Homepage: EMNote.org ■ 🚩Membership: https://tinyurl.com/joinemnote 🚩ACLS Lecture: https://tinyurl.com/emnoteacls Dual sequential external defibrillation (DSED) is a technique that uses two defibrillators to deliver two high-energy shocks in rapid succession, aimed at terminating refractory ventricular fibrillation (VF) when standard defibrillation attempts fail. By applying the shocks sequentially, typically with pads placed in an anterior-posterior configuration for one defibrillator and an anterolateral configuration for the other, DSED can increase the likelihood of achieving defibrillation by disrupting the chaotic electrical activity in the heart more effectively. Emerging evidence suggests that DSED significantly improves survival rates and the return of spontaneous circulation (ROSC) in patients with refractory VF compared to traditional single-shock approaches.