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She was found to be in ventricular fibrillation and was defibrillated 8 times without a single, even transient, conversion out of fibrillation. She was immediately intubated during continued compressions, then underwent a 9th defibrillation, which resulted in an organized rhythm at 42 minutes after initial arrest. References : 1.
She was never seen to be in ventricular fibrillation and was never defibrillated. Medics found her apneic and pulseless, began CPR, and she was found to be in asystole. With ventilations and epinephrine, she regained a pulse. She was hypotensive in the ED and her bedside echo showed a normal RV and LV. BP gradually rose.
Several 200 J shocks did not terminate the VF, so a second defibrillator was applied for double sequential defibrillation with 400 J. She was defibrillated perhaps 25 times. After completing the ACS algorithm with amiodarone and lidocaine, there are diminishing returns on further treatments. SanzRuiz, R., Solis, J., &
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