Defibrillation Plus CPR: A Critical Combination

Defibrillation Plus CPR: A Critical Combination

Early defibrillation is critical to survival from sudden cardiac arrest (SCA) for several reasons

the most frequent initial rhythm in out-of-hospital witnessed SCA is ventricular fibrillation (VF),

the treatment for ventricular fibrillation is defibrillation,

the probability of successful defibrillation diminishes rapidly over time,

and VF tends to deteriorate to asystole over time.

For every minute that passes between collapse and defibrillation, survival rates from witnessed VF SCA decrease 7% to 10% if no CPR is provided.

When bystander CPR is provided, the decrease in survival rates is more gradual and averages 3% to 4% per minute from collapse to defibrillation.

CPR can double or triple survival from witnessed SCA at most intervals to defibrillation.

If bystanders provide immediate CPR, many adults in VF can survive with intact neurologic function, especially if defibrillation is performed within 5 to 10 minutes after SCA.

defibrillation (shock success) is typically defined as termination of VF for at least 5 seconds following the shock.

VF frequently recurs after successful shocks, but this recurrence should not be equated with shock failure.

Shock success using the typical definition of defibrillation should not be confused with resuscitation outcomes such as restoration of a perfusing rhythm (ROSC), survival to hospital admission, or survival to hospital discharge.