Using an automated external defibrillator (AED) on an infant can be a life-saving intervention during a sudden cardiac arrest. While such events are uncommon in infants, knowing how to respond quickly can significantly improve outcomes for infants. Rapid intervention with an AED, alongside cardiopulmonary resuscitation (CPR), is essential because every minute without these interventions reduces the chance of survival.
Recognizing the Need for an Infant AED
An AED should be considered for an infant who is unresponsive, not breathing normally (which includes gasping or no breathing at all), and has no pulse. These are clear indicators of cardiac arrest, a condition where the heart’s electrical activity becomes chaotic or ceases, preventing effective blood circulation. Immediately calling emergency services is the first step, followed by initiating CPR. The AED serves as an important tool used in conjunction with continuous chest compressions and rescue breaths, not as a replacement for them.
Step-by-Step Guide to Infant AED Use
When faced with an infant in cardiac arrest, acting swiftly and systematically is paramount. First, ensure emergency services have been called, providing them with your location and the infant’s condition. Next, place the infant on a firm, flat surface, such as the floor or a table, and quickly expose their chest by removing any clothing. This ensures direct skin contact for the AED pads.
With the infant ready, turn on the AED and carefully listen to its verbal instructions, which will guide you through the process. Attach the appropriate infant/child pads to the infant’s bare skin. For infants, the recommended placement is typically an anterior-posterior position: one pad on the center of the chest (sternum) and the other on the infant’s back, between the shoulder blades. This specific placement ensures the electrical current effectively crosses the infant’s heart.
Once the pads are securely attached, ensure no one is touching the infant. The AED will then analyze the heart’s rhythm to determine if a shock is necessary. If the AED advises a shock, loudly announce “clear!” to ensure everyone is safely away from the infant, then press the flashing shock button when prompted. Immediately after the shock is delivered, or if no shock is advised, promptly resume CPR, starting with chest compressions, and continue without interruption until emergency medical services arrive or the infant shows clear signs of recovery.
Key Considerations for Infant AED Application
Using an AED on an infant involves specific considerations due to their smaller size and developing physiology. Infant/child pads, also called attenuated pads, are specifically designed for use on individuals weighing less than 55 pounds or under eight years old. These pads are smaller to fit an infant’s chest without touching each other and deliver a lower, attenuated energy shock appropriate for an infant’s smaller body and developing heart.
The energy level delivered by pediatric pads is typically around 50 joules, in contrast to the higher energy levels of adult pads. Some AED devices feature a “child key” or a pediatric mode that, when activated, automatically reduces the energy output to a level suitable for infants, even if standard adult pads are attached. Proper pad placement is also specific; the anterior-posterior placement is preferred for infants to ensure effective electrical current delivery and prevent pads from overlapping.
Addressing Scenarios Without Infant Pads
In an emergency, if specialized infant/child AED pads are not available, adult AED pads can be used. The primary consideration when using adult pads on an infant is to ensure that the pads do not touch each other once applied to the skin. To achieve this, an alternative placement, such as the anterior-posterior position, is recommended. While infant/child pads are always the preferred choice due to their reduced energy delivery, using adult pads is preferable to delaying or withholding treatment entirely.
Immediate Actions After AED Use
Following the use of an AED on an infant, continuous care remains essential. Regardless of whether a shock was delivered, immediately resume CPR, beginning with chest compressions. Continue monitoring the infant for any signs of responsiveness or normal breathing. The AED will typically provide prompts, such as advising another shock after two minutes of CPR, and these instructions should be followed. Continue cycles of CPR and follow the AED’s guidance until emergency medical services personnel arrive and take over care for the infant.