Dual sequential defibrillation11/2/2023 ![]() The provision of early CPR can triple the rate of survival from witnessed sudden cardiac arrest. Conventional manual CPR, combining chest compressions with rescue breathing, when done properly, can provide up to 33% of normal cardiac output and oxygenation. Cardiopulmonary Resuscitation (CPR) can provide temporary oxygenation and circulation until defibrillation becomes available. For untreated VF or VT, the likelihood of resuscitation decreases by up to 10% per minute. Untreated VF will rapidly deteriorate into asystole, from which resuscitation rates are dismal. While defibrillation is highly effective in treating VF and pulseless VT, its effectiveness is time-dependent. ![]() The clinical result is a sudden cardiac arrest. ![]() This produces a loss of normal ventricular contraction with the resultant cessation of cardiac output. The chaotic, dysrhythmic firing of multiple irritable myocardial foci in the ventricles causes fibrillation of the ventricles. It can also occur due to sudden interruptions to the cardiac impulse by events such as an electrical shock a blow to the chest (commotio cordis) premature ventricular contractions, especially the “R on T” type abnormal tachycardic rhythms such as ventricular tachycardia and syndromes such as QT prolongation. This can occur in the setting of coronary ischemia or acute myocardial infarction. Ventricular fibrillation occurs when the normal transmission of the cardiac impulse through the heart’s electrical conduction system is interrupted. This increased survival is due to defibrillation being performed closer to the onset of VF. In comparison, adult patients who develop cardiac arrest in a hospital have rates of survival to hospital discharge of up to 25.5%. When defibrillation is delayed, effectiveness is reduced by almost 10% per minute.Īdult victims of nontraumatic cardiac arrest who receive resuscitation attempts by emergency medical services have a rate of survival to hospital discharge of only 10.8%. Defibrillation is highly effective in terminating VF when performed as close to the onset of VF as possible. The definitive treatment for VF is to perform electrical defibrillation. In the adult patient, VF is the most common cause of sudden cardiac arrest. About half of these sudden deaths occur in the pre-hospital setting of these, almost three-quarters happen in the home, and half of these are unwitnessed. Heart disease remains the number one cause of death in both sexes. Under Advanced Cardiac Life Support (ACLS) guidelines, pulseless VT and VF are treated the same.Īccording to the Centers for Disease Control and Prevention (CDC), 610,000 deaths occur annually in the United States from heart disease. Cardiac defibrillation is the act of administering a transthoracic electrical current to a person experiencing one of the two lethal ventricular dysrhythmias, ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT).
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