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- Published:11 February 2025
Defibrillators for Kids: Why Child-Specific Defibrillation Matters
Most people associate defibrillators with adults experiencing sudden cardiac arrest. The thought of using an Automated External Defibrillator (AED) on a child is unsettling for many, largely due to concerns about whether the shock is safe, effective, or even necessary. But here’s the truth: Children can and do experience cardiac arrest, and defibrillators can save their lives when used correctly.
However, paediatric defibrillation isn’t just a scaled-down version of adult treatment. There are key physiological differences, specialised techniques, and equipment adjustments that must be considered to ensure the best possible outcome.
Let’s break down what most people don’t realise about AEDs for children, the nuances of paediatric defibrillation, and the crucial role these devices play in saving young lives.
1. Children’s Hearts Are Not Miniature Adult Hearts
The first mistake people make is assuming that a child’s heart functions like a small adult’s heart. It doesn’t. A child’s cardiovascular system is structurally and electrically different, meaning that their response to defibrillation varies significantly from adults.
Key differences include:
- Heart size and mass: Smaller heart muscle means different conduction pathways and a lower electrical threshold.
- Higher resting heart rate: Children’s normal heart rate is much faster than adults, affecting how arrhythmias present.
- Cardiac Arrest Causes: While adults often suffer from ventricular fibrillation due to coronary artery disease, paediatric cardiac arrests are more commonly caused by asphyxia (lack of oxygen), congenital conditions, or trauma. This changes how and when defibrillation is needed.
What this means: Defibrillation must be tailored to a child’s physiology, and not all AEDs are safe for paediatric use.
Learn how to use a defibrillator on Children
2. When Should You Use a Defibrillator on a Child?
The decision to use an AED on a child must be based on rhythm assessment, not fear.
AEDs are meant to correct specific shockable rhythms:
- Ventricular Fibrillation (VF) – The heart is quivering instead of pumping.
- Pulseless Ventricular Tachycardia (VT) – The heart is beating too fast to pump blood effectively.
Signs a child may need an AED:
- Sudden collapse with no pulse.
- Unresponsiveness despite CPR efforts.
- No normal breathing.
AEDs designed for paediatric use will not deliver a shock unless a shockable rhythm is detected, meaning they are inherently safe when applied correctly.
- 11 February 2025
3. The Role of Paediatric Pads and Shock Energy Adjustments
A major difference between adult and paediatric defibrillation is the energy level used for the shock.
Paediatric Pads vs. Adult Pads
- Adult AED pads should NOT be used on infants under 1 year old.
- For children aged 1-8 years, paediatric electrode pads should be used whenever available.
- If no paediatric pads are available, adult pads may be used with modifications (placement adjustments to prevent excessive energy delivery).
Energy Levels Matter
A child’s heart requires lower defibrillation energy. Standard adult AED shocks range from 120-360 joules, while paediatric defibrillation typically uses 50-75 joules.
Modern AEDs come with paediatric settings or attenuation devices to automatically reduce the shock for younger patients.
Find paediatric-specific AEDs here.
What this means: If an AED has a paediatric mode or child-specific pads, they must be used to ensure the correct shock dose.
4. Paediatric Defibrillation Pad Placement: An Often Overlooked Detail
Unlike adults, where pads are typically placed on the upper right chest and lower left abdomen, paediatric placement differs depending on the child’s size:
- Children over 8 years old: Standard adult pad placement (upper right chest and lower left side of ribcage).
- Children under 8 years old: The preferred method is front-and-back placement (one pad on the centre of the chest and the other on the back between the shoulder blades). This reduces the risk of arcing and ensures better energy delivery.
Why this matters: Improper pad placement can significantly reduce the effectiveness of defibrillation.
5. AED Availability in Schools and Public Places: A Critical Gap
Despite growing awareness of cardiac arrest in young athletes and children, many schools and child-focused public areas still lack AEDs. This is a problem because:
- 1 in 25 schools will experience a cardiac emergency each year.
- Youth sports-related cardiac arrests are rising, especially in children with undiagnosed heart conditions.
- Drownings, choking incidents, and severe allergic reactions can lead to cardiac arrest in children, where AEDs can make a difference.
Explore AED solutions for schools.
What this means: Schools, playgrounds, swimming pools, and any location where children gather should have AEDs easily accessible.
6. Overcoming the Fear of Using AEDs on Children
One of the biggest obstacles in paediatric defibrillation is fear and hesitation. Many bystanders, even trained professionals, are afraid of hurting the child or making things worse. This hesitation wastes valuable seconds.
Here’s what everyone needs to remember:
- AEDs are designed to be foolproof. If a shock is not needed, the AED will NOT deliver one.
- Doing nothing is far worse than doing something. If a child is in cardiac arrest, every minute without defibrillation lowers survival chances by 10%.
- Training makes a difference. Bystander CPR with AED use boosts survival rates above 70%.
Get certified in paediatric AED use.
The Future of Paediatric Defibrillation
More needs to be done to ensure children at risk of cardiac emergencies have immediate access to defibrillators.
- All schools and sports facilities should be required to have AEDs.
- Paediatric defibrillator training must be included in CPR certification courses.
- Parents of high-risk children should consider owning a home AED.
- More public education is needed to eliminate fear and hesitation.
The ability to recognise paediatric cardiac arrest, use an AED appropriately, and act quickly can mean the difference between life and death. Defibrillators are not just for adults; they are critical tools in saving children’s lives.
