DOuble SEquential External Defibrillation for Refractory VF Pilot Study (DOSE-VF)
Ventricular Fibrillation
About this trial
This is an interventional treatment trial for Ventricular Fibrillation
Eligibility Criteria
Inclusion Criteria:
- ≥18 years of age, non-traumatic cardiac arrest of presumed cardiac etiology, presenting rhythm to EMS of ventricular fibrillation; no ROSC or non VF rhythm after three consecutive EMS shocks.
Exclusion Criteria:
- Traumatic cardiac arrest, patients with pre-existing do not resuscitate orders, presumed pregnancy, patients in recurrent ventricular fibrillation (defined as those with a secondary presentation of VF (not the presenting rhythm) or those presenting in VF but did not receive three consecutive defibrillation attempts).
Sites / Locations
- Peel Regional Paramedic Service
- Halton Region Paramedic Services
- County of Simcoe Paramedic Services
- Toronto Paramedic Services
Arms of the Study
Arm 1
Arm 2
Arm 3
No Intervention
Other
Other
Standard defibrillation
Vector change defibrillation
Double-sequential defibrillation
All defibrillation attempts will occur using the standard defibrillation method, i.e. defibrillation pads will be placed in the anterior-anterior configuration. The patient may also be administered antiarrythmic agents and epinephrine, as per current provincial standard.
The first three shocks will occur with defibrillation pads placed in the anterior-anterior position. All further shocks will occur with the pads placed in the anterior-posterior position. The patient may also be administered antiarrythmic agents and epinephrine, as per current provincial standard.
The first three shocks will occur with defibrillation pads placed in the anterior-anterior position. For all further shocks, a second set of defibrillation pads (via a second on scene EMS or fire defibrillator) will be applied in the anterior-posterior position, and defibrillation will be carried out by sequential defibrillation shocks provided by the two defibrillators (i.e. with a short delay between the two defibrillators). The patient may also be administered antiarrythmic agents and epinephrine, as per current provincial standard.