The role of nurses in cardiopulmonary resuscitation and defibrillation

Cardiac [corrected] arrest outcome studies have identified early defibrillation (among other variables) as a strong predictor of survival--with the emphasis placed on minimal delay between arrest and 'shock'. Nurses play a key role in the management of in-hospital cardiac arrest. Often they are first on the scene of an arrest--initiating cardiopulmonary resuscitation (CPR) as well as summoning assistance from the 'advanced life support'/'arrest' team. Thus it is argued that nurses should be willing (and able) to perform defibrillation when required. Notwithstanding this, the community has an expectation (rightly or wrongly) that all nurses are able to appropriately manage a collapse situation. However, research clearly demonstrates that not all nurses are competent in CPR. There is obviously a mismatch between community expectations and reality, which nursing needs to address. Nurses can contribute to the prevention of cardiac arrest in the community by promoting the importance of seeking medical care in the event of chest pain. Furthermore, skilled clinical assessment and recognition of the prodromes of cardiorespiratory collapse may reduce the incidence of in-hospital cardiac arrests.