You are performing cpr on a 3 year old child when an aed arrives. pediatric pads are not available

When performing CPR on a pulseless adult or a non-breathing child or infant, an AED should be applied as soon as it is available.[1]

Perform the following steps without interruption of CPR:

1. Turn on the AED and follow the visual and/or audio prompts from the machine.
2. Open the person's shirt and wipe his or her bare chest dry. If the person is wearing any medication patches, you should use a gloved hand or other protective barrier on your hand to remove the patches before wiping the person's chest.
3. Plug in the AED pads, remove the adhesive backing, and place the pads in the indicated locations on the patient's right upper chest and left lower ribcage for an adult or large child (Fig. 1) or in the anterior/posterior positions for a small child or infant (Fig. 2).
4. Tell everyone to "stand clear" and make sure no one is touching the person.
5. Push the "analyze" button (some models start analysis automatically) and allow the AED to analyze the person's heart rhythm.
6. If the AED recommends that you deliver a shock to the person, it can take some time to charge. Continue chest compressions while charging.
7. Once charged, tell everyone to "stand clear" - make sure that no one, including you, is touching the person while the shock is delivered automatically. For some models which do not auto deliver the shock, once the AED is charged and the patient is clear, press the "shock" button.

Restart CPR immediately after the shock was delivered, or if no shock was advised. Perform 2 minutes (about 5 cycles) of CPR and continue to follow the AED's prompts. If you notice obvious signs of life, discontinue CPR and monitor breathing for any changes in condition.

If ALS is not arriving on the scene, most local protocols advise transporting the patient when one of the following occurs:

• The patient regains a pulse
• Six to nine shocks have been delivered without Return of Spontaneous Circulation (ROSC)
• The AED gives three consecutive messages (separated by 2 minutes of CPR) that no shock is advised.

Your local protocol always takes precedence over this general guideline.

An AED can be used on children and infants and should be used as early as possible for the best chance of improving survival. Check the AED when it arrives at the scene. Pediatric pads should be used if the person is less than eight years old. Standard (adult) pads may be used if pediatric pads are not available. If using standard (adult) pads, do not let the pads touch. For infants less than a year old, a manual defibrillator should be used if available. If a manual defibrillator is not available, an AED may be used. Some AEDs have a switch that can be set to deliver a pediatric shock. If available, turn the switch on when using on children younger than eight years old. If the AED cannot deliver a pediatric shock, an adult shock should be given. It is important to remember an electric shock may be the cure for a fatal heart rhythm.

Fig. 1: Normal Adult AED pad application.

Fig. 2: Pediatric/Infant AED pad application.

Tips and Tricks[edit | edit source]

• When placing the pads, if there is excessive hair, use a razor of second pair of pads to remove the hair. This allows for much greater contact with the patient's skin and increased chances of successful defibrillation.

References[edit | edit source]

1. ↑ CITATION PENDING

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Most AEDs come with both adult and pediatric pads designed to be used on children. Pediatric pads should be used on children under 8 years old or children who weigh less than 55 pounds. Adult pads can be used on children and people 8 years old or older or weigh more than 55 pounds. With that said, if child pads are unavailable standard adult pads can be used. Below are some guidelines on how to use adult pads on a child.

• Do not let the pads touch
• If possible, set the AED to a pediatric setting to produce a pediatric shock
o If there is no pediatric setting an adult shock can be used
• If the child is an infant, please use a manual defibrillator
o However, if there is no manual defibrillator and AED may be used

Pad placement is also crucial for the success of the AED in saving one’s life. The placement of the pads differs from adult to child. Below are how to place pads on each type of person, whether it be an adult or a child.

For Adults
o One pad should be placed on the right side of the chest, just below the collarbone
o The other should be placed on the lower left side of the chest
o Connect the pads to the AED and follow the instructions for use
o Be sure to place pads on bare skin

For Children
o Use child pads as available
o Do not cut or fold the pads and do not let the pads overlap each other
o Use a front-back placement for children and infants

What if pediatric AED pads are not available?

At what age is it necessary to use the child AED pads if available?

Where do you place the AED pads on a child?

What do you do if the child's chest is too small and the AED pads are at risk of touching each other?