Department of Anesthesiology and Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, NM.
Department of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque, NM.
Ann Emerg Med. 2018 Jan;71(1):109-112. doi: 10.1016/j.annemergmed.2017.04.005. Epub 2017 May 27.
The simultaneous use of 2 external defibrillators to administer either dual or sequential cardioversion or defibrillation for refractory cardiac arrhythmias is increasing in both the out-of-hospital and inhospital settings. Using 2 defibrillators to administer higher energy levels than can be achieved with a single defibrillator is considered off-label and is currently not part of published advanced cardiac life support guidelines. We report the first case in which the use of dual-dose cardioversion was associated with external defibrillator damage. Because defibrillator damage, especially if undetected, jeopardizes patient safety and off-label medical product use may void the manufacturer's warranty, this case should urge users to proceed with caution when contemplating this technique.
在院外和院内环境中，同时使用 2 台体外除颤器来给予双相或序贯转复或除颤，以治疗难治性心律失常的情况越来越多。使用 2 台除颤器给予比单个除颤器所能达到的更高能量水平被认为是超适应证的，目前不属于已发布的高级心脏生命支持指南的一部分。我们报告了首例使用双剂量转复与体外除颤器损坏相关的病例。由于除颤器损坏，特别是如果未被发现，会危及患者安全，并且超适应证医疗产品的使用可能会使制造商的保修失效，因此，这个病例应该促使使用者在考虑使用这种技术时谨慎行事。
