OUT-OF-HOSPITAL CARDIAC arrest (OHCA) is a major public health problem, occurring
in 375 000 to 390 000 individuals in the United States each year.1 The rate of survival after OHCA has increased with advances in care via initiatives such as the American
Heart Association’s 5-step Chain of Survival.2 However, the rate is still low,
with recent estimates reporting 8% to 10%.3-5 Better survival has been associated
with the improvement in early access to emergency medical care, early
cardiopulmonary resuscitation (CPR),rapid defibrillation, and integrated post–
cardiac arrest care.6 Early advanced life support is often considered of benefit
in that it provides intravenous drug therapy and advanced airway management.