Dual simultaneous external defibrillation
Also known as:
Double sequential external defibrillation (DSED)
Dual sequential defibrillation (DSD)
Use only in refractory or intractable ventricular fibrillation (VF) after multiple attempts (at least 3 to 5 attempts) at defibrillation and appropriate medications have been given.
Apply TWO sets of defibrillator pads to the patient; one in traditional sternum/apex configuration and the other in anterior/posterior configuration. Some protocols suggest firing the defibrillators "sequentially" (less than 1 second apart), others recommend firing "as synchronously as possible" (simultaneously).
Consider using high-energy, dual simultaneous defibrillation in patients with refractory VF only after high quality CPR, several attempts at defibrillation, and appropriate medications have been given.