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Editorial
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Volume 342:1599-1601 May 25, 2000 Number 21
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Cardiopulmonary Resuscitation — Strengthening the Links in the Chain of Survival

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 by The Italian Group for Antiemetic Research
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The major determinants of survival after witnessed out-of-hospital cardiac arrest due to ventricular fibrillation include whether a bystander initiates cardiopulmonary resuscitation (CPR) and how quickly defibrillation is accomplished.

The now-classic observations of Eisenberg et al. were that among patients with out-of-hospital cardiac arrest due to ventricular fibrillation, 43 percent survived to leave the hospital if CPR was initiated by a bystander within four minutes and if definitive therapy was delivered within eight minutes.1 Survival decreased to less than 7 percent if basic CPR was not initiated until 8 minutes, and no patient survived after 16 minutes of untreated ventricular fibrillation.1

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