The place of defibrillation in the chain of survival is paramount and this review covers advances in this aspect of resuscitation over the past 18 months.The main advance is the publication of 2010 European Resuscitation Council guidelines of which defibrillation is a key aspect. Additionally, there have been a number of important articles discussing safety issues with defibrillation, the occurrence of refibrillation following successful cardioversion, prediction of shock success and changes in transthoracic impedance with sequential defibrillation shocks.The focus of these articles is to improve the delivery of defibrillation without interrupting chest compression and aiming to do so at an optimal stage of the resuscitation attempt.