Everything you need to know about pediatric AED pads, pad placement, and which AED models offer the most convenient solutions for responding to children in Sudden Cardiac Arrest
An Automated External Defibrillator’s (AED’s) electrode pads are one of the most vital components of an AED. In fact, without electrode pads, a patient’s heart rhythm can’t be analyzed and defibrillation can’t be delivered to save a life!
Electrode pads are removable, disposable (one-time-use), and sticker-like so they can be applied to a patient’s chest. They work by using a water-based adhesive gel that ensures an electrical current is bridged between an AED and the patient.
Once the pads are affixed to bare skin, the AED detects impedance and analyzes the patient’s heart rhythm using a custom algorithm to determine whether or not a defibrillation shock is necessary. If the AED determines that a patient is in cardiac arrest – that they’re in a “shockable rhythm” – the AED will charge its capacitor and deliver a shock of energy to try to restart the patient’s heart. Energy is discharged from the AED and carried through the wires connecting the AED, to the electrode pads, completing a circuit between the two electrode pads, and the patient’s heart.
What are pediatric AED pads?
For the most part, pediatric electrode pads work the same way as standard adult electrode pads; by analyzing a patient’s heart and, if necessary, delivering the lifesaving shock generated by the defibrillator to the child’s body.
The primary difference is when the patient is a child, the energy level of the shock is attenuated (“reduced”) from the standard adult energy setting. In most cases, the energy is decreased from 150 joules used for adults to 50 joules, for children.
Why are pediatric AED pads important?
While many AED owners are prepared to treat adult cardiac arrest victims, most aren’t prepared to treat a child, as it’s often assumed that sudden death doesn’t affect children or that the occurrence is “rare.”
That’s not the case, however, as between 7,000-10,000 youth die annually from SCA, and, thus, AED owners need to be prepared to use their device on all possible victims, including children, using pediatric electrode pads.
How are electrode pads attentuated?
Depending on an AED’s make and model, the attenuation might be pre-set into a separate set of pediatric electrode pads, built for the sole and exclusive use of pediatric patients, or it might be built into the AED and activated using a button, “key,” or another switching mechanism.
At what age is it necessary to use the child pads, if available?
Pediatric pads are recommended for children below 8 years of age. If the age of a child is undetermined, ask anyone nearby in audible rage (so as to not leave the victim unattended).
What if you don’t know the child’s age?
American Heart Association (AHA) recommendations if pediatric pads are not available
If the rescuer does not have pediatric pads when responding to a child in cardiac arrest, they should do a quick check to see if the AED they’re using has a switch, “key,” or button that can convert the defibrillator to “child-mode.”
If the AED they are using doesn’t have pediatric electrode pads available, or the device can’t be switched to “Child Mode,” the American Heart Association (AHA) recommends using the AED’s default adult setting on the child.
In these circumstances, rescuers should apply the adult pads in the anterior-posterior (“front-and-back”) position since the adult pad placement may not be possible given the size of the electrode pads relative to the small chest of the pediatric patient.
Installing pediatric AED pads
Older AED units, such as the ZOLL AED Plus, require responders to remove their pre-installed adult pads and insert a separate and detached set of pediatric pads to treat infants and children. The dedicated pediatric pads have a built-in attenuation mechanism that receives the full amount of energy from the AED unit but reduces the energy to a lower level before delivering the shock to a child.
Newer AED models are moving in the direction of using the same set of electrode pads (i.e. universal pads) for adults and pediatric patients.
With universal pads, users can press the “Child Button” on the AED, which switches the device between “adult” and “child” mode, to attenuate the energy of the defibrillation shock.
One set of electrode pads, capable of serving all patients, no matter their size or age, is a much better option than two separate sets of pads (one for adults and one for children) in several ways:
- Saves valuable time: For every minute that defibrillation from an AED is not received, a person’s chances of survival are reduced by 7-10%. During a child cardiac arrest emergency, if an AED owner has a device that requires the installation of separate pediatric pads, the user would need to go through far too many steps just to get the AED to start analyzing the child’s heart rhythm, wasting precious time: (1) find the pediatric pads, (2) take the pediatric pads out of protective packaging, (3) detach the adult pads, and, finally, (4) install the pediatric pads. By owning an AED with universal pads, a user would simply need to press the “Child” button on the device, and just like that, the device is ready to use on a child.
- Saves money: Pediatric pads are expensive and must be replaced every time they’re used and when they expire (typically every 2 years). Depending on the AED’s make and model, pediatric pads can cost over $100, which translates to hundreds of extra dollars spent over a 10-year period of ownership, not counting if they’re used!
- Fewer Headaches: In some cases, such as when an AED’s adult and pediatric pads have different expiration dates, owners can forget to replace them which may lead to expired pads that don’t work when they’re needed most. This extra financial burden of keeping track of two sets of electrode pads is not worth the risk of losing lives, and even potentially facing litigation for failing to properly maintain the device.
Where do you place AED pads on a child?
The electrode pad placement might vary from one AED brand to the next, so be sure to check your AED’s owner’s manual for specific electrode pad placement instructions. If you can’t find it there, most AEDs have an image printed directly on the electrode pads that signify where they should be placed on the patient’s body.
Usually, the proper location to attach AED pads on a child is anterior-posterior (or “front-and-back”) placement – which is when one electrode pad is placed in the center of the child’s chest and the other pad is placed in the center of their back.