UK Resuscitation Council Updates

A key theme of the UK Resuscitation Council updates is the emphasis on making an earlier call to the emergency services. The idea is to call the 999 operator as soon as you discover an unresponsive casualty to give you and the casualty some time.

The previous guidance was to call the 999 operator after checking the casualty's breathing. Updated research suggests this could cause delays in allocating help to those most in need. It also reduces the 999 operator's role in assisting first aiders and bystanders with recognising abnormal breathing. 

One of the criticisms of first aid is that things are constantly changing. It is worth noting that things do often change to improve survival rates, and we hope the criticism is used to drive positive improvements. 

Nothing has changed more than the primary survey, which is defined as your first point of contact with the casualty. The guidelines now instruct a first aider to adopt the ABCDE approach, which looks like the following:

The old guidelines were DRABCD. D stood for danger, which is now assumed as part of the scene survey. R stands for response, which is now also included in the Alert, Confusion, Voice, Pain, Unresponsive (ACVPU) approach. Finally, D used to stand for defibrillator, but this is now part of the CPR process and has been replaced by disability, which has more of a direct relevance to confusion in conditions like head injuries, stroke and dementia. 

One of the most significant updates to the new guidelines is the changes to the CPR ratios for infants, children and adolescents. The first 5 breaths remain the same, but the guidelines now call for 15 compressions and 2 rescue breaths after the initial breaths. 

The previous guidelines were 30 compressions and 2 rescue breaths, repeated until the arrival of emergency services or until the casualty recovered.

The new guidelines only apply to those who undertake paediatric first aid training. These learners are deemed appropriately skilled and would have practised the new technique on their paediatric first aid training course. All other first aiders, such as those on adult workplace first aid courses, will continue to use the 30:2 ratio.

The other main change in paediatric first aid is the switch to the two-thumb encircling technique for both infant chest compressions (CPR) and infant chest thrusts (choking).

Again, the reason for the change is updated feedback, research, and science. Previously, two fingers were used for both techniques, which were judged less efficient than the first-aider using two thumbs. The main reasons include fatigue, nail length, and improved stability with the two-thumb encircling technique.

The best place to learn these techniques is on a paediatric first aid training course. Stay tuned for a new e-learning course for anyone who has recently completed a course and was taught the old guidelines. 

One of the best parts of the new guidelines is that we now have first-aid guidelines for the first time. This is really helpful for all sorts of conditions, including asthma, concussion, heat stroke and many more.

This serves as a central source of information for first aiders who need to quickly access the latest recognition and treatment protocols for the above conditions. It also standardises protocol across the various awarding bodies in the first aid training sector.

For the first time, both learners, a qualified first aider and instructor, are all singing from the same hymn sheet when it comes to conditions outside of traditional resuscitation protocol. This can only be a positive improvement from a highly trusted and reliable source, the UK Resuscitation Council. 

There have been a lot of changes, so let's quickly summarise what to remember:

• Call 999 / 112 as soon as you detect/find an unresponsive person

• Adopt the ABCDE approach when conducting a primary survey

• Use the 15:2 CPR ratio if you are paediatric first aid trained 

• Only use the two-thumb encircling technique when doing chest compressions or chest thrusts on an infant casualty

• Utilise the new first aid guidelines, which have been made available as part of the 2026 updates 

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