- Written by Ethan Abbott
A 72 yo male with a PMH of CAD, s/p stents, HTN, DM, and HLD presents in cardiac arrest. Despite multiple attempts at defibrillation, several rounds of medications, and CPR, the patient remains in refractory ventricular fibrillation. Your attending proposes setting up for “double external simultaneous defibrillation.” What is this?
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Answer: Double external simultaneous defibrillation is utilizing a second defibrillator and a second set of pads to deliver simultaneous shocks to a patient in refractory ventricular fibrillation. There is no standardized methodology or set up, but generally two set of pads are placed next to each other without touching, and then connected to two defibrillators. The defibrillators are simultaneously charged and then the shock buttons are pressed at the same time. CPR is resumed immediately.
El Tawil C, Mrad S, Khishfe BF. Double sequential defibrillation for
refractory ventricular fibrillation. Am J Emerg Med. 2017
Dec;35(12):1985.