During PALS, a child in pulseless ventricular fibrillation receives a defibrillation shock but remains in VF. The correct energy dose for the second and subsequent defibrillation attempts in children is:
- A 2 J/kg for all subsequent attempts
- B 4 J/kg, may escalate up to 10 J/kg or adult dose for subsequent attempts ✓
- C 4 J/kg fixed for all attempts
- D 2 J/kg first shock, 4 J/kg second shock, then adult 200 J for subsequent
Correct answer: B. 4 J/kg, may escalate up to 10 J/kg or adult dose for subsequent attempts
Explanation
Current PALS guidelines recommend 2 J/kg for the first shock, 4 J/kg for the second shock, and 4 J/kg or higher (up to 10 J/kg or adult dose, whichever is lower) for subsequent shocks in pediatric VF/pVT. This escalating protocol is designed to improve defibrillation success in refractory shockable rhythms without fixed-dose limitations.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.