DUAL SEQUENTIAL DEFIBRILATION (aka the return of the CAPS AND COLORS!!!!) Also, thank you for participating, Antony "Not the guy from the 2nd Triumvirate" Mathew, week 1 of fantasy football is in the books! (Just jinxed myself)
Back to the topic at hand, What the hell is it?
- Placing 2 sets of defib pads on a patient
- Charging them both fully
- Hitting the Shock button at the same time. ZAP GOES THE WEASEL
HOW TO PLACE THE PADS
There are a few ways to place the pads, but the general idea is you want to blanket the chest with electricity
Consideration, Evidence, and when to Use (the meat of the article)
- Studies showed that the higher the amount of body fat, the lower the amount of electricity gets to the heart (in pigs)
- However, initial ROSC with VF arrest and single defib is fairly high (studies show various numbers, but it's decent)
- Series of case studies showing that after multiple rounds of CPR, multiple single shocks, and appropriate meds given, Dual Defib can increase the chances of ROSC.
- One study in an EP lab showed increased success of dual defib, but in a more controlled setting.
- Certain EMS systems, and hospitals are now including it in their ACLS protocol, either after FOUR OR FIVE normal shocks.
WHAT WILL I BE DOING????
- By the time you're considering doing this, the patient is pretty dead. They can't get dead-er. I've tried this a few times (never worked) but I think I'll keep using it. There are case studies out there with it working, and some pretty smart people swear to it anecdotally.
- As Einstein put it (probably about defibbing a patient 10 times during a code)
- "The definition of INSANITY is doing the same thing over and over again, butexpecting different results"