Children and circulatory arrest

When a small child (<25 kg) has a circulatory arrest, this usually has a different starting cause than a fibrillating heart. Examples of this are:

The right treatment in this case is:
-dial 999 or 112
-start CPR

Because it is not always clear what caused the circulatory arrest the AED unit will always have to be brought.
If a victim weighs less than 25 kg the use of child pads is recommended but not required.

Reasons for using child pads are:
-the AED uses a special child-database for the heart analysis (that is because the regular heart rhythm of a small child is faster or even much faster than for an adult);
-the surge of the AED will revert from 150 Joule to 50 to 80 Joule.

The adjustment of the database, protocol and Joules varies per brand. This document is based on the Philips AED’s

Reasons not to use child pads are:
-having to change electrodes in the middle of a panic situation, which can lead to delays.
-A child key or switch button can be a solution;
-the AED can also be used with adults’ electrodes for use on children who weigh less than 25kg.
-The Dutch Resuscitation Council writes in the currently applicable guidelines: Standard AEDs may also be used for defibrillation of infants and children if there is no custom AED available for them.
-with children under 25kg circulatory arrest in which fibrillation is the cause is less than 5x a year.

It is better for a child to use child pads, but in emergencies the standard AED should be used.

Remark: for children under 25kg the pads will have to be patched in a different way. See the picture below (one electrode pad on the rear between the shoulder blades and one electrode pad on the breastbone between the nipples: The hands should in this case be placed on the electrode pads during resuscitation).