AED Use in Children Less than 8 Years of Age

Automated external defibrillators were previously approved only for use in adults and children who were 8 years of age or older and greater than 25 kg. Some AED manufacturers have modified their adult AED equipment to include pediatric cables and pads that reduce the energy level delivered by the AED by about 50 to 70 joules, thus making the adult AED available for use in children less than 8 years of age.

If an AED is used in a pediatric patient, it is highly recommended that an adult AED with the pediatric pad/cable system be used to deliver more appropriate energy levels. However, if a pediatric pad/cable system is not available and you are confronted with a child between the ages of 1 year and 8 years of age who is in confirmed cardiac arrest, it is appropriate to apply and use the adult AED. If only one rescuer is on the scene, one minute of CPR should be performed on the child prior to attaching the AED. After one minute of CPR, the adult AED should be attached and the rescuer should proceed with the AED procedure.

Application of the AED and defibrillation is only indicated in ventricular fibrillation and pulseless ventricular tachycardia. Do not apply the AED if the patient has a pulse or other signs of circulation. Do not apply or use the AED in infants less than 1 year of age. If a defibrillator with variable energy settings is not available for use on an infant less than 1 year of age, initiate CPR and contact an ALS unit. Even though an adult AED can be applied to a child older than 1 year of age who is in confirmed cardiac arrest, it is still advisable and preferred that a manual defibrillator with the feature of setting variable lower energy levels be used to defibrillate a child less than 8 years of age. (Samson RA, Berg RA, Bingham R, et al. Use of Automated External Defibrillators for Children: An Update. Circulation. 2003;107:3250.)

For additional information, visit the American Heart Association website at http://circ.ahajournals.org/cgi/content/full/107/25/3250.