AED Pad Placement for Infants and Young Children: A Complete Guide

Sudden cardiac emergencies can happen to anyone, including infants and young children. While sudden cardiac arrest in children is less common than in adults, it is often caused by respiratory failure, trauma, or congenital heart conditions. When you know how to use an automated external defibrillator in such cases, it can make a life-saving difference. In pediatric cases, however, the use of adult AED pads and settings can be dangerous. Pediatric AEDs ensure that the shock is delivered at a safe intensity. AED pad placement for infants and young children requires special care due to their smaller size and different anatomy compared to adults. Proper AED pad placement ensures that the shock is effective and safe for a young child’s heart.

This blog covers everything you need to know about AED pad placement for infants and young children to ensure that you can safely use a pediatric AED in a cardiac emergency.

AED Pads for Infants and Young Children

AED pads are an essential component of the defibrillation process. It delivers an electrical shock to the heart. For infants and young children, it is crucial to use pads of appropriate size to ensure effective and safe shock delivery. Pediatric AED pads are specially designed to fit the smaller body sizes and chest areas of young patients. These pads differ from adult pads in size, energy levels, and placement techniques. Understanding how AED pads work and how to choose the right type for infants and young children can significantly increase the chances of a successful outcome in a cardiac emergency.  

Why Proper AED Pad Placement Matters

AEDs work by delivering a controlled electrical shock to the heart to reset its rhythm. However, for the shock to be effective, the pads must be placed correctly. Because infants and young children have different body structures compared to adults, correct pad placement is crucial to maximize the success of AED treatment.

Improper AED placement can result in:

• Reduced effectiveness of the shock, leading to a lower chance of success in restoring a normal heart rhythm.
• Potential injuries, such as burns or incorrect shock path through the heart.
• Harmful effects if the shock doesn’t pass through the heart as intended, reducing the overall effectiveness of the device.
• Increased risk of delivering a shock to areas of the body that are not the heart, potentially causing harm to other tissues or organs.
• Delayed shock or inaccurate reading.

Components of Pediatric AED Pads

Pediatric AED pads feature unique components tailored to the smaller bodies and delicate hearts of young patients. Below are the key components of pediatric AED pads:

1. Smaller Pad Size:
   Pediatric AED pads are sized to fit a child’s chest, ensuring proper contact and effective shock delivery.
2. Gel Layer:
   The conductive gel layer ensures efficient shock transmission and enhances pad adhesion to the skin.
3. Low Energy Settings:
   Pediatric pads are paired with AEDs that automatically reduce shock energy to safer levels for young hearts.
4. Placement Markings:
   Pads feature clear, visual placement markings to guide proper positioning on a child’s body for optimal shock delivery.
5. Pre-Connected Leads:
   Many pediatric AED pads come pre-attached with leads, streamlining the setup process during an emergency.
6. Child-Specific Designs:
   Pediatric pads often include calming, child-friendly designs to help ease anxiety during a stressful situation.

Where Should Pediatric AED Pads Be Placed on an Infant?

Infants have smaller, more delicate bodies, so it’s essential to follow specific placement techniques to maximize the chances of success. Below are the key placement guidelines for AED pads on infants and young children.

Key Placement Techniques for Infants (Under 1 Year Old)

When using an AED on an infant, pads should be placed in an anterior-posterior configuration. This method ensures the shock travels across the heart efficiently, optimizing the chances of restoring a normal heart rhythm.

• First Pad: Place the first pad on the infant’s chest, just below the right collarbone.
• Second Pad: The second pad should be placed on the infant’s back, between the shoulder blades.

Pediatric AED Pads  To Be Placed on a Child (Aged 1 to 8 years old)

The AED pad placement for children ages 1 to 8 is different from that for infants. Pads should be placed on the front and back of the chest:

• First Pad: Place the first pad on the front of the chest, over the center of the chest.
• Second Pad: The second pad should be placed on the back, directly opposite the first pad.

Step-by-Step Guide to AED Pad Placement for Infants

When using an AED on an infant, proper pad placement is critical to ensure the shock is delivered effectively and safely. Infants have smaller bodies, so precise positioning is essential to ensure the electrical current passes through the heart as intended. The following step-by-step guide outlines the process to help you respond confidently in an emergency.

1. Prepare the AED

 Turn on the AED and carefully listen to and follow the device’s voice prompts.

2. Expose the Infant’s Chest

Remove any clothing or items covering the infant’s chest to ensure direct contact between the skin and the pads.

3. Place the First AED Pad

Position the first pad on the infant’s chest, just below the right collarbone.

4. Place the Second AED Pad:

Place the second pad on the infant’s back, between the shoulder blades, ensuring the pads do not overlap.

5. Check for Proper Connection

Confirm the pads are securely attached, with no gaps or air pockets, and verify the AED is connected correctly.

6. Follow AED Instructions

Allow the AED to analyze the heart rhythm, and if prompted, deliver the shock by pressing the appropriate button.

Common Mistakes to Avoid

Even a small error can impact the performance if AED is not used properly on infants. Here are some of the common mistakes to be aware of and avoid:

• Do not use adult AED pads instead of pediatric ones. Adult pads can deliver excessive shock intensity.
• Do not place the pads too close together. It reduces the shock’s ability to reach the heart.
• Allowing the pad to overlap can disrupt the electrical current and render the shock ineffective. So, avoid it.
• Do not ignore the AED’s voice prompt or rush through the instructions.
• Don’t forget to remove clothing and ensure proper pad-to-skin contact.

Common Myths About Infant AED Pad Placement

When it comes to using AEDs on infants, several myths can cause confusion. Let’s address some of the most common misconceptions:

1. Myth: AEDs are too powerful for infants.
   Fact: Pediatric AED pads are specifically designed to reduce shock intensity, making them safe for use on infants and children.
2. Myth: AED pads should always be placed on the front of the chest.
   Fact: For infants, the anterior-posterior placement (front and back) is recommended to avoid overlap and ensure the shock is properly delivered across the heart.
3. Myth: Adult AED pads can be used on infants.
   Fact: While adult AED pads can be used in emergencies if pediatric pads are unavailable, they should be placed carefully in an anterior-posterior position to avoid overlapping. However, pediatric pads are always the preferred choice for infants.

Tips for Proper Infant AED Pad Placement

Here are some key tips to ensure you are prepared in an emergency:

1. Always use pediatric-specific AED pads for infants and children under 8 years old.
2. Place AED pads in an anterior-posterior configuration for infants and on the chest and back for young children.
3. Familiarize yourself with AED pad placement during training to be confident in an emergency.
4. Make sure that AED pads are easily accessible, and check their expiration dates regularly.
5. You also need to make sure that the pads don’t overlap each other for effective shock delivery.
6. You should always follow the specific instructions provided by the AED manufacturer for pad placement.

Enroll in AED training at Heart Start CPR

As we come to the end of the blog, you have understood that properly placing AED pads in infants and young children can make all the difference in a life-or-death situation. As infants have smaller bodies and delicate hearts, it’s important to follow the techniques we mentioned above to ensure the shock is effective and safe. For more comprehensive understanding and hands-on practice, you can join infant CPR or  PALS classes. At Heart Start CPR, we provide life support training to teach you how to handle pediatric emergencies. Join us, and you will gain the skills needed to use an AED properly, avoid common mistakes, and be prepared when every second counts. Whether you are a parent, caregiver, or healthcare professional, PALS training can make you capable of providing life-saving care in critical situations.