What is the standard amiodarone dose for pediatric shock-refractory VT/VF?

• A. 5 mg/kg IV/IO; can be repeated for a total of up to 15 mg/kg
• B. 10 mg/kg IV/IO; can be repeated to 40 mg/kg
• C. 2 mg/kg IV; single dose
• D. 1 mg/kg IV; repeated to 5 mg/kg

Answer: (A)

Amiodarone is used for pediatric shock-refractory VT/VF to help stabilize the rhythm after CPR and defibrillation by increasing the refractory period of cardiac tissue, making it harder for problematic re-entrant circuits to sustain the arrhythmia. The standard pediatric bolus is 5 mg/kg given IV or IO. If the rhythm remains life-threatening, a second dose can be given, reaching a total of up to 15 mg/kg (with a per-dose limit often around 300 mg). This dosing provides a balance between efficacy and safety in the emergency setting. The other dosing options fall outside these guidelines: they’re either too small to be effective or would exceed the recommended total dose if repeated.