makers
If your service is considering a mechanical CPR device (such as LUCAS), you’ll want to ask:
Under what specific scenarios will the device be deployed (transport, rescuer fatigue, space constraints)?
Is there a documented protocol that defines when manual compressions are insufficient?
Will you be monitoring quality metrics (compression depth, rate, hands-off time) and comparing manual vs device outcomes?
Has training been budgeted and is there a maintenance/service plan?
If you already have one, review usage data: Are you using it regularly? Were manual compressions of acceptable quality available? Does the device help in the scenarios you intended (e.g., difficult extrication, transport)?
Consider cost-effectiveness: With the guideline noting mechanical devices may be useful but are not routine, you’ll want ROI data: does the device reduce provider fatigue, improve hands-off time, support safety, enable earlier defibrillation, etc.?
For Training Coordinators & Medical Directors
Update your CPR protocols to align with the 2025 guidelines, explicitly stating the role (or limited role) of mechanical CPR.
Emphasize manual CPR quality — depth, rate, minimal interruptions, correct recoil — as the foundational standard.
Incorporate device use scenarios in simulation training: when to switch to device, how to deploy without delaying compressions, how to monitor for hands-off time during transition.
Capture data: time to device application, hands-off time during switch-over, outcomes when device used vs manual. Use these for continuous quality improvement.
For EMS / Fire / Hospital Staff
Recognize that mechanical CPR isn’t a replacement for solid manual compressions — device use must be appropriate and justified.
Be vigilant about minimizing delays/interruptions when deploying mechanical devices: frequent complaint is that switching to a device can create an extra pause.
Engage with debriefing and quality-review processes: when device was used, what went well, what didn’t, would the same situation have been managed just as well with manual CPR?
Understand equipment maintenance and readiness: even high-tech devices fail if not charged, serviced, cleaned, or integrated into the workflow.
Bottom Line for AEDPRO & Your Responder Community
The 2025 AHA Guidelines send a clear message: mechanical CPR devices like LUCAS are not the new default standard for all cardiac arrests. They can be very useful in specific circumstances — transport environments, where manual compressions are unsafe or ineffective, or when there are limited providers. But manual, high-quality CPR remains the bedrock of resuscitation.
For you, the responder agency or hospital — and for AEDPRO as your equipment/training partner — that means:
Make decisions on mechanical CPR devices thoughtfully, not reactively.
Build protocols, training, data capture and review systems that support when and how a device is used.
Emphasize manual CPR quality always; device use should enhance outcomes, not replace basics.
Use this guideline update as an opportunity to review your equipment inventory, training curriculum, deployment protocols, and service/maintenance agreements.
Sources:
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001369?utm_source=chatgpt.com
https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/adult-basic-life-support
