Very intriguing! I had been seeing more positive information about A-P pad placement, so that part was a little discouraging though. Do you have the link to the resources mentioned at the 6:35 mark regarding DSED administration? Thanks Dr. Antevy!
Thank you for the comment. There is still a long way to go to better understand the value and utility of DSED. Some are looking at using A/P pads for the first 3 standard shocks and also whether DSED should be initiated after shock #1 (this would be my choice). Here is the folder I promised, thanks for the reminder :) www.dropbox.com/scl/fo/p29oemlrk3sbj40b1r63q/AMeomjtuSY2lH1Ak1npGL_Y?rlkey=5ay3rni56mscq3jdxwjrf1f9m&dl=0
@@TheHandtevy Thank you very much!!! I’d love to see more studies on A/P placement for initial shocks, but I’m sure it would be more challenging for solo lay rescuers with an AED or those using Zoll Z-pads who don’t know you can separate them. (I have AEDs in my personal vehicles and home, and probably would only do A/P pad placement if patient was already prone or on their side if I didn’t have help, but otherwise would definitely try A/P placement whenever possible.) Thanks again for the great content and for all you do for EM!
@@flyboy8752 at some point we will publish our data here at PBCFR. We use mechanical CPR so we start AP on all of our patients. We are going to work with Dr. Cheskes to evaluate our outcomes.
If I had two LP15s and completed DSED. I would imagine they would shock at the same time if both buttons applied at same time. However, If I have a LP15 and AED by Zoll or another manufacturer... and pushed the buttons at same time - would these shock at the same time or +/- difference. Is this something to consider? If the shocks were up to 4 seconds apart? does that make a difference? LP15 manual states - just because you set defib at lets say 375j - it quickly measures impedance first and adjusts power in Joules accordingly...I also wonder would this be a delay as well?
There is a trick to getting the AED to synchronize correctly with the LP15 or Zoll X-Series. In the DOSE VF trial they had to use this method. Dr. Cheskes created videos around this topic which I will add to the folder once I have them. They also published another paper in 2024 looking at the optimal timing between the sequential shocks and it appears to be < 75 msec. Here is the link to that study: www.dropbox.com/scl/fi/35d2937w1u9ug9y9dftwx/2024-Timing-of-DSED-Shocks-Cheskes.pdf?rlkey=cilrjgdglzs4i71odmch51c6g&dl=0 Ideally, the manufacturers will develop a single device that can accomplish DSED. I believe that will become a reality in the coming years.
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Outstanding info as usual Doc , keep it up. Tommy, RA alumni
Very intriguing! I had been seeing more positive information about A-P pad placement, so that part was a little discouraging though. Do you have the link to the resources mentioned at the 6:35 mark regarding DSED administration? Thanks Dr. Antevy!
Thank you for the comment. There is still a long way to go to better understand the value and utility of DSED. Some are looking at using A/P pads for the first 3 standard shocks and also whether DSED should be initiated after shock #1 (this would be my choice).
Here is the folder I promised, thanks for the reminder :)
www.dropbox.com/scl/fo/p29oemlrk3sbj40b1r63q/AMeomjtuSY2lH1Ak1npGL_Y?rlkey=5ay3rni56mscq3jdxwjrf1f9m&dl=0
@@TheHandtevy Thank you very much!!! I’d love to see more studies on A/P placement for initial shocks, but I’m sure it would be more challenging for solo lay rescuers with an AED or those using Zoll Z-pads who don’t know you can separate them. (I have AEDs in my personal vehicles and home, and probably would only do A/P pad placement if patient was already prone or on their side if I didn’t have help, but otherwise would definitely try A/P placement whenever possible.) Thanks again for the great content and for all you do for EM!
@@flyboy8752 at some point we will publish our data here at PBCFR. We use mechanical CPR so we start AP on all of our patients. We are going to work with Dr. Cheskes to evaluate our outcomes.
@@TheHandtevy awesome! I can’t wait!!!
If I had two LP15s and completed DSED. I would imagine they would shock at the same time if both buttons applied at same time. However, If I have a LP15 and AED by Zoll or another manufacturer... and pushed the buttons at same time - would these shock at the same time or +/- difference. Is this something to consider? If the shocks were up to 4 seconds apart? does that make a difference?
LP15 manual states - just because you set defib at lets say 375j - it quickly measures impedance first and adjusts power in Joules accordingly...I also wonder would this be a delay as well?
There is a trick to getting the AED to synchronize correctly with the LP15 or Zoll X-Series. In the DOSE VF trial they had to use this method. Dr. Cheskes created videos around this topic which I will add to the folder once I have them.
They also published another paper in 2024 looking at the optimal timing between the sequential shocks and it appears to be < 75 msec. Here is the link to that study: www.dropbox.com/scl/fi/35d2937w1u9ug9y9dftwx/2024-Timing-of-DSED-Shocks-Cheskes.pdf?rlkey=cilrjgdglzs4i71odmch51c6g&dl=0
Ideally, the manufacturers will develop a single device that can accomplish DSED. I believe that will become a reality in the coming years.
I just added the folder with the requested videos in the drobox. See video description section and scroll the bottom.