Patients in refractory ventricular fibrillation (VF) cardiac arrest may not respond to standard resuscitation such as defibrillation and antiarrhythmics. Until recently there were no additional treatments available to improve outcomes for these patients in the prehospital setting, resulting in overall poor survival. The recently published DOSE VF Randomized Controlled Trial provided high quality evidence that the use of alternative defibrillation techniques (double sequential defibrillation (DSED) and vector change defibrillation) significantly improved outcomes in patients with refractory VF. This talk will describe the evidence behind the use of DSED and vector change defibrillation, discuss the nuances of implementation of alternative defibrillation techniques and how they can be used to improve cardiac arrest management and patient outcomes.
Learning Objectives:

Upon completion of this presentation, participants will be able to describe the evidence behind the use of double sequential defibrillation, including the results of the DOSE VF randomized controlled trial.
Upon completion of this presentation, participants will be able to describe the situations in which alternative defibrillation techniques may be employed during cardiac arrest management
Upon completion of this presentation, participants will be able to define double sequential defibrillation and list the indications for its use.