Infant defibrillation

[Jwade]

So as a PALS instructor and for the sake of debate if the internal voltage regulator on an AED, essentially this is incorrect although a nit picky point are not in the pads in the first place they are just sensed through the pads and is not chest impedance measured in joules of the AED, just how does it do that I must wonder would placement of gel pads affect this measurement, or proper contact, remembering that these are approved for public use.

And if 50 joules is the lowest setting and I believe you are speaking for just one flavor of AED on the market, and last count about 20 manufactures with varying algorithm ? You did hear of the FDA recall one variety for failure (rumored) to give enough energy, you can understand I am so not a fan of AEDs, I am a fan of providing Advanced Care, on the other hand perhaps loosing money in the stock market has made me bitter.

So following your PALS advice as an instructor the lowest setting would be 50 joules and following PALS guidelines of 2J/kg first shock that would amount to a pt weight of 25 kg or converted 55 pounds that would put on my plastic card into the BLUE level ... btw I do have some experience in NICU, PICU settings and have yet to see a 55 pound infant, I think my daughter was 3 years old before she was that weight.

That said I do not disagree at the Paramedic level if an infant was in a shockable rhythm then by all means then agreed but in asystolic just further attempt is just for show, ie you can do everything by the book but fact is our resus rates in the peads demographic are abysmal, even within a hospital setting, dead IS dead, if one has not had a positive response to fluid or pharmacology before arrival to ER ..

And just my anecdotal experience is when vast majority of situations infants respond to stress with tachycardia then bradcardia then flat line in a time frame so quickly never to accommodate the mother may I technique.

And in closing after my last "recert" in PALS there were many errors in instruction and just following the PALS Bible one must look beyond one reference only IMHO.

cheers

Hey, I completely agree with everything, I am NOT quoting PALS as the gospel by any means...Tons of crap I disagree with for sure, HOWEVER, my point was that for the PUBLIC and the use of an AED with PEDI PADS, the joules will be dialed down to 50 in THEORY.........Again, I would rather shock regardless of the age and there is NO time for mother may I BS!!!!!

I apologize for not clarifying my point better in my previous post....Can you elaborate on the red text above....Not sure what you are talking about here....The PEDS AED stuff I have always used, literally has a box wired inline with the PADS which tone down the joules from 360 - 50.

Better to ask for forgiveness than permission any day!

Respectfully,

JW

Edited November 2, 2009 by Jwade

[tniuqs]

I apologize for not clarifying my point better in my previous post....Can you elaborate on the red text above....Not sure what you are talking about here....The PEDS AED stuff I have always used, literally has a box wired inline with the PADS which tone down the joules from 360 - 50.

Better to ask for forgiveness than permission any day!

Respectfully,

JW

The paragraph you highlighted in red is more a question .... dang sure hope arcticcat is watching this thread he would know the answers heck he lays with FLIR on his trucks ... for me I never touch a "flash box" I have an allergies

I prefer to do the selection manually.

cheers

[Jwade]

The paragraph you highlighted in red is more a question .... dang sure hope arcticcat is watching this thread he would know the answers heck he lays with FLIR on his trucks ... for me I never touch a "flash box" I have an allergies

I prefer to do the selection manually.

cheers

Tniuqs,

Ahh, Ok, that explains more to me now...Thank you for the clarification.

JW