Hi everyone,

Can anyone share any recent literature regarding defib pads for AED's for use on children. I noticed that StJohns website indicates that they can be used on babies?

My understanding is as follows:

1)Adult pads can be used on children over 8
2)Pad position is centre of the chest and back for small children (child pads)
3)Defibs cannot be used on babies under 1


Also whilst on the subject of AED's, if a casualty has an implanted device on their left side where the pad would normally be placed on the side under the breast area, can they diagonal position be alternated to go from left to right to avoid any potential complications?

Thanks for any advice and clarity on this.

DJ

I'm a bit rusty, a couple of years since I did my last AED training, but I'm sure I remember being told that the AED probably won't recommend a shock to a patient with a pacemaker as it will pick up the electrical impulse from it and conclude that the heart rhythm is normal.

Direct extract from RESUS Council UK Guidelines:


Although modern CIEDs are designed to resist damage by external defibrillation or cardioversion currents, there is a remote possibility of damage when a shock is delivered through a defibrillation pad placed over or close to these implanted devices. With pacemakers and ICDs with transvenous/endocardial leads there is also a theoretical risk of damage to the person’s myocardium at the electrode interface due to excess current flow. This may elevate pacing thresholds temporarily or permanently or damage the myocardium temporarily or permanently at the electrode-tissue interface. To minimise this risk it is recommended that defibrillator electrodes are placed as far away as is practicable from the pacemaker or ICD generator without compromising effective defibrillation. A distance of at least 10-15 cm between the edge of the device and the edge of the defibrillator electrode is recommended. Placement of the defibrillator electrodes approximately perpendicular to the device and its leads may reduce the risk of current entering the device circuits. If necessary use of alternative electrode positions (e.g. antero-posterior) may be used to achieve this. Similar precautions are advised in people with neurostimulators implanted in the chest. In people with implantable event recorders it is advisable to avoid placing defibrillator pads directly over the device to minimise the risk of damage to the device itself, despite in-built protection.