Excellence in Defibrillation; Roadside to Resus
The Resus Room
Simon Laing
4.9 • 708 Ratings
🗓️ 8 April 2026
⏱️ 47 minutes
🧾️ Download transcript
Summary
Timely and effective defibrillation is fundamental to excellent outcomes in cardiac arrest care. But there is a growing body of evidence suggesting that how we deliver those shocks may matter just as much as when we deliver them. Over the last few years we've seen increasing interest in alternative defibrillation strategies, particularly AP pad positioning and double sequential external defibrillation, and the potential impact they can have on outcomes in refractory VF.
The DOSE-VF trial was a landmark trial in the area, showing markedly better survival to hospital discharge with both vector change defibrillation and DSED compared with standard antero-lateral pad positioning. Since then, further analyses have suggested that the timing of DSED shocks, pad positioning and the vectors of defibrillation my all play an important role in improving the chances of ROSC and good neurological recovery.
Now we've got new evidence from Sheldon Cheskes and colleagues exploring what may actually be driving these improved outcomes. Is it simply that AP pad positioning delivers more current? Or is there something more important about the direction that current travels through the myocardium? The findings from this piece of the puzzle has potential to change the fundamentals of resuscitation strategies.
In this episode we take a deep dive into the emerging evidence around defibrillation, what the latest guidelines are saying and, importantly, what this means for practice. We're also hugely fortunate to be joined by Sheldon Cheskes himself to talk through the science behind defibrillation, the evidence and how systems can implement change.
Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom!
Simon & James
Transcript
Click on a timestamp to play from that location
| 0:00.0 | Welcome to the recess room podcast. |
| 0:03.5 | Five, four, three, two, one, fire. |
| 0:12.3 | So hi, and welcome back to the recess room podcast. |
| 0:15.5 | I'm Simon Lang. |
| 0:16.9 | And I'm James Yates. |
| 0:18.0 | Which means there is an omission from the team, but don't worry, we more than make up for that later on. We're going to be covering today in this Roadside to Reesas, excellence in defibrillation. We have, and you wouldn't believe how long we've been trying to discuss the title of this episode. So hopefully the rest of it comes together a little more smoothly than just the title. |
| 0:39.1 | But man, I'm looking forward to this. This is something that we've talked a lot about in the past. And this is the latest piece of the jigsaw puzzle falling into place, isn't it? So I really can't wait to get stuck into this. I totally agree. And this isn't just a hook to try and get you to listen to the rest of the episode, but this really has potential |
| 0:54.6 | to change outcomes in a dramatic way in Cardac arrest from my perspective. So really excited to be |
| 1:01.0 | covering this. Before we get into it, a huge thanks to Zol Medical Corporation for collaborating |
| 1:06.7 | with this on the podcast and making this all free open access and available to you in their |
| 1:12.9 | pursuit of excellent patient care. So without further ado, let's crack into the episode. |
| 1:23.3 | Well, as I mentioned there, we have talked a lot about defrivelation, about resuscitation, about pad |
| 1:30.5 | positioning over the past few years. But there's good reason for that, you know, the whole point, |
| 1:36.7 | the primary goal of our resuscitation in shockable cardiac arrests is to get that heart back |
| 1:43.6 | into a perfusing rhythm, isn't it, via |
| 1:45.8 | defibrillation? And that sounds really straightforward, doesn't it? Put the pad on, |
| 1:50.8 | deliver a shock, it either works or it doesn't. But actually, we're starting to understand a lot |
| 1:56.8 | more about excellence in defibrillation, why a shock may or may not work. And that is what |
| 2:04.5 | this episode is all about. With our current knowledge and the evolving evidence base, how do we |
| 2:10.3 | provide the optimal defibrillation? And Simon, I don't want to blow our trumpets too much here, |
| 2:16.1 | but I'm going to. I was just thinking back. Such reluctance to do so, that, James. It's palpable. I'm really reluctant, but I will. It's a Saturday morning and the sun's shining, so we want to get outside. I was thinking all the way back to the very foundations of the resus room. And actually, this is where it all started. I mean, I don't want to say that we had the finger on the pulse. Oh, no, don't. That was bad, wasn't it? I was filling in for Rob, really, to be honest, with the bad jokes. But we had our finger on the pulse right back at the beginning, didn't we? Because actually, the resus room came from DSD. You asked me i think after some conversations to write a blog |
| 2:53.4 | post for your website and then on the back of that we said hey why don't we record a podcast episode |
... |
Please login to see the full transcript.
Disclaimer: The podcast and artwork embedded on this page are from Simon Laing, and are the property of its owner and not affiliated with or endorsed by Tapesearch.
Generated transcripts are the property of Simon Laing and are distributed freely under the Fair Use doctrine. Transcripts generated by Tapesearch are not guaranteed to be accurate.
Copyright © Tapesearch 2026.