Title: When ACLS fails: Double sequential defibrillation- A case report and review of the literature

Biography:

Shafeek Kiblawi received his Doctorate of Medicine in 2012 from the American University of Beirut. He is currently in his final year of Residency in Emergency Medicine at the American University of Beirut Medical Center. Shafeek previously worked in EMS as a Paramedic in the United States and has experience in Firefighting and Disaster Medicine.

Abstract

Using two defibrillators at the same time on a patient may seem unusual to those unfamiliar with the concept. This procedure, deemed double sequential defibrillation, is being used for refractory or recurrent ventricular fibrillation when standard Advanced Cardiac Life Support (ACLS) fails. Although not fully understood, mounting evidence exists as to the efficacy of double sequential defibrillation and multiple theories about its mechanism of action can be found in the literature. We report a case of an elderly male with massive gastrointestinal bleeding who developed refractory ventricular fibrillation in the Emergency Department and was successfully resuscitated using double sequential defibrillation. We subsequently review the literature and describe the current evidence and understanding regarding double sequential defibrillation.