AN ELECTRICAL HAIL MARY.
Double sequential defibrillation is currently being employed in a number of EMS systems across the United States, including Wake County, N.C.; Fort Worth, Texas; and New Orleans. Even though there isn't a large body of literature surrounding this technique, it's been demonstrated successful in the electrophysiology lab, ED and prehospital settings. Since access to procainamide--another treatment for refractory v fib--is limited, this may be the only available option when faced with a patient who's failed standard ACLS defibrillation and medication administration. It's an intervention that has little chance to do harm, and it may represent the "hail Mary" pass to a successful ROSC touchdown.
David
D
Neubert
D004554:Electric Countershock / Q000379:methods*; D004562:Electrocardiography; D004632:Emergency Medical Services; D006801:Humans; D014693:Ventricular Fibrillation / Q000628:therapy*