Introduction

Survival outcomes after a cardiac arrest depend on recognising the victim and responding with early defibrillation. Defibrilla-tion remains the only clinically effective intervention for ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT). Traditionally the skill of defibrillation has been confined to those working in critical care areas but advances in technology now make it possible for other healthcare professionals to learn how to defibrillate safely and effectively. Indeed, the introduction of smaller, lighter and easier to operate automated external defibrillators (AED) and advisory defibrillators that are highly sensitive and reliable has facilitated life-saving treatment to be rapidly available and provided by a range of hospital personnel.

In response to the role of early defibrillation in reducing mortality rates from VT/VF, the American Heart Association in collaboration with the International Liaison Committee on Resuscitation (AHA & ILCOR 2000) has issued guidelines for the use of AEDs as part of basic life support (BLS). The guidelines have been informed by the past three decades of research which have demonstrated an increase in survival rates from cardiac arrests following the early use of the AED by a number of health providers, first responders and lay people (Moule & Albarran 2002). Confidence in the ability of lay people and other rescuers to operate AEDs following minimal training resulted in recommendations by the European Resuscitation Council (Bossaert et al. 1998) and the Resuscitation Council UK (2000b) that all hospital and paramedic staff who may need to respond or may be witness to a cardiopulmonary emergency must be competent in BLS and be authorised to perform defibrillation using an AED.

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