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In his letter, Stewart raises concerns about the precision of defibrillation times, particularly those of less than 1 minute within the NRCPR. We agree. Prior studies of defibrillation time have been unable to document times to defibrillation at the second level. Thus, defibrillation times measuring 0 minutes can represent times of up to 59 seconds (eg, a cardiac arrest at 14:12:00 and defibrillation at 14:12:59 is read as 0 minutes because time is documented at the minute level). Because 3 in 5 cardiac arrests in our study1 occurred in intensive care units, achieving such rapid defibrillation times was plausible. However, given the narrow time window in which defibrillation occurs, we agree that achieving greater precision in measuring times to defibrillation would be optimal in assessments of quality of care for defibrillation times and should be encouraged for future studies.
Chan PS, Nallamothu BK. It Is Time to Get More Accurate Times to Defibrillation—Reply. Arch Intern Med. 2009;169(22):2162-2166. doi:10.1001/archinternmed.2009.452