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Inappropriate Shocks and Power Delivery Using Adult Automatic External Defibrillator Pads in a Pediatric Patient

Shai Tejman-Yarden, Uriel Katz1, Marina Rubinstein1

  • 1From the Edmond J. Safra International Center for Congenital Heart Diseases.

Pediatric Emergency Care
|February 23, 2017
PubMed

Insights

Automatic external defibrillators (AEDs) are safe for all ages. However, a case study found two inappropriate AED shocks delivered to a neonate using adult pads, with no adverse effects observed.

Area of Science:

  • Emergency Medicine
  • Pediatric Cardiology

Background:

  • Automatic external defibrillators (AEDs) are recommended for out-of-hospital pulseless resuscitations across all age groups.
  • Guidelines suggest pediatric pads for infants and children, with adult pads as an alternative if pediatric pads are unavailable.

Observation:

  • A case report details two instances of inappropriate AED shocks delivered to a neonate during resuscitation.
  • Adult pads were used on the 3.6-kg neonate, and the device delivered shocks exceeding 200 J for undetected sinus bradycardia.

Findings:

  • Despite receiving two high-voltage shocks inappropriately, the neonate experienced no cardiac or skin complications.
  • The patient demonstrated normal cardiac and neurological development post-event.

Implications:

  • This case highlights a potential risk of AEDs in neonates when using adult pads, even if guidelines permit it.
  • Further research may be needed to refine AED protocols for neonates to prevent inappropriate shocks.
  • The case underscores the importance of careful device selection and monitoring during resuscitation in extremely young patients.

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