In this lesson, you'll learn how to use an AED on an infant who's gone into cardiac arrest. The methods of defibrillating an infant differ a little from adults and children, so be sure and make note of those differences.
As you know, AED pads come in two sizes – adult and pediatric. Pediatric pads are for patients less than 55 pounds or roughly 25 kilograms, while adult pads are for anyone weighing more than 55 pounds.
Remember, if you do not have pediatric pads and the patient is less than 55 pounds, use the adult pads. It's far better to use the wrong size pads than it is to forego using an AED.
Infant-related cardiac arrests are typically the result of:
- Drowning
- Choking/airway obstruction
- Electrocution
This is important for reasons of scene safety. If the infant was pulled from a pool, is he or she laying in too much water to safely use an AED?
If the infant was electrocuted, is the source of that electricity still a threat? It's always important to make sure the scene is safe before helping another person, but it's especially important when using an AED, where one spark can cause a lot of problems in the wrong situation. (And why we often mention combustible gases and flammable liquids in our scene safety warnings.)
How to Provide Care
Just like the last two AED lessons, we're going to assume a few things:
- The scene is safe, and your gloves are on
- You or someone else has called 911
- You have an AED that's ready to use
- The infant is already in cardiac arrest
- CPR is already in progress
AED Technique for Infants (less than 55 pounds)
- Turn on the AED.
- Remove the infant's clothing to reveal a bare chest and dry the chest off if it's wet. Since one pad will go on the infant's back, be sure that area is also accessible and dry.
- Attach one AED pad to the infant's chest, roll the baby over onto his or her side carefully while supporting the head and neck, and attach the second pad to the center of the infant's back between the shoulder blades.
Pro Tip #1: The AED should include a diagram on pad placement if you ever need help. And make sure they adhere well and aren't peeling off, as this will affect the AED's effectiveness.
- Plug the cable into the AED and be sure no one is touching the victim. The AED should now be charging and analyzing the rhythm of the infant's heart.
- If the scene is clear and no one is touching the victim, push the discharge button to deliver a shock. Then go right back into CPR. It's OK to perform CPR over the pads, so don't worry about moving them.
Remember, you want to minimize compression interruptions. Don't delay or interrupt compressions any longer than absolutely necessary and this includes after a shock is delivered. Go right back into your compressions.
- Perform 30 chest compressions.
- Grab the rescue shield and place it over the victim's mouth and nose.
- Seal your mouth over the infant's mouth and nose.
- Deliver two rescue breaths – Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath.
Continue with CPR until the AED interrupts you. At some point, it will reanalyze the victim's heart rhythm and again advise you on what to do next. If the AED advises a shock, do that. If it advises you to NOT shock the victim, continue with CPR only, again over the pads. (The AED will continue to reanalyze.)
Continue this cycle of CPR, re-analyzation, charging, shock, back into CPR until EMS arrives, the patient is responsive and breathing normally, or someone who's equally trained or better can relieve you.
A Few Common Questions About AED Use
Why is it so important to not disrupt or delay CPR compressions?
Current research suggests that minimizing all delays is important for victim recovery, including that first compression after an AED shock. Compressions immediately help get the victim's pulse pressures back up and oxygenated blood circulating again.
Will a wet diaper cause a problem with an AED?
No. As wetness concerns AED use, as long as the victim isn't submerged in a pool or puddle of water, you should be fine. Keep in mind that the only areas that need to be dry are those where the pads will go.
Can I remove the pads if the victim begins breathing normally again?
No. Keep the pads on until EMS or other advanced medical personnel take over. The AED will continue monitoring the victim and will advise you again should problems arise, so keep the pads on and the AED turned on.
