One of the patients in paediatric ICU has developed VF and the staff have staed CPR. You are the physician on call. You want to try DC shock so as to reve to it to normal rhythm. What is the energy you would use in this scenario? The child is 3 years old, weight – 15 kg, SPO2 – 88, BP unrecordable, RR – 40/minute.

**Core Concept**
The management of pediatric cardiac arrest involves the use of electrical defibrillation to restore a normal cardiac rhythm. The American Heart Association (AHA) recommends the use of biphasic defibrillators, which are more effective than monophasic defibrillators in converting VF to a normal rhythm. The energy required for defibrillation is determined by the weight of the patient, with smaller children requiring lower energies.

**Why the Correct Answer is Right**
For children weighing between 1-25 kg, the recommended energy for biphasic defibrillation is 2-4 J/kg. Given that the child in question weighs 15 kg, the total energy required would be 30-60 J. However, the exact energy may vary depending on the specific defibrillator being used. In this scenario, an energy of 50 J would be an appropriate choice, as it falls within the recommended range and is a commonly used setting for pediatric defibrillation.

**Why Each Wrong Option is Incorrect**
**Option A:** Using an energy of 100 J would be excessive and may cause unnecessary cardiac damage.
**Option B:** Using an energy of 20 J would be insufficient and may not be effective in converting VF to a normal rhythm.

**Clinical Pearl / High-Yield Fact**
When using a defibrillator in a pediatric patient, it's essential to use the correct energy setting to avoid unnecessary cardiac damage. Always check the patient's weight and the defibrillator's settings before delivering a shock.

**Correct Answer:** C. 50 J

✓ Correct Answer: A. 60 J