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Most defibrillator manufacturers offer manual defibrillators that use a biphasic waveform, and most automated external defibrillators (AEDs) are now biphasic. Studies of automated implantable cardioverters have favored the biphasic over the monophasic waveform, but there are few data on the comparative effectiveness of the 2 waveforms for external defibrillation in the out-of-hospital setting. These European investigators conducted the first prospective, randomized trial comparing monophasic and biphasic shocks in out-of-hospital cardiac arrest victims. Support was provided by the manufacturers of the AEDs used in the study.
First responders and paramedics who may arrive first on-scene were randomized daily to use either monophasic shocks (2…