Are AEDs safe to use for infants younger than 12 months? This is a question I’m often asked……..The following is from the ERC January 2020 Newsletter:
Frequently in courses candidates ask if the use of automated external defibrillators (AEDs) is safe in infants less than one year of age. Authors report a case with successful AED use in a 31-day-old previously healthy infant with out-of-hospital cardiac arrest. Chest compressions began immediately, paediatric AED pads were applied within less than 5 minutes and the initial rhythm was ventricular fibrillation. Two 50 J shocks resulted in the return of spontaneous circulation. Although the child received two shocks of more than 11 J/kg each, there was no apparent myocardial damage at hospital presentation.
Comments: The safety of the use of an AED in infants is unknown and this case seems to be a unique one to demonstrate a possible safety in infants. However, more research is needed to confirm the safety. Pro: the delivered energy is the minimal dose in AEDs adapted for children. Ventricular fibrillation (FV) occurs only in about 24% of cardiac arrest of primary cardiac origin (Nordseth T., read here) and is consequently the best indication for defibrillation. Studies to discover the initial cardiac rhythm are very rare, especially in the period of 1 minute CPR before applying the AED, as recommended in children with a non-witnessed collapse.