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Updates in the Management of Refractory Ventricular Tachycardia or Ventricular Fibrillation Arrest

ACEP Now

2 Standard management for VT and VF involves the use of electrical defibrillation, high-quality chest compressions, and epinephrine. Initial guidelines defined “refractory” as VT or VF occurring despite three shocks from a cardiac defibrillator. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S.

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What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

Epinephrine infusion was begun. He required multiple defibrillations within a period of a few hours. This time, the arrhythmia did not spontaneously terminate — but rather degenerated to VFib, requiring defibrillation. An ICD ( Implantable Cardioverter Defibrilator ) was placed prior to discharge. What do you think?

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Heads Up! There is No Association with Improved Outcomes for Head Up CPR: Why We Must Read Past the Abstract

REBEL EM

Background: There are only two interventions that have been proven in the medical literature to improved outcomes in cardiac arrest: high-quality CPR and early defibrillation. Article: Moore JC et al. Over the years, we as a scientific community have worked extensively to find other interventions that improve outcomes.

CPR 52
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Calcium in Out-of-Hospital Cardiac Arrest

NAEMSP

Article by Erin Lincoln, MD Case Scenario: You are dispatched to a 68-year-old male in cardiac arrest. CPR is taken over by responding crews, and he is placed on a cardiac monitor/defibrillator. After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest.

E-9-1-1 52
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What Is the Best Defibrillation Strategy for Refractory Ventricular Fibrillation?

ACEP Now

Multiple attempts at defibrillation, epinephrine, and amiodarone have been unsuccessful. Problem What is the best defibrillation strategy to treat refractory ventricular fibrillation? 7 In attempts to improve survival of this devastating condition, investigators have reported alternative defibrillation techniques.

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October Issue Online Exclusives

ACEP Now

Click here for the full article! Click here for the full article! He was defibrillated twice and received 2 doses of epinephrine, with return of spontaneous circulation. Click here for the full article! Click here for the full article! There was no family history of syncope or sudden death.