Automated External Defibrillators (AEDs) are vital devices in responding to sudden cardiac arrest, a condition where the heart abruptly stops beating effectively. For infants, immediate action significantly improves survival chances. Knowing how to properly use an AED can make a life-saving difference. Understanding specific considerations for pediatric patients is important in this emergency.
Understanding Infant AED Pads
Adult AED pads are not suitable for infants due to body size and electrical current differences. Specialized infant/child pads, often called attenuated pads, deliver a lower, safer dose of electricity appropriate for a smaller body. Adult pads typically deliver 150-360 joules, while pediatric pads reduce this to approximately 50 joules, suitable for children under 55 pounds (25 kg).
Infant pads are also considerably smaller than adult pads, which prevents them from overlapping when placed on an infant’s chest. Overlapping pads can lead to ineffective shock delivery by creating a short circuit. Some AEDs feature a “child key” or “pediatric mode” that automatically adjusts the energy level, sometimes even allowing the use of adult pads with reduced energy output.
Correct Pad Placement for Infants
For infants, the anterior-posterior (front-back) pad placement method is recommended to ensure the electrical current effectively passes through the heart. One pad should be placed on the infant’s bare chest, typically in the middle of the chest, avoiding the sternum. This position ensures optimal contact and allows the current to reach the heart.
The second pad is then placed on the infant’s back, between the shoulder blades. This placement forms a pathway for the electrical current to traverse the heart. Ensure that the front and back pads do not touch each other; this would short-circuit the electrical flow and render the shock ineffective. Firmly pressing the pads to the skin ensures good contact, which is essential for the AED to analyze the heart rhythm and deliver a shock if needed.
AED Operation Steps for Infants
After the specialized pads are placed on the infant, turn on the AED. The device will then provide clear voice prompts, guiding the rescuer through the defibrillation process. Listen carefully and follow these instructions.
Before the AED analyzes the heart rhythm or delivers a shock, ensure that no one is touching the infant. The AED will issue a “clear” command, signaling everyone to move away from the patient for safety. If the AED advises a shock, press the flashing shock button when prompted. Immediately after a shock is delivered, or if no shock is advised, resume cardiopulmonary resuscitation (CPR) without delay. Continuous CPR helps maintain blood flow until emergency medical services (EMS) arrive.
Post-Shock Care and Emergency Response
Following an AED shock, or if the device advises no shock, continued CPR is immediately necessary without interruption. This sustained effort helps circulate oxygenated blood for the infant’s recovery. The AED will prompt for continued CPR and re-analyze the heart rhythm every two minutes, advising further shocks if required.
If not already done, calling 911 or the local emergency number should occur as soon as cardiac arrest is recognized. Emergency dispatchers can provide further guidance while awaiting the arrival of professional medical help. Remaining with the infant and following any instructions from EMS personnel is important, as they will take over care upon arrival. Professional medical follow-up is also important to address the underlying cause of the cardiac arrest and ensure comprehensive care.