What is the energy for the first defibrillation shock in a pediatric patient?

• A. 4 J/kg
• B. 1 J/kg
• C. 2 J/kg
• D. 8 J/kg

Answer: (C)

In pediatric defibrillation, the first shock is given at a moderate, weight-based energy. This approach respects the child’s smaller heart and chest impedance, aiming to deliver enough current to terminate a life-threatening rhythm without causing unnecessary myocardial injury. Starting at a moderate per-kilogram dose provides a real chance to restore a normal rhythm, and if that initial shock doesn’t work, you escalate the energy in a stepwise fashion for subsequent shocks. The key idea is to balance effectiveness with safety, using a dose that’s appropriate for a child’s size rather than applying adult-level energy from the outset.