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Aug 1, 2020

Does double defib work? Does it improve your chances of walking out of the hospital? What’s your CPC score? What is a CPC score? And how exactly do you conduct this procedure. In this episode, recorded live at ACEP 2019, Dr. Tiffany Proffitt discussed the ins and outs of double defibrillation with Dr. Mark Ramzy.

Host: Tiffany Proffitt DO, MABS Attending Physician, Honor Health, Scottsdale, AZ

Guest Panel: Mark Ramzy, DO, EMT-P, Critical Care Fellow at University of Pittsburgh, Chair of the EMRA Critical Care Committee.

Suggested References:

Dr. Ramzy’s very own presentation and sources on Double Defibrillation:

  1. El Tawil C, et al. Double sequential defibrillation for refractory ventricular fibrillation. Am J Emerg Med. 2017; PMID: 28978402
  2. Hajjar K et al. Dual defibrillation in patients with refractory ventricular fibrillation. Am J Emerg Med 2018. PMID: 29730094
  3. S. Cheskes, et al. Double sequential external defibrillation for refractory ventricular fibrillation: The DOSE VF pilot randomized controlled trial. Resuscitation 2020; PMID: 32084567
  4. Ramzy M, "The DOSE VF Pilot RCT: Double Sequential External Defibrillation for Refractory Ventricular Fibrillation", REBEL EM blog, March 26, 2020. Available at:
  5. Hamilton R, Ramzy M. Dual defibrillation is highly variable: an analysis of pulse interval delivered in dual defibrillation. Prehospital Emergency Care. 2019 PMID 31116612

Additional Readings:

  1. - Double Defibrillation
  2. REBEL EM - Double Defibrillation

Key Points:

  • Make sure the case is appropriate for the use of Double Defibrillation.
  • Two defibrillators of the SAME brand.
  • Pads, like your kids, do NOT TOUCH EACH OTHER!
  • Completely anterior or anterior and posterior approach. 
  • Hit the buttons at the same time.
  • Try not to shock yourself or ruin your defibrillator.