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The Use of Automated External Defibrillators in Infants: A Report From the American Red Cross Scientific Advisory Council
Pediatr Emerg Care (2015)
  • Joseph W Rossano, University of Pennsylvania
  • Wendell E Jones
  • Stamatios Lerakis, Emory University
  • Michael G Millin, Johns Hopkins University
  • Ira Nemeth, Baylor College of Medicine
  • Pascal Cassan
  • Joan Shook, Baylor College of Medicine
  • Siobán Kennedy
  • David Markenson
  • Richard N Bradley, The University of Texas Health Science Center at Houston
Abstract

Objective: Automated external defibrillators (AEDs) have been used successfully in many populations to improve survival for out-of-hospital cardiac arrest. While ventricular fibrillation and pulseless ventricular tachycardia are more prevalent in adults, these arrhythmias do occur in infants. The Scientific Advisory Council of the American Red Cross reviewed the literature on the use of AEDs in infants in order to make recommendations on use in the population.

Methods: The Cochrane library and PubMed were searched for studies that included AEDs in infants, any external defibrillation in infants, and simulation studies of algorithms used by AEDs on pediatric arrhythmias.

Results: There were 4 studies on the accuracy of AEDs in recognizing pediatric arrhythmias. Case reports (n = 2) demonstrated successful use of AED in infants, and a retrospective review (n = 1) of pediatric pads for AEDs included infants. Six studies addressed defibrillation dosages used. The algorithms used by AEDs had high sensitivity and specificity for pediatric arrhythmias and very rarely recommended a shock inappropriately. The energy doses delivered by AEDs were high, although in the range that have been used in out-of-hospital arrest. In addition, there are data to suggest that 2 to 4 J/kg may not be effective defibrillation doses for many children.

Conclusions: In the absence of prompt defibrillation for ventricular fibrillation or pulseless ventricular tachycardia, survival is unlikely. Automated external defibrillators should be used in infants with suspected cardiac arrest, if a manual defibrillator with a trained rescuer is not immediately available. Automated external defibrillators that attenuate the energy dose (eg, via application of pediatric pads) are recommended for infants. If an AED with pediatric pads is not available, the AED with adult pads should be used.

Keywords
  • cardiac arrest,
  • infants,
  • automated external defibrillator
Publication Date
July, 2015
Citation Information
Joseph W Rossano, Wendell E Jones, Stamatios Lerakis, Michael G Millin, et al.. "The Use of Automated External Defibrillators in Infants: A Report From the American Red Cross Scientific Advisory Council" Pediatr Emerg Care Vol. 31 Iss. 7 (2015)
Available at: http://works.bepress.com/richard_bradley1/39/