Sometimes, we have a problem with Defibillator Pad Placement in obese female with large breasts. Do you have tips for that?
A couple of points from the prehospital arena.
Maximum defibrillation joules may be greater than 200. (Physio is 360J) both bi-phasic waveforms.
If you have uninterrupted Chest Compressions and have shocked the patient 5 times with a traditional approach – Reaccess Pad vectors (placement) and Dual Defibrillation can be a game changer.
Beyond our initial case series (Cabanas JG et al. Double Sequential External Defibrillation in Out-of-Hospital Refractory Ventricular Fibrillation: A Report of Ten Cases. Perhaps Emerg Care 2015; 19 (1): 126 – 130. PMID: 25243771) studies continue to show some success beyond repeating traditional treatment to futility.
This is a good summary – http://rebelem.com/beyond-acls-dual-simultaneous-external-defibrillation/
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