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Attenuated pediatric electrode pads for automated external defibrillator use in children
Dianne L Atkins1, Dawn B Jorgenson
1The Children's Hospital of Iowa, Department of Pediatrics, The University of Iowa, Carver College of Medicine, Iowa City, IA 52240, USA. dianne-atkins@uiowa.edu
Insights
Pediatric pads for automated external defibrillators (AEDs) appropriately reduced energy for pediatric patients. All ventricular fibrillation (VF) patients receiving shocks had VF termination, with five survivors, supporting AED use in children.
Area of Science:
- Emergency medicine
- Pediatric cardiology
- Medical device evaluation
Background:
- Automated external defibrillators (AEDs) are crucial for cardiac arrest management.
- Pediatric pads are designed to attenuate energy delivery from adult AEDs for safe use in children.
- Post-market surveillance is essential for evaluating real-world device performance.
Purpose of the Study:
- To evaluate the reported use and performance of pediatric pads with automated external defibrillators (AEDs) in pediatric patients.
- To assess the appropriateness of energy delivery and patient outcomes when using pediatric pads.
Main Methods:
- Observational, post-market study collecting voluntary user reports on pediatric pad usage.
- Detailed information gathered on patient demographics, cardiac rhythm, shock delivery, and outcomes.
- Analysis of confirmed reports involving pediatric patients, including those with ventricular fibrillation (VF) and non-shockable rhythms.
Main Results:
- Confirmed reports for 27 pediatric patients (0 days to 23 years).
- Eight patients with ventricular fibrillation (VF) received shocks; all achieved VF termination, with five surviving to hospital discharge.
- Sixteen patients with non-shockable rhythms did not receive shocks, with 11 not surviving.
Conclusions:
- Voluntary reports indicate appropriate performance of pediatric defibrillation pads.
- Successful termination of VF and survival in pediatric patients treated with AEDs using pediatric pads.
- Data support the rapid deployment and encouraged use of AEDs with pediatric pads for young patients.
Objective:
This post-market, observational study is intended to evaluate reported uses of pediatric pads that reduce the energy delivered by some adult automated external defibrillators (AEDs) so that they may be used with pediatric patients.
Methods:
Users of the pediatric pads were asked to report any use of the pads, even if no shock was delivered and to provide detailed information about the event, caregiver and the patient.
Results:
Reports of the use of pediatric pads have been received and confirmed for 27 patients, age range 0 days to 23 years, median 2 years. Ventricular fibrillation (VF) was reported in eight cases, age range 4.5 months to 10 years, median 3 years. Shocks were delivered to all VF patients, the average shock number was 1.9, range 1-4. All patients had termination of VF, were admitted to the hospital and five survived to hospital discharge. Non-shockable rhythms were reported in 16 patients, and the AED appropriately did not advise a shock. Eleven of these patients had asystole or PEA as their initial rhythm and did not survive to hospital discharge. One report contained no additional information other than that the patient did not survive, and in two other reports, the pads were not applied to patients.
Conclusions:
Voluntary reports of the use of attenuated pediatric defibrillation pads indicate the devices performed appropriately. All eight VF patients had termination of VF and five survived to hospital discharge. These data support the rapid deployment of AEDs for young children as well as adolescents and adults. Since the pediatric pads are available and deliver an appropriate dose for children, their use should be strongly encouraged.
