Differences Between CPR and Defibrillation
ACLS Certification Association videos have been peer-reviewed for medical accuracy by the ACA medical review board.
Article at a Glance
- It is critical for the provider to determine whether to defibrillate or perform CPR first.
- In a witnessed arrest from VF, perform defibrillation as soon as possible.
- Do not delay defibrillation for CPR.
A long time ago, I was working in the emergency department (ED) as a brand new paramedic. I had a 56 year-old patient who came to the hospital because she didn’t feel well. I helped her to the hospital bed, administered leads, and took her blood pressure. As I’m asking her some questions, I looked at the monitor and saw squiggly lines. I quickly set up the cardiac monitor and shocked her with 200 joules. The patient instantly regained consciousness. The patient in the story came into the hospital for ventricular fibrillation, a life-threatening arrhythmia. After regaining consciousness, the patient exclaimed, “Oww!” as I just shocked her with 200 joules of electricity in the chest. She went back into ventricular fibrillation, and I shocked her again. She instantly regained consciousness, and I started yelling for help. Thankfully, she went to the catheter lab and recovered fully. Remember, if a patient goes into ventricular fibrillation, you must immediately defibrillate to change the heart rhythm. Shock them immediately, as the faster you administer the shock, the more likely it is going to work. Read: Criteria for a SVT (supraventricular tachycardia) The priority is to defibrillate and get the heart back to normal rhythm. Students often wonder if they can perform chest compressions while the defibrillator charges. You may start chest compressions, but not at the expense of defibrillating. If you have enough people, start compressions while putting on the pads and firing up the machine. But, remember, the priority is always defibrillation in a witness to arrest.CPR or Defibrillation First?
Related Video – ECG Rhythm Review – Ventricular Fibrillation
Related Video – Understanding the Limitations of CPR
Summary
If a patient is experiencing ventricular fibrillation, a provider must witness the arrest and immediately administer defibrillation to alter the heart rhythm. Physicians may start chest compressions while preparing the defibrillator, but defibrillation remains the top priority.
More Free Resources to Keep You at Your Best
Editorial Note
ACLS Certification Association (ACA) uses only high-quality medical resources and peer-reviewed studies to support the facts within our articles. Explore our editorial process to learn how our content reflects clinical accuracy and the latest best practices in medicine. As an ACA Authorized Training Center, all content is reviewed for medical accuracy by the ACA Medical Review Board.
More to Learn
This article and video detail the Human Immunodeficiency Virus (HIV). Learn pathophysiology, signs and symptoms...
Master the management of asystole, Hs and Ts, and pulseless electrical activity (PEA) with ACLS Certification Association. Our article helps you be prepared for critical situations.