CHAPTER 26 DELAYING DEFIBRILLATION FOR CPR IN CARDIAC ARREST

Delaying Defibrillation to Give Basic Cardiopulmonary Resuscitation to Patients With Out-of-Hospital Ventricular Fibrillation: A Randomized Trial

Wik L, Hansen TB, Fylling F, et al. JAMA. 2003;289(11):1389–1395

BACKGROUND

Immediate defibrillation was considered standard treatment for patients with out-of-hospital cardiac arrest (OHCA) secondary to ventricular fibrillation (VF). Two small studies, one dog model and one nonrandomized human trial, had suggested that prolonged VF was more responsive to defibrillation if CPR and epinephrine had been administrated prior. Understanding this, there was a need to assess the benefit of early defibrillation with a randomized clinical trial in human subjects.

OBJECTIVES

To determine the efficacy of CPR before defibrillation in patients with VF.

METHODS

Nonblinded, randomized trial in an Emergency Medical Services (EMS) system of Norway.

Patients

Two hundred patients, age >18, with out-of-hospital VF or pulseless ventricular tachycardia (VT) in whom the ambulance personnel had not witnessed the cardiac arrest.

Intervention Evaluated

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