For Pediatric Unstable VT, what is the initial energy for synchronized cardioversion?

• A. 2 J/kg
• B. 0.5 J/kg
• C. 4 J/kg
• D. 1 J/kg

Answer: (D)

In pediatric unstable VT, the goal of synchronized cardioversion is to terminate the tachyarrhythmia with enough energy to restore normal rhythm while minimizing myocardial injury. The first synchronized shock is delivered at 1 J/kg. This dose provides effective cardioversion for most children without overshooting the myocardium. If the rhythm does not convert, the energy can be increased for subsequent shocks, commonly to 2 J/kg. Higher initial energies (like 2 J/kg or 4 J/kg) are generally reserved for later attempts or different clinical scenarios, and 0.5 J/kg, while sometimes cited, is less consistently the standard initial dose in exam-focused guidance.