Category Archives: Pediatric CPR

AED Use on Infants and Children

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 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 an AHA-approved 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 customerservice@cardiopartners.com.

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What are the Differences Between Infant, Child, and Adult CPR?

Learn the Pediatric Chain of Survival and Discover the key differences between Pediatric and Adult CPR

We’re the first to admit that the idea of performing cardiopulmonary resuscitation (CPR) on an infant or child is pretty scary. Although all of us here at Cardio Partners hope that you’ll never be called upon to perform CPR on a child, it’s important to understand the very significant differences between the three types of CPR.

Because a child’s physiology, musculature, bone density, and strength are different from an adult’s, CPR is performed differently. In fact, if adult CPR is performed on a child, it could do more harm than good.

Pediatric Chain of Survival

Earlier this month, we discussed Why the Chain of Survival is So Important, and in this post we’ll cover not only the differences between adult and pediatric CPR, but also the differences in the Chain of Survival for adults and children.

The Pediatric Chain of Survival is a sequence of events this is most likely to save the life of a young victim of sudden cardiac arrest (SCA). Unlike the adult Chain of Survival, which begins with early recognition and call for emergency assistance, the pediatric Chain of Survival dictates that high-quality CPR start immediately. This is because children are more likely to suffer from SCA caused by an obstructed airway or shock, so it’s important to be able to recognize and prevent respiratory problems or cardiac arrest before they occur. Only after performing CPR for a full  two minutes should the rescuer then call 911.

The Pediatric Chain of Survival consists of:

  1. Prevention of Cardiac Arrest
  2. Early, High-Quality CPR
  3. Rapid Activation of the Emergency Response System
  4. Effective Advanced Life Support
  5. Integrated Post-Cardiac Arrest Care

(Source: American Heart Association)

An Overview of the Three Different Types of CPR

Adult CPR

If you’re ever called upon to perform CPR on an adult, call 911 immediately before starting CPR. Check for a pulse and then begin CPR with chest compressions. If you’re not CPR-certified, a 911 operator can guide you through hands-only CPR. Push hard and fast on the center of the chest at a rate of 100-120 compressions per minute. Check out our Greatest Hits to Save Lives playlist to get a sense of the rhythm.

The compression depth for adults should be at least two inches and the chest should recoil completely between compressions. If you are CPR-certified, remember to use the ratio of 30 compressions to two rescue breaths. Use an AED if one is available.

Child CPR

Pediatric resuscitation protocols apply to infants less than 1 year of age and children up to the age of puberty or those weighing less than 121 pounds (Merck Manuals).

Although CPR for children is very similar to adult CPR, rescuers should start CPR before calling 911. If you’re the only person around and you need to make a choice between starting CPR and dialing 911, go for the CPR! Typically, children are more resilient than adults and their chances of survival are much higher if you begin CPR immediately.

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.

If an AED is available, apply pediatric pads and use it after five cycles of CPR.

Infant CPR

Great care should be taken when performing CPR on an infant. Although a baby’s bones are more flexible, they’re also much more delicate. First, confirm that the baby is unconscious. Do not shake the baby; instead, shout and tap or flick the soles of the infant’s feet.

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.

Check for a pulse on the inside of the upper arm and begin CPR immediately if you’re not able to detect a pulse. When providing rescue breaths to an infant, gently tilt the head so that the baby’s nose appears to be sniffing the air — this is known as the “sniffing position.” Do not tip the head back too far! Be very gentle when providing rescue breathing; don’t use the full force of your lungs to expel air. Instead, use your cheeks and puff air into the infant’s mouth and nose.

When providing compressions, use two fingers at the center of the baby’s chest. Compressions should be about an inch and a half deep at a rate of 30 compressions to two rescue breaths.

If an AED is available, apply pediatric pads and use it after five cycles of CPR. According to the American Red Cross, you may use an AED configured for an adult if pediatric settings or pads are not available.

(Sources: American Red Cross and National CPR Association)

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 customerservice@cardiopartners.com.

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