4.6 AED for Infants and Children Under 8 Years

How an AED Works

An Automated External Defibrillator (AED) analyzes the heart’s rhythm and determines whether a shockable rhythm is present. If needed, the AED delivers an electrical shock to the heart, temporarily stunning it and giving it a chance to reset.

This reset may allow the heart’s natural pacemaker to restore an organized rhythm. When CPR is continued after the shock, the heart may resume effective contractions — a return to circulation known as Return of Spontaneous Circulation (ROSC).

Using an AED on Infants and Children

Many AEDs can be used for both pediatric and adult patients. Pediatric-capable models reduce the energy delivered during defibrillation. Always follow the manufacturer’s instructions for pad placement and settings.

Step-by-Step AED Operation

1. Power on the AED. Open the case and turn it on, if required.
2. Select the correct pads:
   • Use pediatric pads for children under 8 years or under 55 lbs (25 kg).
   • If pediatric pads are not available, use adult pads — just make sure they do not overlap or touch.
3. Expose and prepare the chest:
   • Ensure the chest is bare and dry. Wipe away sweat or moisture.
4. Apply the AED pads:
   • Follow the pad diagrams or verbal prompts.
   • Front-and-back placement (Infant or Small Child)
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     Front-and-back placement (Infant or Small Child)

     

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     • Place one pad in the center of the chest, between the nipples.
     • Place the second pad on the back, between the shoulder blades.
   • Front placement (Child)
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     Front placement (Child)

     

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     • Place one pad on the upper right chest, just below the collarbone.
     • Place the other pad on the lower left chest, below the armpit.
   • Ensure both pads are firmly attached to the skin and do not overlap.
5. Connect the pads to the AED (if required).
6. Clear the victim and let the AED analyze.
   • Do not touch the victim during analysis.
   • Some AEDs start analysis automatically; others require you to press a button.
7. If a shock is advised:
   • Ensure everyone is clear of the victim.
   • Loudly announce, “Clear the victim!” or “Everybody clear!”
   • Visually confirm that no one is touching the victim.
   • Press the shock button (if required) or allow the AED to deliver the shock automatically.
8. Immediately resume CPR after the shock, or if no shock is advised.
   • Begin chest compressions followed by rescue breaths (15:2 if two rescuers).
9. Continue cycles of CPR and AED analysis:
   • After about 2 minutes (5 cycles), the AED will prompt another rhythm analysis.
   • Follow prompts and repeat the process as needed.

Important Notes

• Never delay defibrillation while waiting for pediatric pads.
• Do not place pads over implanted devices (e.g., pacemakers).
• If using adult pads on an infant, always use anterior–posterior placement (front and back).