Considerations for AED Use on Children

It’s estimated that around three in every 100,000 children have out-of-hospital cardiac arrests every year. That’s based on figures from Metropolitan Melbourne alone – and this data shows we should all be taking child and AED (Automated External Defibrillator) safety extremely seriously.

 In this guide, we will explore:

• When you should use an AED on a child patient
• How to use an AED on children safely and effectively
• What to look for when purchasing an AED

When Should an AED be used on children?

You should use an AED on children who are experiencing sudden cardiac arrest (SCA). A child experiencing SCA will usually: 

• Stop breathing or gasp sharply
• Suddenly lose consciousness
• Lose heartbeat and pulse

 It’s important to remember that SCA can occur in children of all ages, even in those who have no underlying conditions and who are otherwise healthy.

 It is safe for you to use AED defibrillators on children who are younger than eight years old. Specifically, children younger than eight will benefit from child AED pads designed to fit their smaller bodies. Many children older than eight will require adult pads.

Once an SCA is detected, acting fast with an AED is vital. The nurses and first responders we’ve worked with over the years advise that every second counts.

How to Use an AED on a Child or Infant?

Unless you are with an emergency response team, always make sure to contact emergency services right away if there is any sign of a child experiencing SCA. Stay on the line with your responder for guidance and advice.

While you will be instructed on how to help a child experiencing SCA, here are the steps our customers and clients recommend following.

Check Responsiveness

Quickly check whether the child is breathing normally or responsive to touch and speech. Check their pulse via their neck or wrists. If the child is unresponsive, you must begin CPR before using an AED.

Begin CPR

It’s crucial to start CPR as soon as you detect a child is unresponsive – effective practice can help to improve the child’s chance of survival, and can also improve the effectiveness of an AED if needed.

 For young children, you must place two fingers on the chest centre and start compressing at 100 beats per minute (BPM), up to 120 BPM if necessary. Doing so helps the child’s blood to circulate. Children generally need two-inch compression, whereas infants need around 1.5.

 Ideally, after every 30 compressions, you should attempt to give two rescue breaths. Tilt the child’s head back and cover their mouth or nose with your mouth, then give a gentle blow. You will need to watch if their chest rises.

 In some cases, an AED will guide you through how to effectively deliver CPR to a child.

Get the AED

After immediate CPR, obtain the AED (if you haven’t already). Ideally, if there are more than one of you, have one adult apply CPR while the other gets the AED to hand.

 In a public place, you will normally find an AED in a specific location. It’s important to memorise where these are if you can, just in case you need them in an emergency.

Apply Paediatric Pads

Make sure the area is safe from any intrusion and expose the patient’s chest, ensuring it is clean and dry, ready for paediatric defibrillator pads to be placed. You should also remove any patches for medication or other needs.

 Where you place the pads depends usually on the age and size of the child. For very young children (i.e., younger than one year of age), place the first pad on the upper left of their chest. Then, place the other on their back.

 For older children, carefully place the first pad toward the upper right of the child’s chest and the second to the lower left, just below the armpit.

 That said, it’s usually recommended that you follow the anteroposterior method for placing AED pads on children, meaning there’s one on their back and one on their chest. This is because it can be dangerous to allow pads to cross. 

Follow AED Prompts

Now, attach and switch on the AED and follow its guidelines. Most have visual or audio prompts that guide you through how to deliver shocks to the patient. Be sure to switch your AED to paediatric or child mode if it has one.

 Always make sure there is plenty of space around you and let the AED trace the child’s heartbeat. Follow the steps suggested, and if the AED recommends resuming CPR, do so. 

Monitor the Child

If the child regains consciousness or starts breathing (erratically or otherwise), continue to monitor them and follow advice from first responders (or, continue CPR if appropriate). 

If there is still no response from the child, continue the cycle until emergency services arrive, or until instructed by emergency support. 

What Precautions Should be Taken When Using AEDs on Children?

You should always make sure that the area is clear around a child before using AEDs. Always ensure there is no likelihood of you being interrupted or that public traffic is unlikely to collide. 

Do always be ready to perform CPR before using AEDs – you could save a life without needing the equipment. 

Make sure you adhere AED pads correctly to the child’s body. Crossing pads on their chest, for example, could be dangerous. 

Do not hesitate to use an AED on a child. The Australian Heart Foundation states that 50% of people of all ages stand to survive SCAs with AED support. Without this equipment, this falls to 27%.

 Always call emergency services for help if you need direction for CPR and using AEDs. 

What Should I Consider When Purchasing an AED?

When looking for AED defibrillators, choose devices that are: 

• Easy to install and store where they can be accessed
• Manufactured by a leading brand or firm
• Packaged with pads and other safety equipment
• Sold by a reputable medical retailer

 The nurses and responders we’ve worked with over the years tell us that the best defibrillators for home (and public spaces) are those that come with clear instructions and are easy for anyone to access.

 You shouldn’t ever prioritise cheap equipment when it comes to saving lives. Look for a device that suits you and your public’s needs.

FAQ

Can You Use Adult AED Pads on Children?

Yes, you can use adult AED pads on children who are over 55 pounds or older than eight years of age. However, we recommend you place one on their chest and another on their back so they don’t cross over.

How Common is Sudden Cardiac Arrest (SCA) in Children?

SCA can affect up to three children in every 100,000 every year. In some areas, it can claim the lives of thousands of children annually – meaning it’s always important to have AEDs and pads available in public spaces.

What are the Differences Between Paediatric AED pads and Adult Pads?

Child AED pads are smaller than adult pads so they don’t cross over – and they also deliver less electrical energy. That’s because children typically need less energy than adults when AEDs are in use.