Immediate management

Why?

• Patients with an out-of-hospital cardiac arrest who receive defibrillation by basic life support providers are less likely to die ^b

Defibrillation by BLS providers saves lives

Patient	Treatment	Comparison	Outcome	CER	NNT (95% CI)
out-of-hospital cardiac arrest b	defibrillation by BLS providers	standard BLS care	death at discharge	80%	15 (10 to 28)

Note:

• The polarity of the defibrillator electrodes has no clear effect on resuscitation ^d
• Apex-anterior chest pads or apex-posterior chest pads are probably equally effective ^d
• High-energy shocks are not clearly better than low-energy shocks ^d
• Automatic defibrillators may be worse than manual defibrillators - fewer patients are resuscitated but there is no clear effect on survival at discharge ^b