We recommend that once transport has been initiated, the focus should be on rapid transport and quality CPR. There is a de-emphasis on continued defibrillation, as multiple studies have shown that repeated, ongoing analyses simply interrupt CPR and have no clinical effectiveness or negative effect on morbidity/mortality. Further, there's a risk of an inaccurate rhythm interpretation/analysis. For example, the electric characteristics of the VF waveform are known to change over time. Differentiating between fine VF and asystole may be challenging in a moving vehicle, even if manually interpreting. We hope this is valuable information that can be incorporated into your future clinical practice.
Please note the following Information from the ALS PCS Companion Document:
When en-route and using manual rhythm interpretation, the ambulance should be stopped to minimize artifact and the risk of an inaccurate rhythm interpretation/analysis.
When en-route and using semi-automated rhythm analysis, the ambulance must be stopped to minimize artifact and the risk of an inaccurate rhythm interpretation/analysis.