achieved in casinos, where dedicated training of responders,
a confined environment, and numerous security cameras have
effected a mean time from collapse to delivery of shock of 4.4
minutes. A study of resuscitation in casinos reported survival
to hospital discharge rates of 74% if a shock was delivered
within 3 minutes of arrest.110 Survivors of an early defibrillation
program (applying an automatic external defibrillator immedi-
ately on arrival of emergency medical services) were reported to
have good quality of life and neurological outcome.111 The 2005
American Heart Association guidelines endorse rapid defibrilla-
tion, especially for inpatients, in which the goal is delivery of a
shock within 3 minutes of victim collapse.76 It is important to
remember, however, that performing chest compressions for 1.5
to 3 minutes before defibrillation in ventricular fibrillation
arrests actually shows a trend toward improved survival.112,113
CPR should therefore be initiated during automatic external
defibrillator retrieval and setup if more than 1 rescuer is present,
but defibrillation should be delivered immediately when the
equipment is ready
achieved in casinos, where dedicated training of responders,
a confined environment, and numerous security cameras have
effected a mean time from collapse to delivery of shock of 4.4
minutes. A study of resuscitation in casinos reported survival
to hospital discharge rates of 74% if a shock was delivered
within 3 minutes of arrest.110 Survivors of an early defibrillation
program (applying an automatic external defibrillator immedi-
ately on arrival of emergency medical services) were reported to
have good quality of life and neurological outcome.111 The 2005
American Heart Association guidelines endorse rapid defibrilla-
tion, especially for inpatients, in which the goal is delivery of a
shock within 3 minutes of victim collapse.76 It is important to
remember, however, that performing chest compressions for 1.5
to 3 minutes before defibrillation in ventricular fibrillation
arrests actually shows a trend toward improved survival.112,113
CPR should therefore be initiated during automatic external
defibrillator retrieval and setup if more than 1 rescuer is present,
but defibrillation should be delivered immediately when the
equipment is ready
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