Acute cardiac care & resuscitation
Energy levels in manual defibrillation after prior AED shock
Authors' conclusion
Adherence to escalating energy protocol by EMS during transition from defibrillation with AED to manual defibrillator is limited. Our data did not provide evidence for a relationship between adherence and clinical outcomes.
Study context
- Population
- Adults with out-of-hospital cardiac arrest (OHCA) and shockable rhythm who received ≥1 AED shock and ≥1 manual defibrillator shock by Emergency Medical Services (EMS)
- Participants
- 827 adults
- Exposure
- 360 J vs 200 J
- 360 Jn = 168
- 200 Jn = 659reference
- Outcome
- Adherence to the escalating energy protocol
Methodological detailsARREST-registry, the Netherlands
- ARREST-registry, the Netherlands
Main finding
As reported in the abstract
Adherence to escalating energy protocol
Adherence
20.3 %
95 % CI 17.7 %-23.2 %
Observational data: associations, not effects.
Secondary outcomes
Termination of shockable rhythm by first manual shock
P = 0.33
30-day survival (overall)
- Overall 30-day survival
- 38.4 %
Clinical outcomes by adherence
- Adherence not significantly associated with differences in clinical outcomes after multivariable analyses
Original publication
Energy levels in manual defibrillation after prior AED shock. Resuscitation. Published 23 September 2025. doi:10.
Summarised from the published abstract; every number is checked against it