The Automated External Defibrillator (AED) is a life-saving device designed to deliver an electric shock to restore a normal heart rhythm during sudden cardiac arrest. While AEDs are increasingly common in public places, using them on a child requires a specific understanding of equipment and procedure adjustments compared to treating an adult. The fundamental goal remains the same—to deliver a safe and effective shock—but the smaller body size and lower energy requirements of a pediatric patient necessitate special equipment. Knowing the correct type of pads and placement method for a child ensures the highest chance of a successful outcome in an emergency.
Defining the Pediatric Patient
Emergency medical guidelines establish clear criteria for when a child requires specialized AED equipment and settings. Pediatric pads and lower energy doses are generally recommended for children who are under eight years old or who weigh less than 55 pounds (about 25 kilograms). These guidelines are in place because a child’s smaller body mass and developing heart muscle are more susceptible to injury from the high energy levels designed for adults. For any patient eight years or older, or weighing more than 55 pounds, standard adult pads and settings should be used. This distinction is critical for rescuers, as the wrong setting can negate the potential life-saving benefit of the AED.
Child Pad Specifications and Attenuation
Children require smaller pads, often labeled as “Pediatric Pads” or “Attenuated Pads.” These pads are physically smaller than adult pads to ensure they can be placed on a child’s chest without touching. If the pads overlap, the electrical current passes directly between them instead of traveling through the heart, making the shock ineffective and dangerous. Child pads also contain an internal attenuator mechanism that reduces the electrical energy (measured in Joules) delivered by the AED. While adult AEDs typically deliver 150 to 360 Joules, the attenuator reduces this dose, often to 50 Joules or less. Some newer AED models use a child key or switch to activate this attenuation function within the machine, allowing the same pads to be used for both adults and children.
Correct Placement for Child AED Pads
The physical placement of the pads on a child is significantly different from the standard adult placement to ensure safety and effectiveness. Adult placement involves placing pads on the upper right chest and the lower left side of the torso (anterior-lateral), creating a pathway across the heart. For children, the primary method is the Anterior/Posterior placement, designed to sandwich the heart between the two pads. One pad is placed on the center of the chest (anterior position), and the second pad is placed on the child’s back, between the shoulder blades (posterior position). This front-and-back placement ensures the pads are separated by a safe distance while creating a clear electrical path through the heart.
Using Adult Pads in an Emergency
If pediatric pads or a pediatric switch are not immediately available, adult pads should still be used rather than delaying treatment. When using adult pads on a child, the Anterior/Posterior placement is necessary to prevent the pads from touching. The priority is to deliver the shock quickly; the risk of delay is greater than the risk of using the non-attenuated adult energy dose.