• K G Spearpoint, C P McLean, and D A Zideman.
• Resuscitation Service, Department of Anaesthetics and Intensive Care, Hammersmith Hospital, London, UK.
• Resuscitation. 2000 May 1;44(3):165-9.

ObjectiveTo report the outcomes from and the impact of the chain of survival in 'in-hospital' cardiac arrest where the presenting rhythm was VF/VT, the arrest was witnessed, defibrillation was conducted rapidly and no other resuscitation interventions were required.Outcome MeasuresAny return of spontaneous circulation and discharge from hospital.MethodsA 2-year prospective resuscitation audit using the Utstein style was conducted within a major London NHS Hospital Group.ResultsThere were 124 patients who had primary VF/VT arrest. Eight were excluded from the study and 14 had non-witnessed cardiac arrest. Twenty one patients had witnessed VF/VT arrest but with delayed defibrillation, 81 patients had witnessed VF/VT arrest with rapid defibrillation, 69 patients had witnessed VF/VT arrest with rapid defibrillation, CPR and other additional interventions. There were 15 patients that had witnessed cardiac arrest with a presenting rhythm of VF/VT, who received rapid defibrillation and had no ventilation or chest compression prior to or following defibrillation. All 15 patients achieved a return of spontaneous circulation, and 12 were discharged alive.ConclusionsRapid defibrillation prior to any other resuscitation intervention is associated with increased survival from witnessed VF/VT arrest in in-hospital cardiac arrest victims, and that the time to first shock is critical in enhancing the prospects of long-term survival in these patients.

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