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

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 ...