Dr Tony Smith, Deputy Clinical Director at Hato Hone St John, tells us about Double Sequential and Vector Change Defibrillation for resistant VF/VT.  These new techniques, not currently covered in our NZRC resus algorithms, are being utilised by all ambulance services in New Zealand for patients who do not get ROSC after three shocks.   Tony can be contacted for questions at - [email protected]    Check out the paper mentioned Cheskes S, Verbeek PR, Drennan IR, McLeod SL, Turner L, Pinto R, Feldman M, Davis M, Vaillancourt C, Morrison LJ, Dorian P, Scales DC. Defibrillation Strategies for Refractory Ventricular Fibrillation. N Engl J Med. 2022 Nov 24;387(21):1947-1956. doi: 10.1056/NEJMoa2207304. Epub 2022 Nov 6. PMID: 36342151. https://www.nejm.org/doi/full/10.1056/NEJMoa2207304  And the editorial - https://www.nejm.org/doi/full/10.1056/NEJMe2213562    Check out the Article from the Conversation - https://theconversation.com/a-new-emergency-procedure-for-cardiac-arrests-aims-to-save-more-lives-heres-how-it-works-221979    Check out the article from the NZMJ Dicker B, Maessen S, Swain A, Garcia E, Smith T. Are two shocks better than one? Aotearoa New Zealand emergency medical services implement a new defibrillation strategy: implications for around nine patients per week. N Z Med J. 2024 Mar 22;137(1592):105-107. doi: 10.26635/6965.6429. PMID: 38513209.      www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor