Prehospital Double Sequential Defibrillation Does Not Improve Survival

Ventricular dysrhythmia is the most treatable etiology of out-of-hospital cardiac arrest, but cases refractory to standard defibrillation are challenging. Several prehospital systems have adopted a practice from electrophysiology and implemented protocols for double sequential defibrillation (DSD), which involves attaching a second defibrillator to the patient and attempting to deliver near-simultaneous therapy from the two devices.

Using data from the San Antonio Fire Department, researchers matched 64 patients with refractory or recurrent ventricular dysrhythmia who survived to hospital admission (cases) to 64 patients who did not survive to admission (controls). They compared outcomes between patients treated with DSD by paramedics and th…