Defibrillate then Give Adrenaline for IHCA

Guidelines recommend prompt defibrillation for treatment of in-hospital cardiac arrest due to an initial rhythm of ventricular fibrillation (or pulseless ventricular tachycardia) Epinephrine (adrenaline) is recommended only when patients remain in refractory ventricular fibrillation or pulseless ventricular tachycardia after many defibrillation attempts. Use of epinephrine before defibrillation is associated with lower odds of survival to discharge and of favourable neurological survival, probably due to lower odds of achieving return of spontaneous circulation

CPR: Hands-on or Hands-off Defibrillation

Pauses in chest compressions are known to be detrimental to survival in cardiac arrest, so much so that the 2010 American Heart Association (AHA) emphasize high-quality compressions while minimizing interruptions. There have been some studies that now advocate for continuous chest compressions during a defibrillation shock. There have been substantial changes to external defibrillation technology


The use of hands-on defibrillation (HOD) has been shown to expose the rescuer to voltages ranging from 827 V to ∼200 V, depending on cadaver and anatomic location. The rescuer-received dose (RRD) under the test scenarios ranged from 1 to 8 J, which is in excess of accepted energy exposure levels.