No major overall change from the 2021 edition
Singapore Medical Journal published Singapore Basic Cardiac Life Support and Automated External Defibrillation Guidelines 2026 in July 2026. This is a guideline describing Singapore’s BCLS and AED procedures, not a clinical study of a specific patient group.
Compared with the 2021 guideline from the Singapore Resuscitation and First Aid Council (SRFAC), there are no major changes to CPR performance overall. Changes were made to paediatric CPR and foreign body airway obstruction in conscious adults and children.
- The paediatric compression-to-ventilation ratio is presented as 15:2, replacing the previous use of 30:2 or 15:2.
- For infant chest compressions, either the two-thumbs-encircling technique or the one-hand method is recommended.
- Back blows have been reintroduced into the algorithm for conscious adults and children with foreign body airway obstruction.
Gasping may be a sign of cardiac arrest
The guideline describes recognition of cardiac arrest as one of the most difficult parts of BCLS education and assessment. Studies cited in the guideline found gasping in up to 40% of patients during the early phase of sudden cardiac arrest.
Lay rescuers and healthcare providers should learn to recognize gasping as a sign of cardiac arrest rather than normal breathing and begin CPR immediately. If a person is unresponsive and normal breathing is absent or uncertain, cardiac arrest should be presumed. A brief seizure may also occur at the onset; once it stops, responsiveness and normal breathing should be checked and CPR started if breathing is absent or uncertain.
Dispatcher-assisted CPR and myResponder
Dispatcher-assisted CPR (DACPR) is associated with higher bystander CPR rates and better survival after cardiac arrest. When callers report an unresponsive person with absent or abnormal breathing, Singapore’s call-takers instruct them to stay on the line and provide CPR guidance.
For adults, instructions focus on compression-only CPR; for paediatric arrests, chest compressions with ventilation are advised. Singapore’s myResponder app alerts community first responders within 400 metres and guides them to retrieve the nearest AED while going to the scene.
Why compression-only CPR is emphasized for lay rescuers
The guideline notes that most sudden out-of-hospital cardiac arrests occur in adults and are cardiac in origin. Because oxygen remains in the blood for the first few minutes, uninterrupted chest compressions are more important than rescue breaths at the start. Two observational studies cited in the guideline found improved adult out-of-hospital cardiac arrest survival after compression-only CPR was introduced in the community.
In a Singapore study, only 14.9% of participants trained in mouth-to-mouth ventilation could perform at least five effective ventilations of 400 mL or more six months later, and 3.7% could perform at least ten within five minutes. Another 14.9% only mimicked the ventilation. SRFAC therefore recommends that lay-rescuer CPR training focus on recognizing cardiac arrest, calling an ambulance, and delivering high-quality manual chest compressions.
Public access defibrillator programmes remain a priority
The 2025 ILCOR Consensus on Science with Treatment Recommendations strongly recommends public access defibrillator (PAD) programmes. The guideline reports that studies in residential areas, airports, subways, casinos, and sports facilities associate PAD programmes with improved out-of-hospital cardiac arrest survival.
In Singapore, the Singapore Heart Foundation and Singapore Civil Defence Force provide an AED owner’s guide covering AED use, training, installation, and maintenance.
What Korean readers should distinguish
The 995 emergency number, call-taker breathing checks, myResponder app, and course arrangements reflect Singapore’s system. In Korea, the latest Korean CPR guidelines and emergency medical system apply.
The way Singapore connects cardiac-arrest recognition, immediate dispatcher guidance, community first responders, AED access, and repeatable layperson training is nevertheless a useful point of reference for Korean educators. This is INNOSONIAN’s editorial interpretation based on the guideline.
For training use
This article introduces key changes and re-emphasized points in the Singapore guideline; it does not replace Korean medical guidance. Follow the latest local guidelines and advice from emergency medical professionals in training and real emergencies.
Paper information
Swee Han Lim, Benjamin Sieu-Hon Leong, Jun Hao Loke, Kee Chong Ng. Singapore Basic Cardiac Life Support and Automated External Defibrillation Guidelines 2026. Singapore Medical Journal. 2026;67(7):406–413.
- PubMed · PMID 42507342
- DOI: 10.4103/singaporemedj.SMJ-2026-319
