Editor’s note: This article is in response to the story “Study examines effect of delayed defibrillation for CPR.” Challenging international guidelines, researchers concluded in a meta-analysis that it doesn’t matter whether or not EMTs do a few minutes’ CPR before defibrillation of cardiac-arrest patients. Read the full story and tell us what you think in the member comments.
By Art Hsieh, EMS1 Editorial Advisor
As many of you know, this year the emergency cardiac care community will be releasing new guidelines involving resuscitation.
The American Heart Association (AHA), along with the International Liaison Committee on Resuscitation (ILCOR) meet every five years to formally review the most current scientific studies and develop “best practice” guidelines for managing acute coronary events. During these times of transition, there is increased attention to related information involving this area.
This study is particularly interesting since it potentially contradicts the practice guideline of providing two minutes of CPR to an unwitnessed ventricular fibrillation cardiac arrest prior to defibrillation. This is a study that combines the data of several other studies and looks at it from a statistical viewpoint, a process called meta-analysis.
The researchers looked at several studies that compared the outcome of cardiac arrest patients who were immediately defibrillated, compared to those who received chest compressions for two minutes prior to a defibrillation attempt.
Their conclusion that there is little difference between delayed and immediate defibrillation is intriguing, and is another indication that we need to continue to expand our collective knowledge base.
Resuscitation of sudden cardiac arrest is one of the most intensive cases that EMS providers have to manage well, each and every time, in order to make a difference. Information like this helps us to optimize our approach.
Having been in the industry long enough to have administered sodium bicarbonate as a first line drug and perform CPR with a plunger device, I’m appreciative that we are using a more evidence-based approach toward our care.
Art Hsieh, MA, NREMT-P, is Chief Executive Officer & Education Director of the San Francisco Paramedic Association, a published author of EMS textbooks and a national presenter on clinical and education subjects.