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To examine the theory that a more perfused heart will respond better to defibrillation shock, researchers conducted a cluster-randomized study in 9933 patients with nontraumatic out-of-hospital cardiac arrest at 10 Resuscitation Outcomes Consortium sites in the U.S. and Canada. Patients were divided into two groups and received cardiopulmonary resuscitation (CPR) by emergency medical services (EMS) providers for either 30 to 60 seconds (until pads were applied) or 180 seconds before defibrillation and initial electrocardiograph rhythm analysis. EMS providers received study-specific training every 6 months that emphasized uninterrupted compressions and ventilations in a 30:2 ratio.
The primary outcome — survival to hospital discharge with sat…