Laura Stevenson
Journal of Paramedic Practice, Vol. 10, Iss. 2, 02 Feb 2018, pp 64 - 72

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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