What is the most appropriate intervention for a 9-year-old male with ventricular tachycardia and altered mental status?

The most appropriate intervention for a 9-year-old male with ventricular tachycardia and altered mental status is to perform synchronized cardioversion. Ventricular tachycardia (VT) in a pediatric patient, particularly in the presence of altered mental status, indicates that the child may be unstable and is experiencing incompatible blood flow, potentially leading to hemodynamic collapse or shock.

Synchronized cardioversion is performed to restore normal sinus rhythm while minimizing the risk of precipitating ventricular fibrillation, which can occur if defibrillation is applied without synchronization. The use of 15 J for synchronized cardioversion is appropriate for pediatric patients, and this intervention can quickly restore normal rhythm, effectively addressing the immediate life-threatening situation.

Amiodarone could be considered in cases of stable VT, but in the context of altered mental status indicating instability, immediate cardioversion is prioritized. Defibrillation at 60 J is inappropriate here, as the rhythm is not treated as a shockable rhythm without assessing if further medical treatment rather than immediate defibrillation is warranted. Starting epinephrine would indicate a more advanced cardiac life support approach and is generally reserved for cases of asystole or pulseless electrical activity, not stable VT. Therefore