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Care during the initial 10‐20 minutes of resuscitation should occur at the location where the patient was found, or an area as close as possible with adequate space (e.g., move to family room from hallway). Efforts to “package the patient” or to transfer the patient to the ambulance compromise resuscitation quality, including timeliness of defibrillation and medication interventions and the quality of chest compressions. A large, multicenter, retrospective study found that continuing resuscitation on scene until ROSC, compared to transporting patients while in arrest, was associated with a three‐fold increase in survival. This association was reversed after about 30 minutes of on‐scene resuscitation, at which point there was a survival advantage to transporting the patient [89]. Moving the patient to the ambulance or transporting immediately, except for some very rare situations, is not beneficial.

In pregnant patients who are >20 weeks gestation or fundal height is above the umbilicus, manual displacement of the fetus to the left is recommended during CPR. Rapid transport of this patient to a facility capable of perimortem caesarian section may provide the best opportunity for survival of both patients (see Chapter 45).