Early defibrillation and the chain of survival in 'in-hospital' adult cardiac arrest; minutes count

Resuscitation. 2000 May;44(3):165-9. doi: 10.1016/s0300-9572(00)00158-1.


Objective: To report the outcomes from and the impact of the chain of survival in 'in-hospital' cardiac arrest where the presenting rhythm was VF/VT, the arrest was witnessed, defibrillation was conducted rapidly and no other resuscitation interventions were required.

Outcome measures: Any return of spontaneous circulation and discharge from hospital.

Methods: A 2-year prospective resuscitation audit using the Utstein style was conducted within a major London NHS Hospital Group.

Results: There were 124 patients who had primary VF/VT arrest. Eight were excluded from the study and 14 had non-witnessed cardiac arrest. Twenty one patients had witnessed VF/VT arrest but with delayed defibrillation, 81 patients had witnessed VF/VT arrest with rapid defibrillation, 69 patients had witnessed VF/VT arrest with rapid defibrillation, CPR and other additional interventions. There were 15 patients that had witnessed cardiac arrest with a presenting rhythm of VF/VT, who received rapid defibrillation and had no ventilation or chest compression prior to or following defibrillation. All 15 patients achieved a return of spontaneous circulation, and 12 were discharged alive.

Conclusions: Rapid defibrillation prior to any other resuscitation intervention is associated with increased survival from witnessed VF/VT arrest in in-hospital cardiac arrest victims, and that the time to first shock is critical in enhancing the prospects of long-term survival in these patients.

MeSH terms

  • Blood Circulation
  • Electric Countershock*
  • Heart Arrest / complications
  • Heart Arrest / mortality
  • Heart Arrest / therapy*
  • Hospitalization*
  • Humans
  • Medical Audit
  • Prospective Studies
  • Resuscitation
  • Tachycardia, Ventricular / complications
  • Time Factors
  • Ventricular Fibrillation / complications