Publication

Defibrillation: standard vs. double sequential in adult out-of-hospital cardiac arrest

Stevenson, Laura
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Keyword
Emergency Medical Services
 Defibrillation
 Out-of-Hospital Cardiac Arrest (OHCA)
 Double Sequential Defibrillation
 Refractory Ventricular Fibrillation
Journal Title
Journal of Paramedic Practice
Book Title
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Publication Issue
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Publications - South East Coast Ambulance Service
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URI
http://hdl.handle.net/20.500.12417/184
DOI
10.12968/jpar.2018.10.2.64
Abstract
Abstract published with permission. Background: Refractory ventricular fibrillation (RVF) in out-of-hospital cardiac arrest (OHCA) poses a significant challenge to paramedic teams and is further confounded by an absence of specific guidance on the management of this patient category. Objective: To conduct a systematic literature review to determine whether double sequential defibrillation (DSD) improves patient outcomes in adult OHCA. Methods: Electronic searches of CINAHL, MEDLINE and AMED databases were carried out, using EBSCOhost (2017) and a subsequent filtering process. Results: Three case series and two cohort studies provided the highest category of evidence to evaluate. DSD is offered as a potentially feasible RVF treatment strategy throughout. However, results are consistently limited by varying protocol and small study groups and DSD success is likely multifactorial. Conclusion: The current systematic literature review indicated that no confirmed association existed between DSD and improved OHCA outcomes. More robust research is required to eliminate profound limitations and consider contributing factors to DSD.
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