DOuble SEquential External Defibrillation for Refractory VF (DOSEVF)
Out-Of-Hospital Cardiac Arrest, Ventricular Fibrillation
About this trial
This is an interventional treatment trial for Out-Of-Hospital Cardiac Arrest focused on measuring Resuscitation, Arrhythmia, Cardiac, Heart Diseases, Heart Arrest
Eligibility Criteria
Inclusion Criteria:
- ≥ 18 years of age
- Non-traumatic cardiac arrest of presumed cardiac etiology
- Presenting rhythm of ventricular fibrillation or pulseless ventricular tachycardia
- No ROSC or non-shockable rhythm after three consecutive shocks by EMS or fire department.
Exclusion Criteria:
- Traumatic cardiac arrest
- Patients with pre-existing do not resuscitate orders
- Patients without VF or pulseless VT as presenting rhythm
- Patients without three consecutive shocks delivered
- Patients initially treated by non-participating fire or EMS agencies.
Sites / Locations
- Peel Regional Paramedic Service
- Middlesex-London Paramedic Service
- Halton Region Paramedic Services
- Ottawa Paramedic Service
- County of Simcoe Paramedic Services
- Toronto Paramedic Services
Arms of the Study
Arm 1
Arm 2
Arm 3
No Intervention
Active Comparator
Active Comparator
Standard Arm
Double Sequential Defibrillation
Vector Change 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. 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.
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.