Automated External Defibrillators (AED) (cont.)

Automated External Defibrillator Use in Children

Although ventricular fibrillation is more common in adults than in children, it is now recognized that it occurs more frequently in children than was once thought.

For example:

• Children with congenital heart defects are at risk for rhythm abnormalities such as ventricular fibrillation.
  
  
• Some children go into ventricular fibrillation because of commotio cordis.

Commotio cordis is a syndrome in which a blow to the chest during a relatively brief, specific time period during the heart rhythm cycle can cause ventricular fibrillation.

• This condition was once thought of as a mysterious syndrome of sudden death in young athletes.
  
  
• It is now recognized as a preventable and reversible cause of ventricular fibrillation in children.

The problem with AED use in children is that, unless the child's heart is of a certain size, the amount of current delivered (originally intended for the adult heart) could actually damage the child's much smaller heart and prevent resuscitation.

• If a child is the size of a typical eight-year old, the adult AED protocol is followed.
  
  
• For children older than one year of age but less than the size of an eight-year old, AED manufacturers provide cables capable of reducing the amount of energy that an AED delivers, making it safe to use on the children. When an AED is used on a child, the pediatric cable is used; when an AED is used on an adult (age eight years and older) the adult cable is used.
  
  
• There is insufficient evidence for the American Heart Association to be able to make any recommendations for AED use on children less than one-year old.