Vfib treatment acls

For ACLS, atrial fibrillation becomes a problem when the fibrillation produces a rapid heart rate which reduces cardiac output and causes symptoms or an unstable condition. When atrial fibrillation occurs with a (RVR) rapid ventricular rate (rate > 100 beats/min), this is called a tachyarrhythmia.

Vfib treatment acls. Ventricular fibrillation is a life-threatening cardiac arrhythmia that leads to a loss of cardiac function and sudden cardiac death. In this review, we summarize therapeutic interventions and guidelines for providers managing patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation in prehospital and emergency settings. Additionally, we …

S5.1.5.2-26 For this reason, chronic treatment of young patients with amiodarone should be reserved as a bridge to more definitive treatment options such as catheter ablation. Baseline evaluation of patients may include ECG, liver function tests, thyroid function tests, chest x-ray, and pulmonary function tests (including diffusing capacity of ...

About Arrhythmia. Ventricular Fibrillation. Ventricular fibrillation, or VF, is considered the most serious abnormal heart rhythm. VF is extremely dangerous and can lead to sudden cardiac death. Without treatment, the condition is fatal within minutes.This “2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support” summarizes the most recent published evidence for and …Cardiac defibrillation is the act of administering a transthoracic electrical current to a person experiencing one of the two lethal ventricular dysrhythmias, ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT). Under Advanced Cardiac Life Support (ACLS) guidelines, pulseless VT and VF are treated the same. Heart disease ...Asystole is not a shockable rhythm. So, treatment will involve high-quality CPR, airway management, IV or IO therapy, and medication therapy – specifically 1mg of epinephrine 1:10,000 concentration every 3 to 5 minutes via rapid IV or IO push. Asystole Treatment Steps. ACLS providers perform their initial assessment, which involves the following:Among EMS-treated out-of-hospital cardiac arrest patients, about 21% had shockable rhythms of ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT). Survival to hospital discharge after EMS-treated cardiac arrest was about 11.4%, while this rate was 37.4% for bystander-witnessed VF cardiac arrest in patients of all ages ( 1 , 2 ).A life-threatening complication of V-tach is ventricular fibrillation, also called V-fib. V-fib can cause all heart activity to suddenly stop, called sudden cardiac arrest. Emergency treatment is needed to prevent death. V-fib happens most often in people with heart disease or a prior heart attack. Sometimes it occurs in those who have high or ...

Mar 4, 2021 ... ACLS and pulse check. Hey guys! When it comes to the ... medication. In fact, it discourages it as ... v-fib is likely lower than a course v-fib.The headline figure for US gross domestic product in the second quarter was a better than expected, clocking in at 1.7%, according to the first of three estimates. But the first-qu...Asystole is not a shockable rhythm. So, treatment will involve high-quality CPR, airway management, IV or IO therapy, and medication therapy – specifically 1mg of epinephrine 1:10,000 concentration every 3 to 5 minutes via rapid IV or IO push. Asystole Treatment Steps. ACLS providers perform their initial assessment, which involves the following:Basic treatment of torsade: ⚡️; Treatment of torsade storm: ⚡️; The following treatment strategy is for monomorphic VT, or polymorphic VT due to acute myocardial ischemia. The treatment of these entities is very similar, although there is a greater urgency to pursue revascularization in the context of polymorphic VT due to acute ischemia.Nov 1, 2020 ... ... treatments, and recommend the next steps to properly provide optimal care for the patient. Rationales are included with the correct answers ...ROSC and the Importance of Diagnosing and Treating Underlying Causes. Cardiac arrest will sometimes be caused by an underlying and potentially reversible condition. If ACLS providers can quickly identify a specific condition that is causing or contributing to the patient’s cardiac arrest and correct it, the patient may be able to achieve ROSC.Arrhythmia Recognition. Interpret all ECG and rhythm information within the context of total patient assessment. Inaccurate diagnoses and inappropriate therapy occur when ACLS providers base their decisions solely on cardiac rhythm and neglect to evaluate the patient’s clinical signs, such as ventilation, oxygenation, heart rate, blood pressure, …

This ACLS scenario will usually involve one or two rescuers in an out-of-hospital setting. Ideal equipment would be an AED and a pocket mask. Rapid assessment and treatment using the CAB sequence of BLS should be performed as the first intervention. CPRNov 30, 2010 ... BLS and advanced cardiac life support (ACLS) programs emphasize the treatment of “shockable” rhythms, v fib and v tach, and they even enjoy ...Introduction. Ventricular fibrillation (VF) is an emergency condition that, without immediate treatment, leads to death. In the event of this malignant ventricular …However, it is unclear whether these medications improve patient outcomes. The 2018 AHA Focused Update on ACLS guidelines summarize the most recent published evidence for and recommendations on the use of antiarrhythmic drugs during and immediately after shock-refractory VF/pVT cardiac arrest. The updated guidelines state …

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A = Open airway. B = Breaths (30:2 compression-to-ventilation ratio or 8-10 breaths/min with advanced airway). 1. Use defibrillator to check rhythm: If VF/VT: Give 1 shock immediately then follow the algorithm. If PEA or asystole: Continue CPR, give epinephrine as soon as possible and follow the algorithm. Minimize interruptions of CPR. The treatment for ventricular fibrillation is rapid defibrillation. Every minute that defibrillation is delayed, the chance of survival is reduced by 10%. The key steps to treating ventricular fibrillation are: Rapid assessment to confirm cardiac arrest. Starting CPR. Applying the defibrillator and delivering the first shock as soon as possible. Treatment of monomorphic VT is dependent upon whether the patient is stable or unstable. Expert consultation is always advised, and if unstable, the ACLS tachycardia algorithm should be followed. Polymorphic Ventricular Tachycardia. With polymorphic ventricular tachycardia, the QRS waves will not be symmetrical.Author: American Heart Association Subject: Please contact the American Heart Association at [email protected] or 1-214-706-1886 to request a long description of this image.The reduction in cardiac output resulting can cause symptoms ranging from decreased level of consciousness to a total lack of cardiac output, known as a pulseless ventricular tachycardia. Unstable ventricular tachycardia may present with the following characteristics: Broad QRS arrhythmia. Highly accelerated heart rates.

Ventricular fibrillation (VF) is due to multiple wavelet reentrant electrical activity and is manifested on electrocardiogram (ECG) by ultrarapid baseline undulations that are irregular in timing and morphology. VF is the presenting rhythm for about 70% of patients in cardiac arrest and is thus the terminal event in many disorders.Acute ventricular fibrillation (VF) is treated according to Advanced Cardiac Life Support (ACLS) protocols. [ 81, 82] ) Interest in improving rates of public...Medications used in PEA Vasopressors. A vasopressor is a medication that produces vasoconstriction and a rise in blood pressure. The vasopressor that is used for the treatment within the right branch of the Cardiac Arrest Algorithm is epinephrine.. Epinephrine is primarily used for its vasoconstrictive effects. Vasoconstriction is …A = Open airway. B = Breaths (30:2 compression-to-ventilation ratio or 8-10 breaths/min with advanced airway). 1. Use defibrillator to check rhythm: If VF/VT: Give 1 shock immediately then follow the algorithm. If PEA or asystole: Continue CPR, give epinephrine as soon as possible and follow the algorithm. Minimize interruptions of CPR.Asystole is not a shockable rhythm. So, treatment will involve high-quality CPR, airway management, IV or IO therapy, and medication therapy – specifically 1mg of epinephrine 1:10,000 concentration every 3 to 5 minutes via rapid IV or IO push. Asystole Treatment Steps. ACLS providers perform their initial assessment, which involves the following:VFib is a type of arrhythmia or irregular heartbeat that is the most common cause of sudden cardiac arrest. Several underlying conditions can cause VFib, such as coronary artery disease and heart ...Ventricular fibrillation, or VF, is considered the most serious abnormal heart rhythm. VF is extremely dangerous and can lead to sudden cardiac death. Without treatment, the condition is fatal within minutes. Disordered electrical activity causes the heart’s lower chambers (ventricles) to quiver instead of contracting (or beating) normally.Advanced cardiac life support (ACLS) in adults - UpToDate. View in. Author: Jonathan Elmer, MD, MS, FNCS. Section Editors: Ron M Walls, MD, FRCPC, …VF or VFib (Figure 24) is a rapid quivering of the ventricular walls that prevents them from pumping. The emergency condition, pulseless VT, occurs when ventricular contraction is so rapid that there is no time for …Temu's teams in Boston and Dublin mostly perform functions in tax, marketing and legal matters. Temu, a fast-growing e-commerce platform known for cheap deals, is making inroads in...Ventricular Fibrillation. Ventricular fibrillation, or VF, is considered the most serious abnormal heart rhythm. VF is extremely dangerous and can lead to sudden cardiac death. Without treatment, the condition is fatal within minutes. Disordered electrical activity causes the heart’s lower chambers (ventricles) to quiver instead of ...About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features NFL Sunday Ticket Press Copyright ...

Mar 1, 2021 ... In this video, we give an overview of how to teach the V-fib ... CARDIAC ARREST EMERGENCY MANAGEMENT, UNCONSCIOUS PULSELESS PATIENT TREATMENT ACLS ...

ECG interpretation. Classify the patient into one of three clinical groups: ST-elevation myocardial infarction, or STEMI; non-ST-elevation acute coronary syndrome; or low to intermediate risk acute coronary syndrome. ST-elevation MI (STEMI). If ST elevation or new or presumably new lower bundle branch block is detected, begin treatment for STEMI.EMPOWER LIFETIME 2030 FUND INVESTOR CLASS- Performance charts including intraday, historical charts and prices and keydata. Indices Commodities Currencies StocksAuthor: American Heart Association Subject: Please contact the American Heart Association at [email protected] or 1-214-706-1886 to request a long description of this image.Each ACLS algorithm is designed to simplify the process for the management and treatment of patients experiencing a cardiovascular emergency or progressing toward a cardiovascular emergency. Most often these emergencies are related to an arrhythmia which must be identified and then treated with the appropriate ACLS algorithm.Atrial fibrillation is a cardiac arrhythmia also known as AFib, or AF. During atrial fibrillation, electrical signals within the atria have deteriorated. This deterioration results in a cardiac rhythm change, such that the heart operates in a disorganized manner where the atria fibrillate, or quiver. The signals from the atria are then sent to ...BLS, ACLS, & PALS Algorithms. Algorithms help providers to be prepared to respond to life-threatening medical events in a systematic fashion. These algorithms provide a step-by-step process for responding to various emergency situations. By learning and mastering these algorithms, you will be better prepared to face these challenges in the ...Adult Dosage for Lidocaine: Dosage for cardiac arrest from ventricular fibrillation or pulseless ventricular tachycardia: Initial dose is 1 to 1.5 mg/kg IV or IO. Can also be delivered via endotracheal tube. Dosage for refractory ventricular fibrillation: An additional .5 to .75 mg/kg may be given via IV push.Cardiac Arrest in Pregnancy In-Hospital ACLS Algorithm Author: American Heart Association Subject: Please contact the American Heart Association at [email protected] or 1-214-706-1886 to request a long description of this image. Created Date: 6/12/2020 4:06:44 PMVentricular fibrillation (sometimes called v-fib for short) is an arrhythmia, a malfunction of the heart’s normal pumping sequence. It is the most common deadly arrhythmia. When it happens, the lower chambers of your heart quiver or twitch instead of completely expanding and squeezing. This means they aren’t pumping blood as they …In ACLS, Lidocaine is used intravenously for the treatment of ventricular arrhythmias. (VT/VF) It is also useful for the treatment of stable monomorphic VT with preserved ventricular function and for stable polymorphic VT with preserved left ventricular function, normal QT interval, and correction of any electrolyte imbalances.

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Approximately 300,000 out-of-hospital cardiac arrests (OHCA) occur annually in the United States, with survival around 8%. 10 The initial rhythm may be ventricular fibrillation (VF), pulseless ventricular tachycardia (VT), asystole, or pulseless electrical activity (PEA). 16 Two-thirds of OHCA has an initial non-shockable rhythm of PEA or asystole with an increasing incidence compared with ... In ACLS, Lidocaine is used intravenously for the treatment of ventricular arrhythmias. (VT/VF) It is also useful for the treatment of stable monomorphic VT with preserved ventricular function and for stable polymorphic VT with preserved left ventricular function, normal QT interval, and correction of any electrolyte imbalances. Intravenous esmolol for the treatment of supraventricular tachyarrhythmia: results of a multicenter, baseline-controlled safety and efficacy study in 160 patients. The Esmolol Research Group. Am Heart J. 1986 Sep;112(3):498-505. doi: 10.1016/0002-8703(86)90513-2.Tachycardia with a Pulse Algorithm. Assess clinical condition. Perform an assessment for a clinical condition. A heart rate of 150 beats per minute is more likely to be symptomatic. Identify and treat underlying cause. Identify and treat any underlying cause. Maintain the airway and give the patient oxygen if indicated.ROSC and the Importance of Diagnosing and Treating Underlying Causes. Cardiac arrest will sometimes be caused by an underlying and potentially reversible condition. If ACLS providers can quickly identify a specific condition that is causing or contributing to the patient’s cardiac arrest and correct it, the patient may be able to achieve ROSC.Treatment of monomorphic VT is dependent upon whether the patient is stable or unstable. Expert consultation is always advised, and if unstable, the ACLS tachycardia algorithm should be followed. Polymorphic Ventricular Tachycardia. With polymorphic ventricular tachycardia, the QRS waves will not be symmetrical. The treatment for ventricular fibrillation is rapid defibrillation. Every minute that defibrillation is delayed, the chance of survival is reduced by 10%. The key steps to treating ventricular fibrillation are: Rapid assessment to confirm cardiac arrest. Starting CPR. Applying the defibrillator and delivering the first shock as soon as possible. Feb 1, 2021 ... Want to earn CE credits for watching these videos? Join ICU Advantage Academy. https://adv.icu/academy 10% off Critical Care ...Refractory ventricular fibrillation was defined as an initial presenting rhythm of ventricular fibrillation or pulseless ventricular tachycardia that was still present after three consecutive ...Patients were randomly assigned to early ECMO (15 patients) or standard ACLS treatment (15 patients) on hospital arrival and were included in the intention-to-treat analysis. Overall, the mean age was 59 years (SD 10; range 36–73) and 25 (83%) of 30 patients were men. ….

Aug 22, 2000 · Epinephrine hydrochloride produces beneficial effects in patients during cardiac arrest, primarily because of its α-adrenergic receptor–stimulating properties. 1 The adrenergic effects of epinephrine increase myocardial and cerebral blood flow during CPR. 2 The value and safety of the β-adrenergic effects of epinephrine are controversial ... Feb 1, 2021 ... Want to earn CE credits for watching these videos? Join ICU Advantage Academy. https://adv.icu/academy 10% off Critical Care ...Ventricular fibrillation (VFib or VF) and ventricular tachycardia (v-tach or VT) are two types of heart arrhythmia that occur in the heart’s lower chambers called the ventricles. The ventricles ...While you can still retire in a recession, you should tweak your plans to make your money last. We may receive compensation from the products and services mentioned in this story, ...If you are pursuing a career in healthcare, chances are you have heard of the American Heart Association (AHA) Advanced Cardiovascular Life Support (ACLS) certification. This certi...Atrial fibrillation is a cardiac arrhythmia also known as AFib, or AF. During atrial fibrillation, electrical signals within the atria have deteriorated. This deterioration results in a cardiac rhythm change, such that the heart operates in a disorganized manner where the atria fibrillate, or quiver. The signals from the atria are then sent to ...ACLS is an acronym that stands for Advanced Cardiac Life support. ACLS teaches healthcare professionals advanced interventional protocols and algorithms for the treatment of cardiopulmonary emergencies. These include primary survey, secondary survey, advanced airways, myocardial infarction, cardiac arrest, tachycardias, bradycardias, and stroke.The treatment for ventricular fibrillation is rapid defibrillation. Every minute that defibrillation is delayed, the chance of survival is reduced by 10%. The key steps to treating ventricular fibrillation are: Rapid assessment to … Vfib treatment acls, If ROSC, go to Post–Cardiac Arrest Care. Consider appropriateness of continued resuscitation. Go to 5 or 7. VF/pVT Asystole/PEA. CPR Quality. Push hard (at least 2 inches [5 cm]) and fast (100-120/min) and allow complete chest recoil. Minimize int erruptions in compressions. Avoid e xcessive v entilation., 2020 (Updated): (PALS) When perform-ing CPR in infants and children with an advanced airway, it may be reasonable to target a respiratory rate range of. 1 breath every 2 to 3 seconds (20-30/min), accounting for age and clinical condition. Rates exceeding these recommendations may compromise hemodynamics., Pulseless electrical activity (PEA) is defined as the presence of cardiac electrical activity with organized or partially organized cardiac rhythms without a palpable pulse. Pulseless electrical activity is formerly known as electromechanical dissociation (EMD). During PEA, the heart is unable to move adequate blood volume to maintain systemic ..., Starting June 1, Malta will be one of the few European countries opening its doors to fully vaccinated travelers. Update: Some offers mentioned below are no longer available. View ..., This “2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support” summarizes the most recent published evidence for and …, This ACLS quiz covers general information that may be found on the ACLS written test. ) , () ) : (2020-2025 guidelines) Go to Quiz #2. Return Practice Test Library ... but if the witnessed cardiac arrest is not due due Vfib or pulsless Vtach, then chest compressions and alerting EMS would take priority, to maintain perfusion to identifying ..., In patients with AF, treatment of hypertension should aim for current BP guidelines to reduce stroke, bleeding, and other adverse outcomes. 5,10 An RCT of patients with paroxysmal AF and hypertension noted fewer recurrences among participants treated with renal denervation and pulmonary vein isolation (PVI) compared with PVI alone. 2 …, These pages cover all of the cardiac arrhythmias that you will experience in the ACLS provider course. Rhythms from Ventricular Fibrillation to Complete Heart Block are covered. Examples of each ECG tracing are provided, and after each article is a short video that simulates the ACLS ECG on a defibrillator monitor., Here are the primary ACLS medications broken down by algorithm and a link to its respective page which covers in detail all aspects of medication its use during cardiac arrest and post-resuscitation efforts. Primary ACLS Drugs for the ACLS Algorithms. Vent. Fib./Tach. Epinephrine Vasopressin Amiodarone Lidocaine Magnesium., Trump administration taps former GlaxoSmithKline exec as head of vaccine task force, and how I'm playing Walmart and Datadog....AMZN All alone. Walking along a quiet beach. Adm..., N Engl J Med. 2019;380:1499-1508. Atrial fibrillation (AF) is an abnormal rhythm caused by the rapid firing of multiple cells in the atria, the upper chambers of the heart, which cause the atria to quiver ineffectively. Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia encountered in clinical practice and is associated ..., Lidocaine is one of several ACLS drugs used to treat cardiac arrest from ventricular tachycardia (VT) and Ventricular Fibrillation (VF). Lidocaine is considered a second-line antiarrhythmic drug and should be administered in VF/VT cases where amiodarone is either unavailable or ineffective. While lidocaine is a well-known and established ACLS ..., Treatment of monomorphic VT is dependent upon whether the patient is stable or unstable. Expert consultation is always advised, and if unstable, the ACLS tachycardia algorithm should be followed. Polymorphic Ventricular Tachycardia. With polymorphic ventricular tachycardia, the QRS waves will not be symmetrical., Mar 28, 2024 · The American Heart Association (AHA) formally endorsed cardiopulmonary resuscitation (CPR) in 1963, and by 1966 they had adopted standardized CPR guidelines for instruction to lay rescuers [ 2 ]. Advanced cardiac life support (ACLS) guidelines have evolved over the past several decades based on a combination of scientific evidence of variable ... , This ACLS scenario will usually involve one or two rescuers in an out-of-hospital setting. Ideal equipment would be an AED and a pocket mask. Rapid assessment and treatment using the CAB sequence of BLS should be performed as the first intervention. CPR, In one recent case series on 12 patients in refractory VF ( Cortez 2016 ), double sequential defibrillation resulted in ROSC in 3 patients (25%, 95% CI 9% to 53%), all of whom survived to hospital discharge. Two of these patients had good neurologic outcomes at discharge (CPC scores of 1 and 2) while the third had a CPC score of 3., Good post-arrest care involves maintaining blood pressure and cerebral perfusion, adequate sedation, cooling and preventing hyperthermia, considering antiarrhythmic medications, optimization of tissue oxygen delivery while avoiding hyperoxia, getting patients to PCI who need it, and looking for and treating the underlying cause. Dr., Tests are done to check the heart and confirm a diagnosis of ventricular tachycardia, also called V-tach or VT. Test results also can help determine if another health problem is causing V-tach. Electrocardiogram (ECG or EKG). This is the most common test to diagnose tachycardia. An ECG shows how the heart is beating., A life-threatening complication of V-tach is ventricular fibrillation, also called V-fib. V-fib can cause all heart activity to suddenly stop, called sudden cardiac arrest. Emergency treatment is needed to prevent death. V-fib happens most often in people with heart disease or a prior heart attack. Sometimes it occurs in those who have high or ..., If VF is present when a rhythm check is performed after 2 min. of chest compressions you would perform an unsynchronized shocker the treatment of the VF. Healthcare providers may tailor the interventions to best suit the scenario that is before them, and if a physician thought that synchronized cardioversion should be attempted in a pulseless ..., Tests are done to check the heart and confirm a diagnosis of ventricular tachycardia, also called V-tach or VT. Test results also can help determine if another health problem is causing V-tach. Electrocardiogram (ECG or EKG). This is the most common test to diagnose tachycardia. An ECG shows how the heart is beating., Each ACLS algorithm is designed to simplify the process for the management and treatment of patients experiencing a cardiovascular emergency or progressing toward a cardiovascular emergency. Most often these emergencies are related to an arrhythmia which must be identified and then treated with the appropriate ACLS algorithm. , 2018 American Heart Association Focused Update on Advanced ..., The mainstay of treatment of cardiac arrest due to VF is highlighted in the Advanced Cardiovascular Life Support (ACLS) algorithm, which consists of high-quality cardiopulmonary resuscitation (CPR), accurate heart rhythm diagnosis, and early defibrillation for cases of VF and pulseless ventricular tachycardia, and intravenous …, If a pulse cannot be felt after palpating for up to 10 seconds, move immediately to the ACLS Cardiac Arrest VTach and VFib Algorithm to provide treatment for pulseless ventricular tachycardia. The immediate response to an adult patient with tachycardia and a palpable pulse is. To maintain an open airway; Assist breathing if necessary, This 2018 American Heart Association (AHA) focused update on the advanced cardiovascular life support (ACLS) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) is based on the systematic review of antiarrhythmic therapy and the resulting “2018 International Consensus on CPR and ECC Science With …, May 26, 2022 ... ... VFib, pVT, asystole), tachycardia with a ... ACLS Question. Epinephrine. 2 upvotes ... SIBO treatment protocol- everything in one place (Update)., Knowing the H’s and T’s of ACLS will help prepare you for any ACLS scenario. Learn about this easy-to-remember strategy used in ACLS training. ... Also, a widening of the QRS-wave may be seen. This can be treated in a number of ways which include sodium bicarbonate (IV), glucose+insulin, calcium chloride (IV), Kayexalate, dialysis, and ..., #ACLS Acute atrial fibrillation with RVR Treatment Nik Nikam MDPlease subscribe to this NNN channel by clicking the subscribe button.Host: NIK NIKAM, MD, MH..., Aug 8, 2023 · Arrhythmias originating from the ventricular myocardium or His-Purkinje system are grouped under ventricular arrhythmia (VA). This includes a subset of arrhythmias such as ventricular tachycardia (VT), ventricular fibrillation (VF), premature ventricular contractions (PVC), and ventricular flutter. Wide complex tachycardia (WCT) is used to define all tachyarrhythmia with QRS complex duration ... , VFib is a type of arrhythmia or irregular heartbeat that is the most common cause of sudden cardiac arrest. Several underlying conditions can cause VFib, such as coronary artery disease and heart ..., United Airlines is officially pulling out of New York's John F. Kennedy International Airport on Oct. 29. The carrier restarted flying to JFK in March 2021 during the pandemic. Uni..., Part 6: Advanced Cardiovascular Life Support. For a person in VF the probability of successful defibrillation and subsequent survival to hospital discharge is directly and negatively related to the time interval between onset of VF and delivery of the first shock. 123 Early defibrillation by first rescuers and trained lay responders is a ...