The recommendation to immediately start CPR after a shock is based on the fact that the chance of developing a rhythm associated with an output in the first minute or so after defibrillation is extremely small. Starting CPR immediately after defibrillation, irrespective of the electrical success or otherwise, or the attempt at defibrillation, restores blood flow to the brain and heart and creates an environment more conducive to return of spontaneous circulation. A period of at least 1-2 minutes of good CPR appears to be able to increase the likelihood of success of the next attempt at defibrillation. Obviously there is no need for CPR to continue if signs of life return.
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