What is the first dose energy for defibrillation in VF/pVT in children?

• A. 2 J/kg
• B. 1 J/kg
• C. 0.5 J/kg
• D. 4 J/kg

Answer: (A)

In children, defibrillation energy is scaled to weight. The first shock for a shockable rhythm (VF or pulseless VT) should be delivered at 2 J/kg. This provides enough energy to terminate the arrhythmia while minimizing potential myocardial injury in a smaller heart. If the rhythm remains after the first shock, subsequent shocks are increased to 4 J/kg (up to the device’s maximum pediatric energy, often around 200 J). Doses lower than 2 J/kg are generally unlikely to terminate the rhythm, and 4 J/kg is reserved for repeat shocks, not the initial one.