FAQ: AED Use on Infants and Children

• Based on 2015 AHA Heart and Stroke Statistics, over 6,000 individuals per year under 18 in the U.S. experience EMS-assessed OHCA (Out-of-Hospital Cardiac Arrest).
• CPR and defibrillation using an AED, if administered to a child within 3 – 5 minutes of a heart failure incident, can prevent his or her sudden death.

FAQs about CPR and AED use with infants and children:

• How does an AED work?
• How does an AED give instructions?
• Are AEDs safe to use on children?
• What size AED electrode pads are used on children?
• What AEDs are best for infants (less than 1 yr old) and children (1-8 yrs old)?
• How do you recognize pediatric electrode pads?
• How do you use a defibrillator on a child?
  • To use an AED on an infant under one year old
  • To use an AED on a child under 8 years old and/or less than 55 lbs
• How is CPR performed on a child or infant along with the use of an AED?

How does an AED work?

AEDs are designed to analyze a victim’s heart rhythm and, if it detects a shockable rhythm, it will prompt the AED operator to administer an electric shock, or it will administer a shock automatically. The heart beats in response to electrical impulses originating within the heart itself.  When a heart is in fibrillation (quivering rather than beating normally), using an electrical shock to “throw out” the chaotic electrical impulses will allow it to reset itself. To learn more about sudden cardiac arrest and how an AED functions to treat it, read this article on the AED Superstore Resource Center by Dr. S. Joanne Dames.

How does an AED give instructions?

Once activated, either with the push of a button or simply by opening the cover, every AED is programmed to give step-by-step audible instructions for its use.  All AEDs also have visual instructions either on the machine itself, or on an enclosed card. The electrode pads for both adult and pediatric use have illustrations on the packaging and the electrode pads themselves.

Are AEDs safe to use on children?

The simple answer is yes, AEDs are safe to use on everyone. Children, adults, and infants can all be treated with an AED.  The important thing to remember when someone is in sudden cardiac arrest is the AED will not advise or deliver a shock to someone unless their heart is in one of two shockable rhythms. You cannot accidentally shock someone. Children and infants, however, should be treated with either pediatric electrode pads, or adult electrode pads and a pediatric “key” or attenuator. Check your AEDs operator’s manual for how to use your AED with a child or infant.

What size AED electrode pads are used for children?

While the exact size of AED pads for children may vary, some are slightly smaller than adult pads to ensure they do not touch when placed on a child. Some pads are the same size as adult pads but have an attenuator on the cord to “dial down” the voltage applied to the electrode pads..

What AEDs are best for infants (less than 1 yr old) and children (1-8 yrs old)?

All AEDs are safe to use with children and infants. Most AEDs use special pediatric electrode pads which deliver a lesser shock to a pediatric patient with the use of an attenuator, and one uses a child/infant “key” and adult electrode pads.

How do you recognize pediatric electrode pads?

Typically, pediatric electrode pads are in packaging which is a different color, and the illustrations show a child or infant with the pads placement for each clearly illustrated. If your AED uses a child/infant key, the key itself will have an illustration on it showing placement of the adult AED electrode pads for use on a child or infant.

How do you use a defibrillator on a child?

If a child is under the age of eight and/or 55 lbs in weight, an AED equipped with pediatric electrode  pads or an infant/child “key”should, ideally, be used, although adult electrode pads can be used if there are no other options

To use an AED on an infant under one year old:

1. Do 1-2 minutes of Infant CPR immediately.
2. If the baby doesn’t respond, call 911 and either retrieve or send someone for an AED, then continue CPR.
3. When the AED arrives, locate the pediatric electrode pads, unplug the adult electrode pads, plug the pediatric pads firmly into the machine, and press the start button. If using a child/infant “key”, place the key in the slot and press the power button.
4. Listen carefully to the verbal instructions and follow them. In a typical AED use scenario, the AED will advise you to:
   • Apply the electrode pads to the patient’s bare chest. For infants, you should adhere one pediatric (or adult) electrode pad to the middle of the infant’s chest, and one electrode pad to the infant’s back between the shoulder blades. The electrode pad packaging and the electrode pads themselves will have an illustration to show placement.
5. • Not touch the patient so the AED can analyze the baby’s heartbeat.
   • If a shock is advised, the AED will advise you to not touch the patient and push the AED’s shock button.
   • You will then be prompted to continue  CPR and/or give shocks as needed until EMS arrives.

To use an AED on a child under 8 years old and/or less than 55 lbs:

1. Do one to two minutes of CPR immediately.
2. If the child doesn’t respond, call 911 and retrieve or send someone for an AED, then continue CPR.
3. When the AED arrives, locate the pediatric electrode pads, plug the pediatric pads firmly into the machine, and press the start button. If using a child/infant “key”, place the key in the slot and press the power button.
4. Listen carefully to the verbal instructions and follow them.
5. In a typical AED use scenario, the AED will advise you to:
   • Apply the electrode pads to the patient’s bare chest. For a child with a chest large enough to accommodate the pads without touching each other, you should adhere one pediatric (or adult) electrode pad to the upper right area of the chest and the other to the lower left side. The electrode pad packaging and the electrode pads themselves will have an illustration to show placement.
   • Not touch the patient so the AED can analyze the child’s heartbeat.
   • IF a shock is advised, the AED will advise you to not touch the patient and press the AED’s shock button.
   • You will then be prompted to continue  CPR and/or give shocks as needed until EMS arrives..

How is CPR performed on a child or infant along with the use of an AED?

Child and Infant CPR is different than adult CPR – taking an AHA approved CPR/AED certification class which includes infant/child and choking first aid will give you hands-on practice with appropriately sized and calibrated manikins so you will have the confidence to act quickly when needed. While there has been a big push for “hands-only” CPR for teens and adults recently, the 2015 American Heart Association CPR guidelines still advise 2 breaths for every 30 compressions in children and infants. Compress the chest about one-third of the child’s torso depth using the heel of your palm for children or your first two fingers for infants.