What is the correct placement for AED pads for infants and children less than 8?

Bystanders can give sudden cardiac arrest (SCA) victims the best chance of survival by calling 911 and providing early CPR and AED use.

Although CPR can help supply oxygen to the brain and other vital organs, it usually can’t restore a normal heart rhythm on its own – making early AED use a critical step in surviving SCA.

In fact, the chance of survival decreases 7-10% every minute that passes without an AED shock. And it’s most effective when given in the first three minutes of cardiac arrest.

Fortunately, businesses and communities are becoming more aware of the importance of having access to an AED during an emergency. They can now be found in large public spaces, like airports, stadiums and schools – which means more lives can be saved.

Even though AEDs are a lifesaving device, they’re designed to be simple and user-friendly.

Here’s a breakdown of how to apply AED pads during a SCA emergency.

AED Pad Placement 101

The AED will provide visual and auditory cues to help direct bystanders. This means that anyone can use an AED, even without formal training.

The basic steps of using an AED are as follows:

1. Turn on the AED.

2. Apply AED pads. 

3. Follow the AED prompts.

4. Clear the victim and shock.

5. Resume compressions and continue to follow prompts.

But how do you apply the pads? This will depend on the age and size of the victim.

For adults (includes children age 8 or older or more than 55 pounds):

• Peel the pads off the backing.

• Place one pad on the right side of the chest, just below the collarbone.

• Place the other pad on the lower left side of the chest.

• Connect the pads to the AED. Some pads come pre-connected to the AED.

Always apply the pads to the chest according to the pictures on the pads. And always apply them to bare skin.

Expose the chest by opening or cutting the shirt (and bra if applicable) before applying the pads.

If the chest is wet, wipe it dry. If the chest is hairy, use a razor or an extra set of AED pads to remove hair from the pad placement area.

AED Pad Placement for Children and Infants

Children require a lower level of energy to defibrillate the heart. Some AEDs may include pediatric pads or equipment that are designed for children and infants.

In terms of using an AED, a child is younger than age 8 or weighs less than 55 pounds.

Follow these AED use guides for children and infants:

• Use child pads and equipment if available. If not available, use adult pads.

• Do not cut or fold AED pads. Do not let AED pads overlap.

• Use a front-back pad placement for small children and infants.

If you don't know the child's weight or age, look for signs of puberty (e.g. facial hair, breast development, etc.) If a child is showing signs of puberty, use adult pads. In this case, pediatric pads wouldn't deliver enough energy to defibrillate the child's heart.

AEDs Save Lives

Here’s a brief AED pad placement summary:

Contact your local Training Center to learn about AED use and get certified in CPR, AED and First Aid.

Need an AED for your business? Contact your HSI representative or find an AED in our online store.

For ASHI or MEDIC First Aid customers, shop online: ASHI | MEDIC First Aid

For EMS Safety or new customers click here

And be sure to check out How to Position Your Hands for CPR to learn correct CPR hand placement.

Can you use an adult AED on an infant or small child?

In a word, YES! Although AEDs are manufactured with adults in mind, pediatric settings and pads adjust the energy level used, making them safe for young children who weigh less than 55 pounds. The American Heart Association recommends that pediatric attenuated pads should be used on children under the age of eight and on infants. Adult pads are used on children eight years and older.

However, the Journal of Pediatric Emergency Care notes that “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 (eg, 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.”

We think this bears repeating: if the infant or pediatric settings and pads are not available, rescuers may use adult pads on infants and young children. Apply one pad to the front of the chest and the other to the child’s back so that the pads do not come into contact with one another.

Once the pads are attached, follow the instructions given by the AED.

Remember, without prompt treatment (CPR and defibrillation), sudden cardiac arrest (SCA) is always fatal. If you have an AED and you suspect that a child or infant is in cardiac arrest, use it!

All AEDs are designed to analyze a victim’s heart rhythm regardless of age, and if a shockable rhythm is detected, the device will prompt the rescuer to administer an electric shock. Some devices will administer shocks automatically. An AED will not advise or deliver a shock unless the victim’s heart rhythm is in one of two shockable rhythms. You cannot accidentally shock someone with an AED.

How Do You Recognize Pediatric AED Pads?

Pediatric electrode pads are typically smaller and feature a different color packaging than adult pads. Generally speaking, the instructions and pad placement illustrations will depict a small child or infant. If your AED requires a child/infant key, the key will likely have an illustration on it showing the proper placement of the adult AED electrode pads for use on a child or infant.

How Common is Sudden Cardiac Arrest in Children?

Thankfully, SCA is fairly 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 released by the American Heart Association found that 6,300 Americans under the age of 18 experienced an EMS-assessed out-of-hospital cardiac arrest (OHCA). When CPR and AEDs are administered within three to five minutes of cardiac arrest, sudden death can be prevented.

What Causes Sudden Cardiac Arrest in Young People?

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

Hypertrophic Cardiomyopathy (HCM)

A condition that’s typically inherited, HCM causes the heart muscle cells to enlarge, which then causes the walls of the ventricle (usually the left ventricle) to thicken.

Congenital Abnormalities

Occasionally people are born with unusual or abnormal heart arteries. If this occurs, arteries may become compressed during exercise and not provide adequate blood flow to the heart. Some congenital cardiac abnormalities include Long QT syndrome, atrial septal defects, ventricular septal defects, and Ebstein anomaly.

Commotio Cordis

Commotio Cordis is a rare cause of sudden cardiac death that occurs as the result of a blunt blow to the chest. Young athletes are especially susceptible and the average age of athletes who suffer from sudden cardiac arrest is just 17.

How is Infant and Child CPR different than Adult CPR?

Child and infant CPR is different from adult CPR. We strongly urge you to take a CPR and AED certification class. These classes will teach you how to perform adult, child, and infant CPR and how to effectively use an AED.

CPR for children is very similar to adult CPR, however, rescuers should start CPR before calling 911. After two minutes of CPR with rescue breaths, call 911. Because a child’s airway is more fragile than an adult’s, use caution when providing rescue breaths and be careful not to tilt the head back too far. When providing chest compressions, use one or two hands, depending on the size of the child. The depth of compressions should be only one and a half inches. The ratio of compressions to rescue breaths, 30:2, is the same for children as for adults.

It stands to reason that great care should be taken when performing CPR on an infant. Although a baby’s bones are more flexible than an adult’s, they’re also much more delicate. As with older children, you’ll want to begin CPR on an infant before calling 911. Of course, if there’s another person at the scene, ask them to call 911 immediately.

To learn more about our CPR and AED Training or to purchase an AED with pediatric capabilities, visit aed.com or call Cardio Partners at 866-349-4362. You can also email us at .

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