AEDS AND INFANTS

[ERDoc]

As others have stated, go by your local protocals. Many units have peds pads available that reduce the energy delivered (though I do not know specifically if they are made to be used on those under 1, read the manual to become familiar with your equipment). As far as the comment by the OP about the hole in the AHA guidelines, you cannot expect them to make any recommendations when there is a lack of research. This would go against every law of EBM. Pediatric arrests are rare (thankfully) so it is hard to design a good, relaible study. As others have said, peds arrests usually don't present in shockable rhythms because it is usually an airway issue (even in the kids with congential disease). So, to design a study to look at defibrillation in an infant population is very difficult. You are trying to find a rare subgroup in an already rare population.

[VDCavey]

As others have stated, go by your local protocals. Many units have peds pads available that reduce the energy delivered (though I do not know specifically if they are made to be used on those under 1, read the manual to become familiar with your equipment).

Thes pedi pads are usually for infants from 1-4 yo (as far as the Leardal's over here) but we do not carry them annymore, we are instructed to use adult pads, the shoulder pad on the front, the side pad on the back and use your AED as with an adult

[buckeyedoc]

Absolutely, infants are respiratory unless it has a congenital heart defect. We had a 6 week old code a couple of weeks ago. Grandma rolled over on baby while sleeping. I can't imagine the guilt that grandma feels and the anger the parents feel. Unfortunately, accidents happen.

My wife and I also teach CPR (AHA) and we're asked all the time about infant AED's. Most people understand, but some still don't get it. I don't think that there will be enough evidence to support infant AED's anytime in the near future.

[kristo]

I was under the impression that hypoxia led to ventricular fibrillation? Let's say an infant's problem is initially airway or breathing related, that's fixed by the responder, but the hypoxia has led to ventricular fibrillation...that being a shockable rhythm, one would assume that defibrillation was indicated.

Maybe it's just that I shouldn't post before my morning coffee, but this sounds fairly logical to me...

[AZCEP]

In that case, kristo, the duration of the ventricular fibrillation will be so short that you will likely be unable to apply and analyze quickly enough to be of therapeutic benefit.

[Ridryder 911]

I was under the impression that hypoxia led to ventricular fibrillation? Let's say an infant's problem is initially airway or breathing related, that's fixed by the responder, but the hypoxia has led to ventricular fibrillation...that being a shockable rhythm, one would assume that defibrillation was indicated.

Maybe it's just that I shouldn't post before my morning coffee, but this sounds fairly logical to me...

If you review ped.'s, you will find that they are not as susceptible to v-fib like adults as others have described. The usual pattern is bradycardia to aystole. Hence, the reason for initiating compressions <60 rate, and rare defibrillation.

R/r 911

[kristo]

In that case, kristo, the duration of the ventricular fibrillation will be so short that you will likely be unable to apply and analyze quickly enough to be of therapeutic benefit.

Ahh, true. The AED would have to be very close. Still means that the AEDs in the public swimming pools are a good idea... :wink:

If you review ped.'s, you will find that they are not as susceptible to v-fib like adults as others have described. The usual pattern is bradycardia to aystole. Hence, the reason for initiating compressions <60 rate, and rare defibrillation.

Interesting. Didn't know that. Thanks for the info.