Prehospital Double Sequential Defibrillation: A Matched Case–Control Study.

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 matche...

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Publicado en:Academic Emergency Medicine Vol. 26; no. 9; pp. 994 - 1002
Autores principales: Mapp, Julian G., Hans, Alan J., Darrington, Anthony M., Ross, Elliot M., Ho, Calvin C., Miramontes, David A., Harper, Stephen A., Wampler, David A., Braithwaite, Sabina A.
Formato: pictorial research tables/charts Journal Article
Publicado: Wiley-Blackwell Sep2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2019
      vid: 26
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Prehospital Double Sequential Defibrillation: A Matched Case–Control Study.
      aug:
        au:
          Mapp, Julian G.
          Hans, Alan J.
          Darrington, Anthony M.
          Ross, Elliot M.
          Ho, Calvin C.
          Miramontes, David A.
          Harper, Stephen A.
          Wampler, David A.
          Braithwaite, Sabina A.
        affil: San Antonio Uniformed Services Health Education Consortium, JBSA Fort Sam Houston, TX
      sug:
        subj:
          Defibrillation Methods
          Prehospital Care
          Ventricular Fibrillation Prognosis
          Tachycardia, Ventricular Prognosis
          Human
          Case Control Studies
          Ventricular Fibrillation Therapy
          Tachycardia, Ventricular Therapy
          Prospective Studies
          Patient Admission
          Algorithms
          Odds Ratio
          Confidence Intervals
      ab: 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.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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