CPR should immediately resume following administration of DED, and the patient’s pulse checked after that 2-minute cycle of compressions. RVF is generally defined as 3 or more episodes of sustained or recurrent VF despite appropriate. The PubMed, and MEDLINE databases were reviewed in February of 2018 and. Dual Sequential Defibrillation (DSD) has demonstrated success in terminating VF that is refractory to multiple attempts using a single defibrillator. Once both devices become fully charged, and the scene is checked to make sure that no one is touching the patient or in contact with anything touching the patient, administer the shock as described using one of the two methods detailed above. DD, also known as double sequential defibrillation, double sequence defibrillation, dual simultaneous defibrillation, or dual axis defibrillation, refers to the use of two defibrillators to electrically cardiovert a patient in refractory VF (RVF). Shockable rhythms such as ventricular fibrillation (VF) have a survival rate of 20-30 outside of the hospital setting. CPR should continue while both defibrillators are charging to their initial energy level of 200 Joules. Alternatively, if only one ACLS qualified healthcare provider is available, then the “shock” button on both defibrillators can be pushed with one hand to ensure the creation of the intentional delay.Īs per the current ACLS recommendation with single defibrillation minimize interruptions to chest compressions. If attempting DED sequentially using the setting up theory, then it is recommended that two healthcare providers each operate a single defibrillator device to ensure an intentional delay exists between the two administered shocks. If attempting DED simultaneously using the power theory then it is recommended that a single healthcare provider operate both defibrillator devices to ensure the administration of is as close together as possible Patients who experience RVF during their cardiac arrest have a mortality of up to 97%. The estimated incidence of RVF is 0.5 to 0.00 of the population some authors report that 10 to 25% of cardiac arrest cases could develop RVF or recurrent VF.

Refractory ventricular fibrillation is defined as ventricular fibrillation that does not convert with three or more single defibrillation attempts. This use of DED occurs after standard transthoracic electrical current from a single defibrillator have failed to terminate this lethal rhythm. 'The usefulness of double sequential defibrillation for refractory shockable rhythm has not been established.' It is currently not recommended. In November of 2020, the American Heart Association guidelines changed. Double external defibrillation (DED) is the application and administration of transthoracic electrical currents from two defibrillator devices to a single patient experiencing a single type of lethal dysrhythmia during cardiac arrest, known as refractory ventricular fibrillation (RVF). Double sequential defibrillation was attempted with successful Return Of Spontaneous Circulation (ROSC) after a total of 61 min of cardiac arrest.

Dual sequential defibrillation