Can you use child AED pads on an adult? The question comes up fairly often. For instance, what if your adult pads are about to expire and you’re left with just your pediatric set? Or what if your only set of adult pads failed during a cardiac emergency (such as by not adhering to the patient’s chest)?
Although some newer AEDs allow you to modify the level of shock for children using just a button or pediatric key, some defibrillator models still require separate adult and pediatric pads. Considering that as many as 8 out of every 100,000 children experience sudden cardiac arrest (SCA), having pediatric capabilities is important for any AED. But pediatric patients have vastly different needs from adult patients.
Can You Use Child AED Pads on an Adult?
Pediatric AED pads should never be used on an adult patient. They are not designed to deliver an efficient level of shock for adult cardiac arrest patients. These pads are designed for infants and children under 8 years old and less than 55 pounds.
A typical automated external defibrillator will deliver 150 to 360 joules of electricity to adult patients. For a typical device that uses escalating energy, the first shock will be delivered at 150 to 200 joules, with subsequent shocks delivered with progressively higher electricity up to 360 joules. As more than half of patients require multiple shocks, this method of shock delivery has proven extremely effective.
Research from Physio-Control reaffirms that higher escalating energy is the best method of reviving sudden cardiac arrest patients, and it’s extremely common for adult patients to require up to 360 J.
Why is this important? Because pediatric pads typically deliver just 50 J, the ideal intensity for small, developing hearts. But while it might be good for small children, it’s three times less powerful than even the weakest recommended shock delivery for adults. It’s just not sufficient for older patients, and attempting to use child pads on an adult could actually make an already dangerous situation even more perilous for the patient.
In addition, adult pads are usually equipped with stronger adhesives to account for the presence of chest hair. If you try to place a child pad on a hairy chest, it’s unlikely that the pad will stick firmly.
Can You Use Adult AED Pads on a Child?
While you should never use child pads on an adult, you can use adult pads on a child or infant if no other options are available. You just have to make sure to place the pads in the appropriate spots for children: one on the center of the chest, and one on the center of the upper back—making sure that the two pads do not touch.
It may be advisable to use adult AED pads on a child if:
- No pediatric AED pads are available
- Your pediatric AED pads have expired
- You use an AED that relies on the same pads for both adults and children, like the Philips HeartStart FRx (in this case, just remember to switch to the child setting before operating the AED)
Once you’ve applied the pads, follow the AED voice prompts just as you would for an adult patient. Automated external defibrillators are designed to scan for shockable heart rhythms regardless of a patient’s age and will provide shock recommendations accordingly. As long as you properly modify the AED pad placement for small children, you will be giving the young patient their best chance for survival.
When emergency services arrive, be sure to notify the EMTs that you have treated the pediatric patient using adult pads. If any additional intervention is required, they can take over from there.
How Old Is Too Old for Child AED Pads?
Ideally, child pads should only be used on patients no older than 8 years old and no more than 55 pounds. However, if no adult pads are present or if you can’t tell the child’s age and weight just by looking, there may be some wiggle room for very young children.
The key is to look for signs of puberty. Most girls begin puberty around 11, and most boys begin puberty around 12. At this point, child pads are out of the question. However, for a prepubescent child of 9 or 10, you should be okay if no other options are available. If you notice signs like breast development, facial hair, or acne, don’t use child pads. The energy delivery likely won’t be sufficient.
How to Identify Child Electrode Pads
Not sure what kind of pads you’re dealing with? Child AED pads are easy to spot. In fact, they’re clearly labeled to prevent accidental use. All you have to do is examine the pads themselves. Child pads might contain:
- The words “Child AED Pads” or “Pediatric AED Pads”
- An illustration of a child or infant
- Child-specific pad placement instructions (a diagram of one pad on the front of the chest and one pad on the patient’s back)
- An illustration of a teddy bear or other child-friendly icon
- Bright, child-friendly colors like pink or baby blue
Child-specific AED pads should be kept in your AED case or cabinet for emergency use and should not be connected to the defibrillator by default.
Can You Use Pediatric AED Pads if No Adult Pads Are Available?
If you have an adult cardiac arrest patient but no adult pads, do not attempt to use child pads or expired adult pads. Have someone call 911 while you begin performing CPR.
It’s okay if you don’t have CPR experience. For adult patients, it’s generally acceptable for untrained lay responders to use compression-only CPR:
- Begin by rolling the victim carefully onto their back.
- Remove any clothing covering their chest.
- Kneel beside the patient and place the heel of one hand in the center of their chest, on the breastbone. Put the heel of the other hand on top of the first hand and interlace your fingers.
- Push straight down in a repetitive motion at a rate of 100 to 120 chest compressions per minute (or to the beat of Stayin’ Alive by the Bee Gees) and a depth of about 2-2.4 inches (about ⅓ of the patient’s chest depth).
- Let the chest rise fully between each compression.
- Continue until emergency services arrive.
By performing CPR until help arrives, you’ll be helping to pump blood to vital organs. When emergency services arrive, they can defibrillate the patient.
You never know when you’ll need to use an AED to restore someone’s heart rhythm, so it’s a good idea to always keep at least one extra set of adult pads on hand at all times. While you can sometimes use adult pads in a child emergency, you should never use child pads in an adult emergency. So don’t take your adult AED pads for granted.