AED Units: So Simple that Children Can Use Them?

When a teacher at Georges-Vanier high school in Montreal suddenly lost consciousness, it was not the school nurse or other staff members who responded. Rather, three students immediately jumped into action by performing CPR and using an AED to save the teacher’s life. When the school’s vice-principal heard that students were in the room during the emergency, his first thought was to get them away from the scene. However, upon arrival, he saw the students were administering lifesaving treatment. Adults are not the only ones who can and will respond to a cardiac arrest emergency!

Public access defibrillation (PAD) programs seek to reduce the time that victims of Sudden Cardiac Arrest (SCA) have to wait before receiving CPR and a “shock” from an automated external defibrillator (AED). By giving the general public access to AEDs, PAD programs enable bystanders to quickly respond to cardiac arrest and reduce reliance on EMS for life-saving defibrillation.

While coordinated systems involving both out-of-hospital and in-hospital measures offer the most exciting opportunities to save lives, the success of PAD programs relies almost exclusively on lay responders.

By placing AEDs in public settings, PAD programs aim to equip everyone, regardless of medical training or age, with the tools to assist patients experiencing SCA.

AEDs are made with ease-of-use in mind. They offer clear instructions and labeling to help almost anyone save a life. AED units are designed to be simple and easy to operate, requiring that the user only need to do the following:

• Turn the device on
• Correctly apply the electrodes to the person’s chest according to the pictures provided
• Stand back and let the AED analyze the person’s heart rhythm to determine whether or not they would benefit from a “shock”

(Of course, check your AED user manual for specific instructions as to the use of your particular AED for more information).

Many imagine that adults will always be the ones to deliver treatment from an AED. After all, that’s what we see in the movies, right? But there are scenarios in which only a child or minor is present when the SCA occurs. For example, a parent might experience SCA when alone with their child, or a student may go into SCA when playing with their peers.

So, Exactly, How Easy are AEDs to Use? Can Children Use Them Effectively?

You might think that children may not be able to use AEDs properly. They are medical devices, after all. Perhaps they’re too sophisticated or require significant specialized medical training?

However, researchers have looked into these questions and generated some surprising results that suggest that, with some modest training, children can operate AEDs as well as trained adults and paramedics. 

In a study examining the performance of 15 sixth-graders responding to a mock cardiac arrest compared to 22 professional EMTs, researchers found only minor differences in the speed of AED use between the two groups. The mean time between entry to the scene and the shock delivery was 90 seconds for the children and 67 seconds for EMTs.

Another study investigating children’s preparedness in general Basic Life Support (BLS) skills found that 45% of children between 12 and 14 years old knew what an AED was. 75.7% of the children could perform all seven critical AED skills asked of them, and, upon training, up to 95% of the children could perform key AED actions. Children between 6 and 7 years old were also able to use AEDs after training, showing great adeptness at identifying symptoms, and deploying the device.

In another observational study, children over 13 years old were found to be able to deliver CPR compressions of adequate depth after receiving just a 20-minute BLS lesson. 

These studies indicate that children can quickly learn lifesaving skills and are as reliable as adults in rendering aid with an AED to patients experiencing Sudden Cardiac Arrest.  

Given this evidence, many jurisdictions have made training children in CPR and AED use mandatory. In doing so, children contribute as a crucial link to the chain of survival by enabling them to respond when they witness peers or adults in cardiac arrest. 

Since SCA is the leading cause of death in student-athletes, school sports fields are an essential setting in the fight against SCA. Sporting facilities also attract attendees who can also fall victim to SCA. Training students in CPR and AED use increases the odds that cardiac arrest victims receive life-saving treatment. 

When children learn how to use AEDs, it is not expected that their training will be used in “real life” situations immediately. Instead, training a large number of young responders on how to do CPR and use an AED teaches them the critical skills that they can use to save lives in the future. For example, in Denmark, when CPR training was made compulsory for children over 11 years of age, the survival rate from out-of-hospital cardiac arrest tripled within six years. 

As CPR and AED awareness continue to improve over time, you never know who might come running over with an AED!