Double Sequential Defibrillation in Refractory V-Fib: Does It Deliver?

You're running a code on a patient in refractory ventricular fibrillation. After multiple shocks, epinephrine, and amiodarone, the VF persists. Someone suggests, "Should we try double sequential defibrillation?" Before you can reach for the second defibrillator, a nurse responds, "Won’t that damage the machines?" You pause and think—does this actually work, and is it safe?