What is the recommended amiodarone dose for pediatric refractory VF/pVT?

• A. 10 mg/kg IV/IO; may repeat once for a total up to 20 mg/kg
• B. 5 mg/kg IV/IO; may repeat once for a total up to 15 mg/kg
• C. 1 mg/kg IV/IO; may repeat with a smaller second dose
• D. 15 mg/kg IV/IO; may repeat twice for a total 30 mg/kg

Answer: (B)

In pediatric resuscitation, amiodarone is used when a child with ventricular fibrillation or pulseless ventricular tachycardia remains refractory to initial defibrillation attempts. The goal is to suppress ongoing malignant arrhythmias while preserving hemodynamics.

The recommended approach is to give a bolus of amiodarone at 5 mg/kg IV or IO. If the rhythm persists after that initial dose, a second bolus may be given. This allows a total dose up to 15 mg/kg, balancing effectiveness with safety in children. Amiodarone works by several electrophysiologic actions that help stabilize the heart rhythm, but it can cause hypotension and other adverse effects, so dosing is kept within these pediatric guidelines.

So the best choice reflects giving 5 mg/kg IV/IO, with the possibility of a repeat dose to reach a cumulative total up to 15 mg/kg in the refractory situation.