Adult AEDs Should Be Used on Young SCA Victims if Pediatric AEDs Are Unavailable

October 30, 2007­–CHICAGO­–The use of automated external defibrillators (AEDs) has saved the lives of thousands of adult cardiac arrest victims, and now AEDs are shown to be equally effective as life-saving interventions for children. Although the incidence of ventricular fibrillation (VF) in young children is low, there is a need for developing strategies to provide early defibrillation to patients younger than eight years, which is why the American Academy of Pediatrics (AAP) has come out with a new clinical report and policy statement.

“As AED programs expand, pediatricians must advocate on behalf of children so that their needs are accounted for,” according to an AAP policy statement in the November issue of Pediatrics. The statement was released Monday during the American Academy of Pediatrics annual meeting in San Francisco.

Recent studies have shown that children do experience ventricular fibrillation, a potentially fatal condition in which the heart fails to contract properly. And, while the use of defibrillators to save a child’s life by providing an electrical jolt has been advocated for several years, the “software on AEDs has become more extensive and validated for children, and attenuation devices have become available to downregulate the energy delivered by AEDs to allow their use on children,” the statement said.

The existence of cardiac arrest caused by ventricular fibrillation (VF) in children and infants needs to be recognized. The likelihood of survival decreases by 7-10 percent with each minute of delay to defibrillation after cardiac arrest, so effective methods need to be used as early as possible to improve the chance of survival in children and infants.

Because AEDs were first used on adults and not tested on pediatric patients, they were not authorized for use in young children. Technology has improved, and pediatric-capable AEDs have been approved and found safe to use on young children and infants. Additional studies have shown that regardless of the weight or size of a child, an adult AED with the capability of providing a lower electric shock dosage should be used if a pediatric AED is not available. If the AED can only provide one level of dosage, it should still be used for infants and children because the benefits far outweigh the risks.

A factor that has delayed professional organizations advocating AED use for young children and infants is the need to simplify resuscitation training for adults. The policy statement includes specific recommendations for implementing rescuer AED programs in schools. Once proper training is completed, increased use of AEDs in children is recommended.

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-Source: American Academy of Pediatrics

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