Introduction: Refractory ventricular fibrillation is not uncommon and can be extremely difficult to abort. There is currently no standard guideline to effectively manage this electrical storm. Case Presentation: We hereby present the first successful reported use of dual simultaneous external defibrillation on a patient with refractory ventricular fibrillation in Hong Kong. Conclusion: Given the numerous successful cases with intact neurology in literature, dual simultaneous external defibrillation should be employed in indicated patients.

Introduction: Transorbital low-velocity penetrating head injuries are uncommon but important. Minor skin wounds may herald intracranial injury with high morbidity and mortality. Case presentation: A fencing coach was pierced by a sabre between his nose and right eye resulting in orbital roof fracture and frontal lobe laceration. With prompt recognition of these injuries under multidisciplinary management, he attained uncomplicated recovery. Conclusion: The emergency physician should maintain a high index of suspicion for intracranial injury in patients presenting with history of penetrating head injury. Understanding orbital anatomy, injury mechanisms and patterns can facilitate timely management to prevent potentially sight-threatening and life-threatening complications.