Dual Sequential Defibrillation

[coolidge]

Does anyone recall reading a report/story about the use of two AEDs at the same time? And if so, where the reference is found.....Thanks

 

[NYMedic828]

Why would you ever use two AEDs at the same time? There is zero reason whatsoever to support a benefit for that...

Also if this is an ALS related discussion, why is an AED being used and not a monitor :/

 

[mikie]

Try looking up Double Sequential Defibrillation

 

[NYMedic828]

Try looking up Double Sequential Defibrillation

Now that makes more sense to me.

That would be done using a pair of monitors though, not using AEDs.

AEDs could not possibly achieve that.

 

[Shishkabob]

Dual device defibrillation is being used around here for refractive v-fib. Apparently it's been showing decent results.



We had a refractive V-fibber last week that was shocked 7 times between fire and us. Converted to asystole before we gave the dual shock a shot.

 

[Medic Tim]

Double Sequential Defibrillation
there was an article about it in Jems or Emergency mag. last year. I cant remember which

 

[Shishkabob]

That would be done using a pair of monitors though, not using AEDs.

AEDs could not possibly achieve that.

If they were sAEDs, sure they could. Granted it'd take some effort syncing them, but as long as you're the one that presses the button, it's good to go.



EMS world article;

http://www.emsworld.com/article/10318805/hold-the-coroner

 

[mycrofft]

Dueling AED's?

 

[NomadicMedic]

Thought they were doing this in Wake?

 

[STXmedic]

Doing it down here, considerable on the third shock and beyond. Haven't personally had to do it yet, though.

 

[JPINFV]

Dueling AED's?

Dualing AEDs... making patients squeal like a pig since 1972.

 

[bigbaldguy]

Dualing AEDs... making patients squeal like a pig since 1972.

:rofl:

 

[Handsome Robb]

For the double sequential defib how are you guys placing your pads? I started a thread about it a while back when I saw something on WCEMS website about it. They seem to put the pads next to eachother.

I could see apex/sternum and posterior/anterior working well with the different vectors, I don't see the point of dual apex/sternum placement.

 

[Shishkabob]

We do apex/sternum and anterior/posterior.

 

[STXmedic]

We do apex/sternum unless it doesn't fit well on the pt, then we go front/back.

Rob: The way our Med Director explained it to me was like upping the dose of medication. If X amount of Y drug isn't working, you need to up the dose or it will continue to not have the desired effect. Especially since shocking isn't a cumulative effect between shocks. So it's not necessarily the placement and trying to affect more vectors, but upping the "dose". Now, I haven't done enough research on it to be able to determine if that's a very reasonable simile or if he was trying to explain it to me like a 4th grader. :unsure:

 

[NomadicMedic]

It's nothing like upping the dose. It's the second, quickly delivered shock through a separate pathway terminating VF after the first shock reduces the defib threshold. It actually takes LESS energy to convert VF using the sequential shock methodology.

http://www.ncbi.nlm.nih.gov/m/pubmed/3782643/

 

[STXmedic]

Well I guess he was talking to me like a 4th grader Your post prompted some quick journal searches, all of which confirmed this. Thanks n7

 

[NomadicMedic]

Well I guess he was talking to me like a 4th grader Your post prompted some quick journal searches, all of which confirmed this. Thanks n7

Or perhaps he doesn't understand the mechanism of action.

It's an interesting concept. I won't be surprised when, in the future, we are issued the new LP115 with 4 pads, able to deliver sequential shocks.

 

[epipusher]

Our service has been considering doing a study on this. They are currently working on the continuous cpr during defib.

 

[Hockey]

Interesting for sure. I'll forward Linus' article on as well.