There are quite a few semi-automated and automated AEDs being sold and installed in public places. However, the problem with almost all of these defibrillators is that the general public in most cases knows almost nothing about them. This is why both types of defibrillators have been designed to make it extremely easy for anyone with no knowledge of delivering a heart jolting shock to use the devices. Fully automated devices are designed to monitor the hearth rhythm and then advice the user to sit back while the shock is delivered. The problem with automatic defibrillators is that the shock delivered is intended for adults and can never be above a particular threshold. Kids require a lower intensity shock and this is where semi-automated defibrillators come in. The advanced features allows a person with some experience to override the automatic features to deliver a shock of the required intensity.
Even though ventricular fibrillation was very common in the past with adults the latest research shows that children are as likely to require ventricular fibrillation as adults. Ventricular fibrillation is mostly required for children suffering from congenital heart issues like rhythm abnormalities. Commotio cordis is yet another condition where a heavy blow to a child’s chest at a specific time can disrupt the heart’s rhythm cycle and cause ventricular fibrillation.
By far the biggest problem with using AEDs on kids is that unless their heart is large or a given size, the shock delivered can in fact damage the muscular tissue and do more harm than good. Usually, if a child is over eight years old regular AED protocol can be followed. Semi-automatic defibrillators will need to be overridden to be used on children over the age of one year yet under eight years old. There are some manufacturers that provide special cables that will reduce the intensity of the delivered shock making it somewhat safe for smaller children. This is often referred to as a pediatric cable.
Doctors and child specialists recommend that semi-automatic defibrillators not be used on infants. The best way to deliver oxygen to infants is via the use of manual defibrillation or CPR.
Using a semi-automatic defibrillator on children under 9 years old
The first thing you’ll want to do is to call emergency services. The defibrillation you perform using the device is until the services arrive at the scene.
- Start by checking to see if the child is breathing. If you see their chest rising and deflating it means the child is breathing if not then you’ll have to put your ears to his nose. If he is breathing, and also has a pulse then there is no point using an AED. If he is not breathing, then start by delivering some rescue breathing followed by chest compressions at 30 compressions and two breaths.
- Then find a semi-automatic defibrillator and prepare it for the child. In the meanwhile someone else can take over chest compressions.
- Use the pediatric adhesive pads that are designed for kids and attach it to the unit. The unit should have a diagram of where the negative pad should be attached. If the diagram is not available the negative pad should be placed on the child’s upper chest near the neck right above the nipple. The positive pad will be attached to the left end of the chest below the pectoral muscle.
- Turn on the defibrillator and go into the defibrillator’s settings and set it to the lowest intensity. Remember, that a child’s heart is small so you do not want to risk damaging it with a high intensity shock.
- Stop the other person from performing CPR and press the analyze button. This is usually located on the front of a semi-automatic defibrillator. Once it has monitored and analyzed the heart, a shock message will be delivered, then shock the victim.
- Then deliver five cycles of CPR right after a shock. One cycle is 30 compressions and with two rescue breaths.
Then press the ‘analyze’ button on the system to analyze the rhythm and if it’s still irregular the system will shock the child again. Make sure that the child’s airways are clear before delivering a second round of shock treatment and CPR.
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- License: Image author owned
- License: Image author owned
Manu Alias is a CPR and rescue expert with over a decade of experience as a paramedic. He specializes in using semi-automatic defibrillators as well as offers courses for regular people. When he’s not teaching people about saving lives he is saving lives as a paramedic.