When should defibrillation be performed?

Defibrillation is a critical intervention specifically indicated for patients who are in ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT). In these arrhythmias, the heart is not effectively pumping blood, which leads to a lack of circulation and oxygen to vital organs. The purpose of defibrillation is to deliver an electric shock to the heart, which can restore a normal rhythm by depolarizing the myocardial cells and allowing the natural pacemaker of the heart to regain control.

In this context, the recognition of VF or pulseless VT is paramount. When a patient is in these states, immediate defibrillation can often be life-saving and is a critical step in managing cardiac arrest. Defibrillation should not be attempted in cases where the patient is conscious and alert, where their heart rate is simply elevated, or in cases that involve chest pain without the presence of VF or VT. In those scenarios, other treatments and assessments would be more appropriate rather than using defibrillation, which is reserved for specific life-threatening arrhythmias.