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Childhood emergencies come in many variations. Whether one must call poison control or navigate a high fever, the requirements to move quickly and steadily forward are the same. Most pediatric emergencies are those caregivers are equipped to handle, but what about the unthinkable? What about pediatric cardiac arrest? Basic first aid training is always helpful, though some folks who have the course under their belts may not have received training in CPR.
It’s possible to understand how to use an adult defibrillator for cardiac arrest and still be unclear about the procedure when it comes to using an AED defibrillator to rescue an infant or child. For example, adult AED pads are both placed on the anterior side of the chest, but what about placing AED pads on a child less than 55 pounds? To prevent uncertainty costing valuable moments, here’s everything you need to know about pediatric AED pads.
What Is An Infant AED Pad?
To understand specifics about infant or pediatric electrode pads, one can start by asking, “What makes up a standard AED pad?” Answering this basic question leads to foundational understanding and life-saving confidence.
Most automated external defibrillators are equipped with adult pads. These electrode pads are constructed of thin metal plates with wires attached. The plates are then couched in plastic surroundings and one side is coated with a type of metallic adhesive gel. The gel serves to close airspace between the skin and the pads preventing burns; it also aids the defibrillator as it analyzes the victim for a shockable heart rhythm and transports electrical energy directly to the heart. An AED unit using adult pads will typically deliver a shock between 120-200 joules.
In order for the automated external defibrillator to work, electrode pads should be unexpired and fully contact the patient’s chest skin. Most AED kits include one set of standard adult pads and sometimes include a second set of adult pads for backup.
Infant pads are of essentially the same composition as adult pads except for two key differences. First of all, pads designed for a pediatric patient, or child weighing less than 55 pounds, use an attenuated energy level of about 50 joules or 2-4 joules per kilogram. This is a much gentler electric shock to meet the physical requirements presented in small children and infants. Secondly, pediatric pads are smaller, to help with successful electrode pad placement on a little one’s chest and/or back.
Infant AED Pad Placement & AED Use Instructions
The following instructions are general steps for placing AED pads on an infant and successfully using an AED. Please consult the manufacturer recommendations for a specific AED when possible.
Step 1: Turn on the AED and follow any prompts and instructions provided.
Step 2: Expose the victim’s chest and wipe dry if needed.
Step 3: Attach the AED pads
For infants up to 1 year, place infant pads in the anterior/posterior position.
If AED infant pads are not available and/or the AED doesn’t have an infant energy setting, adult versions may be used in a pinch.
In the emergency of pediatric sudden cardiac arrest (SCA), infant electrode pads are recommended to be placed in anterior posterior position. One pad must first be applied directly to clean dry skin in the center of the patient’s chest–on the sternum–and the second pad should be placed on the back between the shoulder blades. This will ensure an AED will most effectively treat infants and children.
By contrast, anterior lateral adult pad placement works for grown-ups, larger children (over age 8 and weighing more than 55 lbs) and youths because they usually have enough skin surface on the front and side of the chest to accommodate both pads without the pads touching.
As inferred above, when it comes to AED use, it’s crucial the pads do not touch when delivering shock so the electrical current can reach the heart without danger of short circuit while still making contact with a sufficient area of bare skin (learn more in our general AED pad placement article). In other words, when incorrect AED pad placement causes pads to touch, interference with the electrical current could occur, causing the device to malfunction.
In a situation where for any reason the infant or small child absolutely cannot be lifted or rolled over, defibrillator pads can be placed in anterior lateral position, providing the pads do not touch.
Do I need Infant AED Pads?
Whether or not pediatric AED pads must be included within any particular AED kit is a decision for each facilitator to make. Always including pediatric pads is of course the safest option.
While adult pads can be used on children or infants if absolutely necessary, this course of action involves the risk of using larger pads which may not fit optimally. This might potentially compromise the little one’s skin, as well as exposing them to a much stronger shock than may be needed.
What Do I Do if No Pediatric Pads are Available?
Sudden cardiac arrest is less common in children than adults, but still a formidable threat which can’t be minimized. When SCA happens in a little one as with anyone else, don’t hesitate to begin CPR and using an AED immediately, even when pediatric pads are not accessible.
Always use pediatric pads in the process when available, but if pediatric pads aren’t available–or the AED doesn’t have a pediatric setting–it’s reasonably safe and recommended to use an AED with adult pads or adult levels of energy.
Regardless of whether a rescuer finds pediatric pads available or must meet the need with adult pads, correct manual defibrillator pad placement will be crucial. To ensure an AED works effectively to find an infant or child’s shockable rhythm and restore normal heart rhythm, anterior posterior placement is most highly recommended.
How Much Do Infant AED Pads Cost?
While pediatric electrode pads can be purchased from many different places, the average cost to add a set of these to your AED kit will likely be between $100 and $135 dollars.
How Long Do Infant Pads Last?
The expiration date for the infant/child pads is typically 2-4 years from the manufactured date. The expiration date will be listed clearly on the product. Electrode pads must be regularly checked in order to prevent pad gel from drying out and becoming ineffective. For safety, always include extra gel with any provided AED kit and check all battery and pad expiration dates regularly. CPR/AED inspection tags can be purchased at heartsmart.com to help keep maintenance information up to date and centrally visible.
Child Vs. Infant Electrode Pads
In short, infant and child electrode pads are one and the same. Pediatric or infant-child pads are designed for use in emergencies involving children and infants weighing less than 55 pounds and being less than 8 years old. Once a child weighs more than 55 pounds, adult AED pad placement and electrical shock are acceptable.
Which AEDs Can be Used with Infants and Children?
The following AEDs have pediatric modes built into the device, pediatric keys or pediatric / infant AED pads:
AEDs with Pediatric / Infant AED Pads
- Heartsine Samaritan 350P / 360P
- Heartsine Samaritan 450P
- Philips Heartstart Onsite
- ZOLL AED Plus
- Cardiac Science G3 AED
- Cardiac Science G5 AED
- Defibtech Lifeline AED
- Defibtech Lifeline View AED
AEDs with Pediatric Key
AEDs with Pediatric Modes
Purchasing an AED defibrillator which has been enabled for pediatric resuscitation either with a pediatric key or pediatric pads is straightforward. A pediatric key is inserted into the defibrillator and allows the device to deliver appropriate levels of attenuated shock, adjusting electrical force in much the same way as pediatric pads. Either method of attenuation acceptably modifies the AED for children and infants.
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