Until pioneering work in Belfast (Pantridge & Geddes 1967), the only place a defibrillator would be found was in a hospital. It is not difficult to see that sending out an ambulance, collecting a casualty and then taking them to hospital for defibrillation was unlikely to succeed very often. Regardless of how proficient CPR had been in the intervening period, delaying advanced interventions reduced survival because:
• simple CPR (without oxygen, drugs or airway management devices) can only stave off hypoxic brain damage for a limited time;
• it will not offer any protection of the airway so it is likely that stomach contents will be aspirated into the lungs;
• CPR will delay the process of VF fading away to asystole but will not prevent it.
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