A 10-year-old boy is unresponsive and shows signs of ventricular tachycardia. After defibrillation fails, what drug should be administered?

In the context of a 10-year-old boy who is unresponsive and exhibiting signs of ventricular tachycardia (VT), it's crucial to select an appropriate antiarrhythmic medication after defibrillation has failed. Lidocaine is considered an effective option in this scenario.

Lidocaine functions as a sodium channel blocker, which can help stabilize the myocardial membrane and reduce the rapid electrical impulses responsible for ventricular tachycardia. It is particularly useful in cases of VT that are associated with a wide QRS complex and can be administered intravenously at a dose of 1 mg/kg. This makes it a suitable choice for managing VT in children, especially when initial defibrillation attempts do not restore normal rhythm.

While other options like amiodarone can also be considered, the specific recommendation in pediatric advanced life support guidelines for refractory VT after defibrillation strongly leans towards lidocaine as a first-line antiarrhythmic agent. The use of other agents like atropine and adrenaline does not directly address the treatment of ventricular tachycardia in this critical situation, as atropine is primarily used for bradycardia and adrenaline is more relevant in the context of cardiac arrest rather than for rhythm disturbances like VT.