What is the initial defibrillation energy dose for a pediatric patient?

• A. 1 J/kg
• B. 3 J/kg
• C. 5 J/kg
• D. 2 J/kg

Answer: (D)

The main idea is that defibrillation in children is done with weight-based energy, starting with a low, carefully chosen dose. For a child in cardiac arrest with a shockable rhythm, the first shock should be delivered at 2 J/kg. This energy level is high enough to interrupt chaotic electrical activity but low enough to minimize injury to a child’s still-sensitive myocardium. If the first shock doesn’t restore circulation, subsequent shocks are given at 4 J/kg. Higher first doses aren’t recommended because they don’t improve outcomes and increase the risk of myocardial damage. Choices like 1 J/kg or 3 J/kg aren’t the standard starting doses, and 5 J/kg would expose the child to more energy than necessary on the initial attempt. Use pediatric-defibrillation equipment and pads to ensure the energy is appropriately scaled to weight.