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Survival after ventricular fibrillation (VF) arrest is usually less than 20%. Early cardiopulmonary resuscitation and early defibrillation are essential for successful resuscitation. The 2005 American Heart Association guidelines recommend eliminating the “stacked shock” concept incorporated in prior guidelines, consequently extending the interval of chest compressions. In anticipation of these guideline changes, the King County, Washington, emergency medical services (EMS) system implemented a new automated external defibrillator protocol. The protocol called for a single shock without rhythm reanalysis or post-defibrillation pulse check and extended the period of CPR between rhythm analyses from 1 minute to 2 minutes.
Hypothesizing that us…