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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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 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 ★★★★★★☆


Embedded ImageDesign:

randomised controlled trial.

Embedded ImageAllocation:


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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  • * See glossary.

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

  • Source of funding: Medtronic Emergency Response Systems.

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