A 4-year-old child in the emergency department is found to have a shockable rhythm (pulseless VT) on the cardiac monitor. According to PALS, what is the correct energy dose for the first defibrillation attempt?
- A 1 J/kg
- B 2 J/kg ✓
- C 4 J/kg
- D 360 J (fixed dose)
Correct answer: B. 2 J/kg
Explanation
PALS guidelines recommend an initial defibrillation dose of 2 J/kg for pediatric pulseless VT or VF. If the first shock is unsuccessful, subsequent shocks are given at 4 J/kg. Adult doses (up to 360 J) and dose escalation protocols differ from pediatric protocols. Using weight-based dosing prevents both under- and over-defibrillation in children.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.