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  • An escalating higher energy regimen was better than a fixed lower energy regimen for defibrillation in out of hospital cardiac arrest

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Therapeutics
An escalating higher energy regimen was better than a fixed lower energy regimen for defibrillation in out of hospital cardiac arrest

https://doi.org/10.1136/ebm.12.5.142

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    Stiell IG, Walker RG, Nesbitt LP, et al. BIPHASIC Trial: a randomized comparison of fixed lower versus escalating higher energy levels for defibrillation in out-of-hospital cardiac arrest. Circulation 2007;115:1511–7.
    OpenUrlAbstract/FREE Full Text

    
 
 Q In patients with out of hospital cardiac arrest, is an escalating higher energy regimen better than a fixed lower energy regimen for arrhythmia termination with an automated external defibrillator (AED) using a biphasic waveform?

    Clinical impact ratings Emergency medicine ★★★★★★☆ Internal medicine ★★★★★★☆ Cardiology ★★★★★★☆

    METHODS

    Embedded ImageDesign:

    randomised controlled trial.

    Embedded ImageAllocation:

    concealed.*

    Embedded ImageBlinding:

    blinded (healthcare providers, patients, data collectors, and outcome assessors).*

    Embedded ImageFollow-up period:

    to death or hospital discharge.

    Embedded ImageSetting:

    out of hospital locations in 3 Canadian cities.

    Embedded ImagePatients:

    221 patients ⩾8 years of age (mean age 66 y, 80% men) who had out of hospital cardiac arrest and required defibrillation (for ventricular fibrillation [VF] or pulseless ventricular tachycardia) and whose initial defibrillation was provided by first responders using an AED. Exclusion criteria included terminal illness, acute trauma, exsanguination, and not having basic cardiopulmonary resuscitation for >10 …

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    Footnotes

    • ↵* See glossary.

    • For correspondence: Dr I G Stiell, Ottawa Health Research Institute, Ottawa, ON, Canada. istiell{at}ohri.ca

    • Source of funding: Medtronic Emergency Response Systems.

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      BMJ Publishing Group Ltd
      BMJ Evidence-Based Medicine 2007; 12 160-160 Published Online First: 01 Oct 2007. doi: 10.1136/ebm.12.5.160