A more effective approach to in-hospital defibrillation

Survival rates from in-hospital cardiac arrests are low and have not improved since the 1960s. Increased emphasis on early defibrillation has significantly improved prehospital survival rates in recent years, but the organization of resuscitation efforts in hospitals has not changed. Nurses throughout the hospital should be trained and authorized to defibrillate on their own initiative, using defibrillators that are already close at hand. The basic procedure is not difficult, and an aggressive protocol using blind defibrillation could further simplify training and maximize survival. Working together, nurses can overcome psychologic and emotional barriers to these changes and improve their patients' odds of survival.