Emergency defibrillation performed by coronary nursing staff: A pilot report

The time taken to initiate defibrillation is a key factor in determining survival after cardiac arrest; all first-responding medical or paramedical personnel are thus recommended to receive training in defibrillation skills. We have recently established a working programme that allows trained coronary care nurses to defibrillate in emergencies. Prospective data collected from 1 October 1996 to 31 January 1997 showed that a total of 11 witnessed episodes of ventricular fibrillation or pulseless ventricular tachycardia occurred in nine patients, and were defibrillated by nurses. All the defibrillations were started within 1 minute of cardiac arrest. In five patients, defibrillation was commenced before the arrival of the crash team of doctors; three of the five patients survived. There were no violations of the resuscitation protocol or complications relating to defibrillation. Through programmed training in advanced cardiac life-support, coronary care nurses are capable of providing safe and prompt defibrillation. The importance of training and re-certification is also stressed.