Palm Beach County Fire Rescue’s new protocol uses two defibrillators and four pads to deliver dual shocks earlier for some cardiac arrest patients

PALM BEACH COUNTY, Fla. — Palm Beach County Fire Rescue has implemented a new cardiac arrest protocol that allows first responders to use an advanced defibrillation technique earlier in resuscitation efforts.

Department leaders say the change is designed to improve survival for cardiac arrest patients who do not respond to initial defibrillation attempts.

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The technique, known as double sequential defibrillation, uses two defibrillators and four pads placed on the patient’s chest and back. The devices deliver shocks from different directions to restore a sustainable heart rhythm, CBS 12 reported.

Chief Charles Coyle said the protocol was developed using national research and input from local medical directors.

“If there’s something out there that we can do right now, and there’s science out there that says it’s the right thing to do, and we’ve spoke to the experts through our medical director staff, it’s very simple for us,” Coyle said. “We have to create the protocol to save lives today and not wait for the science to develop tomorrow.”

Under the protocol, crews bring two defibrillators to the patient, with two sets of pads positioned to create separate electrical pathways through the heart. The first pad is placed on the front of the chest, with the second positioned slightly off-center on the patient’s back to create an electrical pathway through the heart.

EMS Capt. Anthony Robles said the two defibrillators operate independently, delivering the same amount of energy simultaneously during double sequential defibrillation.

The technique is part of the department’s “pit crew CPR” model, which assigns responders specific roles during cardiac arrest.

For Ken Beck, the new protocol may have helped save his life. When Palm Beach County Fire Rescue crews arrived, Beck was pulseless and experiencing agonal breathing while his wife, Tara, performed CPR.

It was one of the crew’s first uses of double sequential defibrillation on a patient. After the initial dual shock, Beck’s heart converted to a sustainable rhythm, and crews detected a pulse and blood pressure.

Beck spent six days in a medically induced coma and nearly a month at Delray Medical Center, where doctors diagnosed him with cardiac sarcoidosis, a condition that can cause dangerous heart rhythms.

His case was later included in a medical study examining early use of double sequential defibrillation for refractory ventricular fibrillation. Researchers said the approach could improve outcomes for some patients, but further study is needed.

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