Hoyme DB, Zhou Y, Girotra S, et al. - For pediatric cardiac arrest with ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT), first defibrillation energy dose of 2 Joules/kilogram (J/kg) has been recommended by the American Heart Association (AHA). However, uncertainty remains concerning optimal first energy dose. Researchers here assessed data from 301 children ≤ 12 years with IHCA due to VF/pVT using AHA Get With the Guidelines-Resuscitation (GWTG-R) database. Outcomes revealed lower rate of survival to hospital discharge in correlation with first energy doses other than 1.7–2.5 J/kg in patients ≤ 12 years old with initial VF/pVT, and lower survival rates with first doses > 2.5 J/kg in all patients ≤18 years old with initial VF. This study thereby supports current AHA guidelines for first pediatric defibrillation energy dose of 2 J/kg.