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Background Refractory ventricular fibrillation (rVF) is a life-threatening condition where VF persists despite multiple defibrillation attempts, with survival rates as low as 3%. NHS ambulance services face this challenge frequently. Double sequential defibrillation (DSD) has emerged as a promising intervention for managing rVF when standard resuscitation efforts fail.Method A literature search was conducted via Library and Knowledge Services for NHS Ambulance Services in England (LKS ASE) using MEDLINE and CINAHL databases. Boolean search terms related to double sequential defibrillation and refractory ventricular fibrillation were applied. Articles were filtered for relevance and recency, with only peer-reviewed studies from the past ten years included to ensure validity and reliability.Results Seventeen articles were selected for review, with eleven supporting double sequential defibrillation (DSD) and six calling for further research. Most evidence came from case series, with one randomized controlled trial. Key themes included inconsistent DSD protocols, pad placement variability, and concerns about defibrillator damage—though evidence suggests damage is rare with proper technique. While current UK guidelines do not endorse DSD outside research, emerging evidence and international recommendations may prompt future updates supporting its use in refractory ventricular fibrillation.Conclusions While evidence for double sequential defibrillation (DSD) is largely based on case series, recent studies, including the DOSE VF Randomised Control Trial, show promising outcomes in refractory VF. Although some research questions its benefit, most advocate for further trials. DSD demonstrates potential for improved ROSC and survival, especially when applied early. With ILCOR supporting its use and UK services beginning to adopt it, DSD may become a viable option for specialist paramedics under defined protocols in prehospital cardiac arrest care.