Understanding the distinctions in cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) care for different age groups is crucial. These age-specific approaches are based on physiological differences that significantly impact the effectiveness and safety of life-saving interventions. Grasping these nuances can make a profound difference in the outcome of an emergency.
Understanding Age Categories for Emergency Care
In the context of CPR and AED care, age categories are defined with specific considerations for physical development. An “infant” is under 1 year of age. This age group requires specialized techniques due to their small and delicate anatomy.
A “child” is defined as someone from 1 year of age up to the onset of puberty. Puberty is clinically identified by breast development in females and axillary (underarm) hair in males. This stage marks a transition where a person’s body begins to resemble that of an adult.
Beyond puberty, or for individuals weighing over 55 kg (approximately 121 pounds), they are classified as “adults” for resuscitation guidelines. These definitions are consistent across major guidelines from organizations like the American Heart Association (AHA) and the American Red Cross, ensuring a standardized approach.
Adapting CPR Techniques
Anatomical differences across age groups necessitate specific adaptations in CPR techniques. For infants, chest compressions are performed using two fingers (for a single rescuer) or two thumbs encircling the chest (for two rescuers), placed just below the nipple line.
The compression depth for infants should be about 1.5 inches (4 cm), which is approximately one-third the anterior-posterior diameter of their chest. Rescue breaths for infants are delivered by covering both their mouth and nose, ensuring gentle puffs of air.
For children, compressions can be performed using one or two hands, depending on the child’s size, with the heel of the hand placed in the center of the chest. The compression depth is approximately 2 inches (5 cm), or about one-third the anterior-posterior diameter of their chest. Rescue breaths involve pinching the nose and forming a seal over the child’s mouth, delivering breaths until the chest rises. The compression-to-breath ratio for a single rescuer is 30 compressions to 2 breaths for children and infants. With two rescuers, the ratio for children and infants changes to 15 compressions to 2 breaths.
For adults, CPR involves using two hands, one on top of the other, placed in the center of the chest. Compressions should be at least 2 inches (5 cm) deep but no more than 2.4 inches (6 cm). Rescue breaths are given after pinching the nose and making a complete seal over the mouth, delivering breaths until the chest rises. The rate of compressions for all age groups is consistent, aiming for 100 to 120 compressions per minute.
AED Use for Different Age Groups
Automated External Defibrillators (AEDs) are designed with specific considerations for different age groups to ensure appropriate energy delivery. For children under 8 years old or weighing less than 55 pounds (25 kg), pediatric attenuated pads are recommended. These smaller pads deliver a reduced energy shock.
Proper pad placement is essential. For infants, an anterior-posterior (front-back) placement is often recommended, with one pad on the upper left chest and the other on the back between the shoulder blades. This placement helps prevent the pads from touching each other. For children over 1 year but under 8, anterior-lateral placement (one pad on the upper right chest, the other on the lower left side below the armpit) can be used, provided the pads do not touch.
Some AED models feature a pediatric key or switch that automatically reduces the energy output for children, even when using adult pads.
Responding When Unsure
In an emergency, uncertainty about a person’s age category or equipment availability can arise. The immediate priority is to act quickly and call emergency services. Delaying care significantly reduces survival chances.
If a rescuer is unsure whether a person is a child or an adult, it is safer to initiate CPR using child techniques, as these are less forceful than adult techniques.
If pediatric AED pads are not available for a child or infant, adult pads should be used. Ensure the adult pads do not touch each other on the smaller body, which might necessitate placing one pad on the chest and the other on the back. The primary goal is to deliver a shock as quickly as possible if indicated by the AED, as early defibrillation is key to improving outcomes. Always follow the voice prompts from the AED.