If a shockable rhythm is identified during pediatric resuscitation, what is the recommended immediate action?

• A. Wait for a rhythm check.
• B. Deliver a defibrillation shock promptly.
• C. Administer epinephrine first.
• D. Continue CPR without defibrillation.

Answer: (B)

When a shockable rhythm is present, the priority is to deliver a defibrillation shock immediately. This countershock targets the chaotic electrical activity (like ventricular fibrillation or pulseless ventricular tachycardia) and can rapidly restore a perfusing rhythm, which has the greatest impact on survival. Delaying defibrillation to recheck the rhythm or to give medications first reduces the chance of restoring circulation. After the shock, promptly resume high-quality CPR, and recheck the rhythm after about two minutes. In children, use weight-based energy for the first shock (and for subsequent shocks if needed). Epinephrine is used in later cycles or for non-shockable rhythms, not before delivering the initial defibrillation.