Background: Initiation of effective cardiopulmonary resuscitation (CPR) at the earliest possible time is the most important determinant of prognosis for patients with prehospital cardiac arrest. Basic life support CPR, defibrillation by emergency medical systems or first responders as well as vasopressor drugs or antiarrhythmics are essential.
Results: Today, cardiocompression seems to be superior to ventilation. Defibrillation is the most effective treatment for ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT). The effectiveness of defibrillation diminishes rapidly over time. The use of automated external defibrillators (AED) by first responders is very promising with excellent results caused by a short "call-to-arrival" time. Epinephrine and vasopressin are pressor drugs used in the treatment of cardiac arrest with similar success rates. Among antiarrhythmic drugs, lidocaine should no longer be used in patients with cardiac arrest, whereas amiodarone has high efficacy rates in VF or pulseless VT.
Conclusion: Technique and methods of resuscitation are ranging from CPR to additional drugs. Fast and consequent work is essential. Among the "chain of survival" there is an increased value of first responders.