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When the standard ACLS algorithm fails to resolve ventricular fibrillation, what are the next steps? Consider beta blockers, double sequential external defibrillation and, if you’ve got it, ECMO.
Neil P. - February 7, 2017 6:06 AM
Any thoughts on metoprolol? Easier to locate and to administer.
Joshua B. - February 7, 2017 8:23 AM
Great question! I'm not aware of any data on the topic but it's definitely not unreasonable. There is data on giving beta blockers to patients in ventricular tachycardia storm with a pulse using metoprolol so it's definitely a potential in the absence of easily available esmolol.
R Alexander R. - February 7, 2017 8:07 AM
If double sequential defibrillation theoretically defibrillates 95% of the heart, what percentage is defibrillated with a single set of pads?