After the emergency, and staying ready

The ambulance doors close, and the street goes quiet. You're standing there with someone else's blood on your sleeve, or kneeling on your own kitchen floor, and nobody tells you what happens next. Six months later, the class you took is a memory, and your hands have forgotten more of it than you think. This last lesson is about both: the hours and weeks after an emergency, for you and for the person you helped, and how to keep what this course taught ready for the day you need it.

It also finishes three things earlier lessons started: the list of where to train and what each option gives you, the DNACPR question from lesson 1, and the first aid response to someone thinking about suicide, which lessons 1 and 14 both sent here. The course project, "Your household's first ten minutes", starts here too.

The handover

The emergency does not end when the crew walks in. It ends when they have taken over.

RCUK's 2025 first aid guideline says to keep CPR going until professional help arrives and takes over, or tells you to stop; until the person becomes responsive, which it spells out as speaking, opening their eyes, moving purposefully or breathing normally; or until you are exhausted (RCUK 2025).¹ The ERC's guide for the public puts the adult cycle as "repeated until EMS are on scene and able to take over".⁵ This course found no US guideline line on when a lay rescuer stops, so its reading for a US reader is the same: keep going until the crew takes over or the call-taker tells you to stop. Either way, you don't stop when you hear the siren. You stop when someone with the kit says they have it.

Lesson 1 gave you the law for that moment. RCUK's booklet on CPR and the law says it wouldn't be reasonable for an unqualified person to act once a professional rescuer has arrived and offered to help, though you may keep helping under their direction.²⁵ That is general information, not legal advice, and the law differs by state and by country.

The crew will ask questions, and some of the answers only you have. Lesson 2's call gave the call handler location, what happened and a number to call back. At the handover, this course's own list, drawn from the lessons you've done, is:

• What you saw, in order, with times if you have them: when they collapsed, when CPR started, when the AED shocked.
• Anything with a clock on it. The time a tourniquet went on, which RCUK says to write down (lesson 9); the time of an adrenaline dose (lesson 13); when sugar went in, or when a seizure started and stopped (lesson 14).
• Anything you gave or they took: the naloxone, the aspirin, the inhaler, the auto-injector.
• What you were told, even if you weren't sure what to make of it: "he has a heart condition", "she took some tablets", "he has a DNR".

The NHS's list for while you wait includes gathering the person's medicines, and "call 999 again if the person's condition changes".²⁶ 911.gov's line holds all the way through: "Do not hang up until the call-taker instructs you to do so."²⁶

Now the DNACPR question, again. Lesson 1 quoted RCUK's booklet: in England and Wales, if a legally binding advance decision or a DNACPR recommendation becomes known, it should be respected, and the booklet says first that "in the real world, it’s very unlikely that a rescuer acting in an emergency would be aware of any such advance decision".²⁵ It gives no instruction for a rescuer who is unsure. Lesson 1's reading, which is this course's and not the booklet's, was that being told about one is not the same as knowing it's in place, so unless you have been shown it, you carry on and tell the call handler.

Suppose someone hands you a form. The booklet does not say what a rescuer should do with one, and this course cannot tell you from a page whether a form is valid. Its reading, not the booklet's: tell the call handler about it, do what they tell you, and give the form to the crew. RCUK's 2025 ethics guidance, written about clinical teams, puts the final decision in an emergency with the treating team, and names ReSPECT forms (a UK form that records someone's wishes about emergency care) among the documents that should be easy to find.³ This course read nothing on US DNR or POLST forms, so it makes no claim about them.

The BHF's page for people who have given CPR says what happens next in the UK: paramedics take over, the police often come too, sometimes first, and the crew takes the person to hospital; if you know them, you'll have been asked to go there.⁶

Afterwards: what you may feel

That was a scientific statement, the AHA's name for an expert review of research that informs guidelines without making recommendations; this course read the AHA's announcement of it, not the statement itself.⁸ The feelings it lists are exhaustion, guilt, flashbacks, trouble sleeping, self-doubt, anger, sadness and fear.⁸ The BHF's page gives a similar list: shock, ups and downs, anxiety or flashbacks, blaming yourself, wanting to be alone more than usual, feeling numb or hopeless, and physical signs such as nightmares, tiredness, a racing heart and trouble concentrating.⁶ It says there's no right or wrong way to feel, and that most people feel better in time.⁶

RCUK's 2025 guidelines and the ERC's guide for the public now both say lay rescuers may need support afterwards and that systems should offer it, though neither sets out what it should be, and this course found no US guideline recommendation on it.²³⁵

"If they died, I did it wrong"

This is the thought the BHF's page is written for. Its clinical psychologist says guilt is very common after CPR, especially if the person does not survive, and that it comes as a string of what ifs: longer, sooner, hands somewhere else.⁶ His answer is that many things decide the outcome, not only the CPR.⁶ The BHF names three: the cause of the arrest, how long it was before CPR or a defibrillator started, and the type of arrest rhythm, and it says some people do not survive even when the CPR is done by a health professional.⁶

Lesson 4 gave you the numbers behind that. About one person in ten survives a cardiac arrest outside hospital, in the US to discharge and in England to 30 days. Lesson 5 showed that an AED shocks only some rhythms, and lesson 4 that CPR mostly keeps a chance alive rather than restarting a heart. So most people in cardiac arrest die, whoever gives the CPR. That is not a finding about the rescuers. The same lesson's registries showed that bystander CPR goes with better survival: what you did raised a chance that was always going to be small.

Mental Fitness lesson 7 has the other half: after a potentially traumatic event, about two thirds of people in the studies it reviewed stayed roughly steady, and the rest took other courses, including doing badly for a while and then recovering.

Where to get support

These are support lines, not emergency numbers. Each country's own list, from the pages this course read:

In the US:

• 988, the Suicide and Crisis Lifeline (988lifeline.org), by call, text or chat. Its page says it is for everyone, including for mental health struggles and emotional distress, free, confidential and open 24/7/365.⁹ Some older pages still show the Lifeline's previous ten-digit number; 988 is the one to use.
• Your own doctor, which is this course's suggestion. The AHA's announcement says lay responders may need support and resources to help process what happened, and calls debriefing and post-event support important tools; this course read no US list of services for rescuers.⁸

In the UK:

• The BHF Heart Helpline, 0808 802 1234, freephone, cardiac nurses on weekdays 9am to 5pm; RCUK's support page says they offer a place to share your experience.⁶⁷
• Your GP, if the feelings do not go away or get worse (the BHF), or if they are significantly affecting your quality of life (RCUK).⁶⁷
• Samaritans (samaritans.org), 116 123, free from any phone, any time; the BHF also names Mind, 0300 123 3393.¹⁰⁶
• In Scotland, Chest Heart and Stroke Scotland's advice line, 0808 801 0899 (RCUK's page).⁷
• Your local ambulance service, which the BHF says may be able to talk to you about the event.⁶

The BHF's practical suggestions are the ordinary ones, and it offers them as tips, not treatment: talk to friends or family, ask your work for time off, do things you enjoy, and ask the doctors and nurses looking after your loved one, or your GP, for help.⁶ If you know someone who gave CPR, the same psychologist's advice is to ask how they are feeling, listen, and ask again later, because they may not want to talk in week 1 but may in week 5.⁶

If what you feel ever turns into thoughts of harming yourself, that's the next section's subject, for you as much as for anyone else.

Someone in crisis

This part of first aid is new. The ERC's 2025 first aid chapter added suicidal thoughts, with a short set of steps; RCUK's 2025 first aid guideline adapted them for the UK.⁴¹ Neither ILCOR's 2025 first aid review nor the AHA/Red Cross 2024 guideline has a topic on it, so there is no US first aid guideline to set beside it.²⁴ What this section teaches is the European and UK first aid response, and where to point someone in each country.

The ERC's evidence text opens with the scale: "About 720,000 people die worldwide from suicide every year."⁴

The steps

RCUK 2025 First aid, "Suicidal thoughts";¹ ERC 2025 First Aid, concise guidance.⁴ The RCUK column and the ERC's summarising step are this course's paraphrase; the ERC's quoted steps are its own words. Rows line up by topic, not by the ERC's own order.

The two agree on the hinge: a plan, or a threat, means you get help now. RCUK's version adds a route for the person who is not at that point, and the ERC's adds hope. In the US, the same hinge lands on two numbers: 911 for someone in immediate danger, and 988, the Suicide and Crisis Lifeline, whose page says it is for everyone and for helping a friend or loved one too.⁹ That US mapping is this course's, drawn from the European steps and the 988 page, not from a US guideline.

Both texts tell you to ask about suicidal thoughts in so many words. People often worry that asking puts the idea in someone's head. This course read no study on that question either way, so it makes no claim about the effect of asking. It does report what the ERC's evidence text says about talking: talking through suicidal thoughts "may decrease the risk of suicide".⁴ Keep the "may".

Mental Health First Aid is a course built for exactly this role. A 2018 review of 18 controlled trials with 5,936 people, by Morgan and colleagues, found small to moderate improvements in knowledge and in confidence and intentions to help, lasting up to six months, with effects at a year unclear; a small increase in the amount of help trainees later gave; and no clear change in the quality of that help.¹¹ The authors declare that they have collaborated with the programme's founders.¹¹ The ERC's evidence text reports two meta-analyses finding that such training raises knowledge and reduces stigma, and a Cochrane review that could not show long-term effects; this course didn't read the Cochrane review itself.⁴ So the course teaches the steps and makes no promise about what a course in them does to outcomes.

Mental Fitness carries this box on every lesson, and here it is word for word:

The text at midnight

In Aberystwyth, just after midnight, Carys gets a message from her friend Gethin: "don't really see the point of any of it any more. sorry. ignore me." She's in Wales, so RCUK's steps apply.

1. Don't ignore it. She calls him. If he won't pick up, she texts back that she's worried and wants to talk. If he still does not answer and she thinks he may be in danger, that is a 999 call with his address. RCUK's steps do not cover a person you cannot reach, so that's this course's reading, from the callout above. RCUK's first step, once they are talking, is to ask if he's all right, how he feels and why.¹

2. Ask directly. When he answers, she asks, in plain words, whether he's thinking about killing himself (RCUK 2025; ERC 2025: "Ask if the person has suicidal thoughts and plans").¹⁴

3. Assess the risk. He says he has thought about it a lot lately. She asks whether he has thought about how, or when. He says no, not really, he just feels flat and exhausted.

Carys's job was to ask, listen, judge whether this is an emergency, and connect Gethin to someone who can help. It was not to treat his low mood, and it was not to keep a secret that stops her calling. Mental Fitness covers what happens next: its lesson 1 on where ordinary low mood ends and its routes to help, and its lesson 9 on when a question stops being a self-help one.

How fast a skill fades

Lesson 3 gave you one sentence from a 2019 review of 34 studies of lay people. Its summary says more.

The rest of their summary:¹²

• The fade. "Skills deteriorated within 3 months, then plateaued from 3 to 6 months."
• Training helps. Training improved skills compared with none, and any previous training went with better skills than none.
• Their advice. Every lay person should do an instructor-led session with feedback, real-time or afterwards, and should refresh the skill, with the focus on skills and confidence rather than knowledge, every 3 to 6 months, "although this timeframe needs further validation".

The review covered 34 studies and 35,421 participants, but this course read only its abstract, so it can't say what "deteriorated" means in centimetres or compressions a minute.¹² And the review gives no mechanism for why knowing and doing come apart. This course will not supply one. What it can offer is a connection, labelled as such: How to Learn Anything lesson 1 separated how well something is stored from how easily you can get at it right now, and its lesson 7 built practice around a specific drill and a source of feedback. Riggs's advice reads like that lesson, applied to CPR.

What keeps the skill

A short course can work. In the American Airlines study, Roppolo and colleagues randomised lay people to a 30-minute course or the multi-hour Heartsaver AED course. At six months, the 30-minute group was "either equivalent or superior" on every measure; 84% still performed CPR adequately overall, 93% did compressions adequately, and 93% used the AED correctly.¹³ It's one trial, and this course read only its abstract, but it's why a short refresher is not second best.

Feedback matters. ILCOR's 2025 training review: "We recommend the use of CPR feedback devices during resuscitation training for health care professionals and laypersons (strong recommendation, moderate-certainty evidence)."¹⁵ The AHA's 2025 education guideline agrees: "Feedback devices are recommended for use during CPR training for lay rescuers." (AHA 2025, COR 1, LOE A).¹⁶

So does spacing. The AHA: "It is reasonable to use a spaced learning approach in place of a massed learning approach for resuscitation training." (AHA 2025, COR 2a, LOE B-R), and where a course is taught in one block, "It is recommended to implement booster sessions when utilizing a massed learning approach for resuscitation training." (COR 1, LOE B-R).¹⁶ Behind the spacing question, an ILCOR systematic review by Yeung and colleagues found 15 of 17 studies favoured spaced learning, but "overall certainty of evidence was rated as very low", and it found too little data to compare how well spacing works for lay people against health professionals.¹⁴ So the AHA backs spacing and boosters, the review under the question rates its own evidence very low certainty, and neither says much about lay people.

Then there's the cushion. RevivR's cushion is what lesson 3 used, and the AHA has a line about it: "The usefulness of alternative objects to train laypeople in chest compressions, when compared to a manikin, is not well established." (AHA 2025, COR 2b, LOE C-LD).¹⁶ Lesson 4's key reads that as weak and on limited data: not "don't", and not "as good as". A cushion keeps the rhythm and the routine alive between classes. A manikin that measures depth is where you find out whether the push is right.

How often, by body and year

The certificates run two or three years, three bodies say every year, and Riggs's review suggests every 3 to 6 months. None is wrong: a certificate's lifetime is an employer's rule, and the evidence on how fast hands forget is what Riggs found. This course's reading of the table: the certificate tells you when a workplace wants you retested, not when your hands need practice, and the only interval here that comes from a review of skill decay is the shortest.

Some readers learned CPR at school. At the end of 2024, "84% of states require students to have CPR/AED training", according to a 2025 US study whose abstract this course read, and England's statutory health education has included "Life-saving skills, including how to administer CPR." for secondary schools since 2020.²³ A school lesson from before late 2025 taught the earlier guidance, so the audit below applies to it too.

Where to train

Lesson 1 promised the list, with what each option does and does not give you.

In the US:

• The American Red Cross (redcross.org/take-a-class) offers three formats. Its page says the online-only course has no demonstration of skill proficiency and gives a two-year certificate of completion that may not meet workplace requirements; the blended course is online work followed by showing your skills to an instructor; and the in-person class combines teaching with hands-on sessions. It says the last two satisfy OSHA workplace requirements.¹⁸
• The AHA's Heartsaver courses come in classroom, blended and self-guided forms, which "result in the same AHA Course Completion Card", with a hands-on skills session for anyone who starts online.¹⁹ This course could not read the AHA's course finder.
• Stop the Bleed, from the American College of Surgeons, runs a free online course, and its training page says in-person instructors check your movements until you show the three bleeding-control skills, and its FAQ says: "The skills portion of the ACS Stop the Bleed course is still an in-person requirement to complete the course and receive a certificate."²¹

In the UK:

• The British Red Cross (learn first aid) runs free workshops for adults and for young people aged 10 to 19, online and face-to-face, and says plainly: "These free workshops do not give you a first aid qualification, but equip you with basic skills".²⁰
• St John Ambulance lists free first aid awareness sessions on its website; this course did not read those pages, only the listing.²⁰
• Workplace courses follow HSE's syllabus: Emergency First Aid at Work in one day, First Aid at Work in three, with practical skills assessed in person (lesson 1).¹⁷

Across Europe, the ERC works through national resuscitation councils, and its European Restart a Heart Day falls on 16 October; the ERC says more than 12 million people were trained in its World Restart a Heart campaign between 2018 and 2023.⁵

Free, at home, anywhere:

• The BHF's RevivR: "In just 15 minutes", with a cushion and your phone's camera for feedback on your compressions, a simulated 999 call and the AED; it gives you a certificate at the end.²²
• RCUK's Lifesaver: an interactive film with "four action-packed scenarios", which ends by offering to sign you up as a GoodSAM volunteer responder, the kind of app-alert scheme lesson 5 described.²²
• The British Red Cross and American Red Cross first aid apps, which lessons 10 and 11 pointed to.

This course's summary of the pages above. Nothing in the right-hand column is a reason not to do the thing on the left.

ILCOR's 2025 review suggests either instructor-led or self-directed digital training for learning CPR and AED skills, and digital training where a class isn't accessible, which lesson 1 quoted in full; the AHA's 2025 education guideline says "A blended learning educational approach may be considered for teaching guideline-based life support courses." (AHA 2025, COR 2b, LOE B-NR).¹⁵¹⁶ HSE wants practical skills seen in person.¹⁷ That is the online-against-in-person question, and it is still contested. ILCOR's own justification carries the caution that what training builds in simulation "may not translate to real-life situations".¹⁵

One more thing to have ready: a kit. RCUK's 2025 first aid guideline says homes and cars, as well as workplaces and public buildings, should have one suited to the setting and its likely risks, and checked regularly (RCUK 2025); this course read no kit list, so it does not print one.¹

How the guidelines are made and changed

Every label in this course carried a body and a year, and this is why.

It starts with the evidence. ILCOR, the international committee, runs systematic reviews and publishes its Consensus on Science with Treatment Recommendations, the CoSTR. RCUK's 2025 executive summary describes its guidelines as the result of a continuous four-year process led by ILCOR, using GRADE to rate the certainty of evidence and the strength of recommendations, with members of the public and survivors among the people consulted.³ The ERC's guide for the public says ILCOR publishes yearly summaries of the evidence and that where the evidence is missing or too thin, experts give advice from clinical experience.⁵ That last part is the good practice statement you met in lesson 4.

Then the national bodies write their own guidelines. The ERC has updated its guidelines every five years since 2000; RCUK adapts the ERC's for the UK, and its executive summary says it intends to change within the five-year cycle only for a significant intervention, found through ILCOR's process, that affects outcome to a significant degree. Its 2025 guidelines were to reach courses from January 2026.⁵³ The US pattern read here has more steps between the big years: the AHA/Red Cross 2024 first aid guideline says it supersedes the 2015 guideline and the focused updates of 2019 and 2020.²⁴

Guidelines are fixed after publication too. Lesson 7 met one: in September 2026 an erratum changed the ERC's line on naloxone in cardiac arrest to "Naloxone is probably not effective once cardiac arrest occurred. However, this should be investigated in a large clinical trial."²⁷

Last, the pages most people read catch up, each on its own review schedule. This course named several that hadn't yet, each in the lesson it belongs to: the BHF's CPR page on hands-only CPR "since the Covid-19 pandemic" (lesson 4); St John's page on moving someone from a bed to the floor (lesson 3); the NHS, British Red Cross and American Red Cross pages still showing two fingers for a baby (lessons 6 and 8); the NHS cuts page on raising the limb (lessons 9 and 10); the American Red Cross's nosebleed page, with a shorter pinch than the guideline it co-wrote (lesson 10); and the ERC's own guide for the public, with a different figure for what each minute before a shock costs (lesson 5). Pages lag because they are reviewed on their own timetables, and several of these were reviewed months before October 2025.

The 2025 changes, as a case study

• Adult choking, US (lesson 8). Before: the AHA's previous guidelines had no adult choking guidance, and its earlier guidance for children was abdominal thrusts only. In 2025: 5 back blows, then 5 abdominal thrusts, repeated (AHA 2025, COR 1, LOE B-NR).
• A baby's chest compressions, US (lesson 6). Before: two fingers was one of the AHA's techniques. In 2025: two fingers removed; one hand or two thumbs (AHA 2025, COR 1, LOE B-NR).
• The call, UK and Europe (lesson 2). Before: confirm abnormal breathing, then call. In 2025: "Call 999 for any unresponsive person. Rescuers no longer need to confirm abnormal breathing before calling." (RCUK 2025)
• COVID-19 changes, UK and Europe (lesson 4). Before: modified CPR during the pandemic. In 2025: "COVID-19 patients should be treated as any other patients. Modifications to CPR are no longer required." (ERC 2025)
• Suction choking devices (lesson 8). Before: ILCOR 2020 suggested against routine use. In 2025: ILCOR made no recommendation either way, and RCUK, in 2026, none either way.

Each as the named lesson taught it, with its sources there.

Look at what moved. None of the core adult numbers did: 100 to 120 a minute, 5 to 6 cm, 30:2 for the trained. What changed was at the edges, where the evidence was thinnest, and in the choking change the AHA's stated reasons were one cohort study, case reports of injury from thrusts, and consistency, one sequence taught for every age.

Checking an instruction yourself

Here's a first aider's notebook, checked against 2025.

Maureen is a warehouse first aider in Doncaster. Her Emergency First Aid at Work certificate is from 2021, which HSE's three-year rule has already timed out, and her notes from the course say:

1. "Unresponsive: check breathing for up to 10 seconds, then call 999."
2. "CPR: 30 compressions, 5 to 6 cm, 100 to 120 a minute, then 2 breaths if trained."
3. "Covid: hands-only, and keep your face away."
4. "On a bed: move them to the floor first."
5. "Baby: two fingers on the chest."

Take them one at a time, asking the course's question of each: which guideline, which year, and how strongly?

1. Changed. RCUK 2025 puts the call first, for anyone unresponsive, and the breathing check while the call connects (lesson 2). Her note is the old order.

2. Unchanged. RCUK 2025 gives the same numbers and 30:2 for the trained (lessons 3 and 4). The US and UK agree on them.

3. Changed. The ERC and RCUK withdrew the COVID modifications in 2025 (lesson 4). It's the BHF page in the list above that still says otherwise.

4. This one is yours.

5. Changed. The ERC's 2025 paediatric chapter: "The two-thumbs encircling technique for chest compressions in infants is recommended for all situations."; its 2021 version allowed two fingers for a lone rescuer.⁴ One of her five notes is still right as written and four need relearning, and her certificate needs renewing anyway. That's a good reason to book the class rather than just re-read her notes: the class will teach the 2025 versions with her hands on a manikin.

If Maureen had trained in Ohio, the audit would run the same way against the AHA. Note 5 changed there too: the AHA removed two fingers in 2025 (one hand or two thumbs, COR 1, LOE B-NR; lesson 6). Note 4 comes out closer to her old version, since the AHA prefers a firm surface when getting there does not delay compressions (AHA 2025, COR 2a; lesson 3).

The method is the same for anything you meet. Find who says it, a guideline or a page; find the year, or the page's review date; find the grade, if there is one; and look for anything newer from the same body. The places to look are the bodies' own sites, ILCOR's CoSTR pages, RCUK's guidelines and the AHA's, and, simplest of all, your instructor at your next class.

The course's question, and the institute's sort

Every course here sorts its claims three ways: established, contested, and questions of value. This course's question was which guideline, which year, and how strongly. The two fit together.

• Established, and stated plainly: the adult CPR numbers everyone agrees on (lesson 3); that bystander CPR goes with better survival, as an association in registries (lesson 4); that doing something beats doing nothing, which lesson 4 called the finding under almost every weak grade.
• Contested empirical: the places where two bodies weigh thin evidence and land differently. Five breaths or compressions first for a child (lesson 6), 20 minutes or 5 to 20 for a burn (lesson 10), the second adrenaline dose (lesson 13), online against in-person training (above). A weak grade and a US/UK difference are usually the sign you're here. Neither side is wrong, and the course followed the country you're in.
• Value: questions no study can settle. Whether the law should make you help (lesson 1), and whether everyone ought to learn CPR. The course described those and didn't answer them.

The course project

The project, "Your household's first ten minutes", is listed with the final test on the course page, and its brief has the details and the rubric. The first exercise below is its fourth part.

What people get wrong

"Once trained, always trained." Skills fell within 3 months in Riggs's review, and knowing the numbers didn't go with doing them well.¹²

"An online course is the same as a class." ILCOR suggests either for learning the skill, on weak, very low certainty evidence; HSE wants practical skills assessed in person; the American Red Cross's online-only course has no skills check.¹⁵¹⁷¹⁸ Which is better is contested. That feedback devices help in training isn't: ILCOR's recommendation is strong.¹⁵

"If they haven't got a plan, there's nothing to do." RCUK's step when those warning signs are not there is still to listen without judging and encourage professional or other support.¹

"If they died, I did it wrong." Most people given CPR by anyone do not survive; the BHF names the cause, the delay and the rhythm as reasons.⁶

"A certificate from years ago means I'm current." A certificate's life is a workplace rule; the 2025 guidelines changed several things a 2021 course taught.¹⁷

Practice

Connections

The case study and the audit used every lesson's labels. Lesson 4's grading key and survival figures carried the aftermath section, and lesson 2's call handler is the person you talk to until the crew takes over.

From earlier on the Core, Mental Fitness holds the crisis numbers and everything after first aid's part. How to Learn Anything taught spacing, and Memory what forgetting looks like when someone plots it; this lesson asked the same questions of a skill in your hands, where knowing turned out not to predict doing. Habits and Self-Discipline lesson 3, on what a cue does that motivation does not, is worth rereading before you set a refresher date.

Later on the Core, Medical Literacy will take the grading key further, and Teaching and Mentoring can assume skill decay and feedback as the reason practice is spaced.

Go deeper

• British Heart Foundation, Support after you've given CPR, updated November 2025. Read in full here. Plain, practical and specific, for anyone who has given CPR or knows someone who has.
• Resuscitation Council UK, 2025 Guidelines: executive summary. Read in full here. One page on what changed in 2025, how the guidelines were made, and when the next ones are due.
• Riggs, Franklin and Saylany, "Associations between CPR knowledge, self-efficacy, training history and willingness to perform CPR and CPR psychomotor skills", Resuscitation, 2019. The abstract is read here; worth finding for the whole review if you teach, or plan to.
• European Resuscitation Council, The ERC Guidelines 2025 on Resuscitation for Everyone. Its ethics, education and systems sections and its page on how the guidelines are made are read here. The guidelines in plain words, from the body that writes them.

Sources

1. Resuscitation Council UK, 2025 Resuscitation Guidelines: First aid, 27 October 2025 . Read level: full, direct; the suicidal thoughts, kits, courses and cardiac arrest sections re-read on 2026-09-25.
2. Resuscitation Council UK, 2025 Resuscitation Guidelines: Adult basic life support, 27 October 2025 . Read level: full, direct; the safety section re-read on 2026-09-25.
3. Resuscitation Council UK, 2025 Resuscitation Guidelines: Executive summary of the main changes, 27 October 2025 . Read level: full, direct; re-read on 2026-09-25.
4. T. Djärv, J. Rogers, F. Semeraro and colleagues, "European Resuscitation Council Guidelines 2025 First Aid", Resuscitation 215 (suppl 1), 2025, 110752, and the ERC 2025 Paediatric Life Support chapter's summary of changes . Read level: full, direct, at the publisher for the first aid chapter; partial (the summary of changes table), at the publisher for the paediatric chapter. The Cochrane review the first aid chapter reports was not read.
5. European Resuscitation Council, The ERC Guidelines 2025 on Resuscitation for Everyone, December 2025 . Read level: the ethics, education and systems sections, direct; the adult CPR pages, and the pages on how the ERC develops its guidelines and on survivors, read on 2026-09-25.
6. British Heart Foundation, "How to do CPR", undated, and "Support after you've given CPR", updated 1 November 2025 . Read level: full, direct, both read on 2026-09-25.
7. Resuscitation Council UK, Support after cardiac arrest and Responder and bystander wellbeing. **Read level: full, direct**, on 2026-09-25.
8. American Heart Association Newsroom, "Lay rescuers who do CPR are heroes and survivors, new statement addresses their perspective", 21 March 2022, announcing K. N. Dainty and colleagues, "Understanding the Importance of the Lay Responder Experience in Out-of-Hospital Cardiac Arrest", Circulation, 2022. **Read level: the news release in full, direct; the scientific statement itself not read.**
9. 988 Suicide and Crisis Lifeline, home page . Read level: full, direct, on 2026-09-25.
10. Samaritans, Contact a Samaritan. **Read level: full, direct**, on 2026-09-25.
11. A. J. Morgan, A. Ross and N. J. Reavley, "Systematic review and meta-analysis of Mental Health First Aid training: effects on knowledge, stigma, and helping behaviour", PLoS One 13(5), 2018, e0197102 . Read level: abstract only (PubMed 29851974), with its conflict of interest statement, re-read on 2026-09-25.
12. M. Riggs, R. Franklin and L. Saylany, "Associations between cardiopulmonary resuscitation (CPR) knowledge, self-efficacy, training history and willingness to perform CPR and CPR psychomotor skills: a systematic review", Resuscitation 138, 2019, pp. 259 to 272. **Read level: abstract only** (PubMed 30928504), re-read on 2026-09-25.
13. L. P. Roppolo, P. E. Pepe and colleagues, "Prospective, randomized trial of the effectiveness and retention of 30-min layperson training for cardiopulmonary resuscitation and automated external defibrillators: the American Airlines Study", Resuscitation 74(2), 2007, pp. 276 to 285. **Read level: abstract only** (PubMed 17452070).
14. J. Yeung, T. Djarv, M. J. Hsieh and colleagues, "Spaced learning versus massed learning in resuscitation: a systematic review", Resuscitation 156, 2020, pp. 61 to 71. **Read level: abstract only** (PubMed 32926969), re-read on 2026-09-25.
15. R. Greif and colleagues, "Education, Implementation, and Teams: 2025 ILCOR CoSTR", Circulation 152 (suppl 1), 2025, pp. S205 to S249, doi 10.1161/CIR.0000000000001359. Internet Archive capture 20260430180745. **Read level: Wayback, direct (recommendation sections read; evidence tables skimmed).** EIT 6404 and 6406.
16. A. J. Donoghue and colleagues, "Part 12: Resuscitation Education Science: 2025 American Heart Association Guidelines", Circulation 152 (suppl 2), 2025, doi 10.1161/CIR.0000000000001374. **Read level: the recommendation tables on feedback devices, alternative training objects, blended learning, and booster and spaced learning, from the publisher's table images**; no archived copy exists.
17. Health and Safety Executive, First aid at work, L74, 3rd edition 2013, amended 2018 and 2024 . Read level: full, direct (PDF). Paragraphs 62, 74 and 75.
18. American Red Cross, Take a Class, Internet Archive capture 20260917080331, and "First Aid Steps". **Read level: the class-formats panel, from the capture, on 2026-09-25; First Aid Steps full, direct.**
19. American Heart Association, "Heartsaver First Aid CPR AED Course Options", Internet Archive capture 20260422003426 of cpr.heart.org . Read level: Wayback, direct.
20. British Red Cross, Learn first aid. **Read level: full, direct**, re-read on 2026-09-25. [St John Ambulance](https://www.sja.org.uk/)'s free sessions: its site navigation only, re-read on 2026-09-25.
21. American College of Surgeons, Stop the Bleed training and interactive course, with its FAQ. Read level: full, direct; the training page read on 2026-09-25.
22. British Heart Foundation, RevivR, and Resuscitation Council UK, Lifesaver. **Read level: full, direct**, both re-read on 2026-09-25.
23. C. M. Eason, G. Frey, W. M. Adams and colleagues, "CPR/AED training state requirements for US high school students and athletic coaches", Journal of Public Health Management and Practice 31(6), 2025, E379 to E386, read level: abstract only; and Department for Education, Relationships Education, Relationships and Sex Education (RSE) and Health Education, statutory guidance, read level: full, direct (the first aid sections).
24. E. K. Hewett Brumberg, M. J. Douma and colleagues, "2024 American Heart Association and American Red Cross Guidelines for First Aid", Circulation 150, 2024, e519 to e579. **Read level: full, direct, from the Internet Archive capture 20260329073336**, for all prose. It has no section on suicidal thoughts; ILCOR's 2025 first aid CoSTR (Part C S2) has none either.
25. Resuscitation Council UK, Cardiopulmonary resuscitation, automated defibrillators and the law, April 2018. **Read level: full, direct (pp. 1 to 13 closely; remainder skimmed).**
26. NHS, When to call 999, read level: full, direct; and 911.gov, "Calling 911", Internet Archive capture 20260907153825, read level: Wayback, direct .
27. European Resuscitation Council, Corrigendum to the ERC Guidelines 2025 First Aid, Resuscitation 228, November 2026, 111316 . Read level: full, at the publisher.