When shockable rhythm is present during cardiac arrest and biphasic manual defibrillator is available, the initial energy selected should be between 120 - 200J
If a person goes into cardiac arrest immediately start CPR and also provide oxygen and connect a defibrillator if available. Continue CPR for 5 cycles and check for shockable rhythm.
If a shockable rhythm is observed, use the biphasic manual defibrillator for the initial shock at 120 - 200 J based on the device. Then check for a pulse. If a pulse is present, begin the post resuscitation care.
If there is no pulse or asystolic, then start the CPR cycle again until the shockable rhythm is observed. Then shock at 200J using a biphasic manual defibrillator.
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