Article Synopsis
- The study aimed to assess if prehospital double sequential defibrillation (DSD) improves survival rates for patients experiencing refractory ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) during out-of-hospital cardiac arrest (OHCA).
- The research involved a matched case-control analysis based on data from San Antonio Fire Department, comparing OHCA patients who survived to hospital admission with those who did not, focusing on the use of DSD.
- Findings revealed that survival to hospital admission was similar for both DSD patients (48.0%) and those receiving conventional therapy (50.5%), indicating that DSD did not lead to improved survival outcomes.
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Article Abstract
Objectives: The goal of our study was to determine whether prehospital double sequential defibrillation (DSD) is associated with improved survival to hospital admission in the setting of refractory ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT).
Methods: This project is a matched case-control study derived from prospectively collected quality assurance/quality improvement data obtained from the San Antonio Fire Department out-of-hospital cardiac arrest (OHCA) database between January 2013 and December 2015. The cases were defined as OHCA patients with refractory VF/pVT who survived to hospital admission. The control group was defined as OHCA patients with refractory VF/pVT who did not survive to hospital admission. The primary variable in our study was prehospital DSD. The primary outcome of our study was survival to hospital admission.
Results: Of 3,469 consecutive OHCA patients during the study period, 205 OHCA patients met the inclusion criterion of refractory VF/pVT. Using a predefined algorithm, two blinded researchers identified 64 unique cases and matched them with 64 unique controls. Survival to hospital admission occurred in 48.0% of DSD patients and 50.5% of the conventional therapy patients (p > 0.99; odds ratio = 0.91, 95% confidence interval = 0.40-2.1).
Conclusion: Our matched case-control study on the prehospital use of DSD for refractory VF/pVT found no evidence of associated improvement in survival to hospital admission. Our current protocol of considering prehospital DSD after the third conventional defibrillation in OHCA is ineffective.
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| http://dx.doi.org/10.1111/acem.13672 | DOI Listing |
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