Can You Use an Adult AED on an Infant or Small Child?

AED Safety, a leading national distributor of AEDs, understands the importance of knowing when and how to use an AED on infants and small children. Although AEDs are primarily designed for adults, they can be safely used on young children and infants with the correct adjustments. This article will explore the guidelines and recommendations for using AEDs on young patients.

Can You Use an Adult AED on an Infant or Small Child?

Yes! While AEDs are manufactured with adults in mind, pediatric settings and pads are available to adjust the energy level, making them safe for children who weigh less than 55 pounds. The American Heart Association (AHA) recommends using pediatric attenuated pads for children under eight years old and on infants. Children aged eight and older should use adult pads.

According to the Journal of Pediatric Emergency Care:

"In the absence of prompt defibrillation for ventricular fibrillation or pulseless ventricular tachycardia, survival is unlikely. Automated external defibrillators should be used in infants with suspected cardiac arrest if a manual defibrillator with a trained rescuer is not immediately available. Automated external defibrillators that attenuate the energy dose (e.g., via application of pediatric pads) are recommended for infants. If an AED with pediatric pads is not available, the AED with adult pads should be used."

This means that if pediatric settings and pads are unavailable, adult pads can be used on infants and young children. Place one pad on the front of the chest and the other on the child's back to ensure they do not touch.

Once the pads are attached, follow the AED's instructions. Without prompt treatment (CPR and defibrillation), sudden cardiac arrest (SCA) is always fatal. If you have an AED and suspect a child or infant is in cardiac arrest, use it immediately.

Recognizing Pediatric AED Pads

Pediatric electrode pads are usually smaller and feature different color packaging than adult pads. Instructions and pad placement illustrations will depict a small child or infant. If your AED requires a child/infant key, it will likely show the proper placement of the adult AED electrode pads for use on a child or infant.

Sudden Cardiac Arrest in Children

How Common is Sudden Cardiac Arrest in Children?

Sudden cardiac arrest is relatively uncommon in children. According to the Children's Hospital of Philadelphia:

"Although SCA is rare in children, it can affect anyone, even those who are physically fit. Each year, SCA claims the lives of over 2,000 children and adolescents in the U.S. and accounts for approximately 3-5% of all deaths in children aged 5-19 years. It is also responsible for 10-15 percent of sudden unexpected infant deaths."

The 2015 AHA Heart and Stroke Statistics revealed that 6,300 Americans under 18 experienced an EMS-assessed out-of-hospital cardiac arrest (OHCA). Timely CPR and AED use within three to five minutes of cardiac arrest can prevent sudden death.

What Causes Sudden Cardiac Arrest in Young People?

Some common causes of sudden cardiac death in young people include:

• Hypertrophic Cardiomyopathy (HCM): An inherited condition where heart muscle cells enlarge, causing the ventricle walls to thicken.
• Congenital Abnormalities: Some individuals are born with abnormal heart arteries that may become compressed during exercise, reducing blood flow to the heart. Examples include Long QT syndrome, atrial septal defects, ventricular septal defects, and Ebstein anomaly.
• Commotio Cordis: A rare cause of sudden cardiac death resulting from a blunt blow to the chest, often affecting young athletes. The average age of athletes who suffer from sudden cardiac arrest is 17.

Differences in CPR for Infants, Children, and Adults

How is Infant and Child CPR Different from Adult CPR?

Child and infant CPR differ from adult CPR, and taking a CPR and AED certification class is crucial to learn these differences. Here are the key points:

• Children (1 year to puberty):

  • Start CPR before calling 911.
  • After two minutes of CPR with rescue breaths, call 911.
  • Use caution when providing rescue breaths, as a child's airway is more fragile.
  • Use one or two hands for chest compressions, depending on the child's size.
  • Compression depth should be 1.5 inches.
  • The compression-to-rescue breath ratio is 30:2.

• Infants (under 1 year):

  • Begin CPR before calling 911. If another person is present, have them call 911 immediately.
  • Use great care due to the delicate nature of an infant's bones.
  • Use two fingers for chest compressions.
  • Compression depth should be about 1.5 inches.
  • The compression-to-rescue breaths ratio remains 30:2.