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Use of Automated External Defibrillators for Children: An Update—An Advisory Statement From the Pediatric Advanced Life Support Task Force, International Liaison Committee on Resuscitation

Ricardo A. Samson, MD^*, Robert A. Berg, MD^* for the American Heart Association, Robert Bingham, MBBS, FRCA for the European Resuscitation Council

^* American Heart Association
European Resuscitation Council

Abbreviations: PALS, Pediatric Advanced Life Support • ILCOR, International Liaison Committee on Resuscitation • AED, automated external defibrillator • VF, ventricular fibrillation • CPR, cardiopulmonary resuscitation • FDA, Food and Drug Administration • J, Joule • SIDS, sudden infant death syndrome • VT, ventricular tachycardia • LOE, level of evidence • ECG, electrocardiogram • AHA, American Heart Association

The first 300 words of the full text of this article appear below.

	INTERNATIONAL LIAISON COMMITTEE ON RESUSCITATION (ILCOR) RECOMMENDATIONS

 
On the basis of the published evidence to date, the Pediatric Advanced Life Support (PALS) Task Force of ILCOR has made the following recommendation (October 2002):

• Automated external defibrillators (AEDs) may be used for children 1 to 8 years of age who have no signs of circulation. Ideally the device should deliver a pediatric dose. The arrhythmia detection algorithm used in the device should demonstrate high specificity for pediatric shockable rhythms, ie, it will not recommend delivery of a shock for nonshockable rhythms (class IIb).
  In addition:
  
• Currently there is insufficient evidence to support a recommendation for or against the use of AEDs in children <1 year of age.
  
• For a lone rescuer responding to a child without signs of circulation, the task force continues to recommend provision of 1 minute of cardiopulmonary resuscitation (CPR) before any other action, such as activating the emergency medical services system or attaching the AED.
  
• Defibrillation is recommended for documented ventricular fibrillation (VF)/pulseless ventricular tachycardia (VT; class I).
  

	INTRODUCTION

 
This statement expands and clarifies the 2000 ILCOR recommendations about the potential use of AEDs in children. The need for this update has become critical. A growing number of AEDs for adults are being placed in public access settings, and the use of AEDs by nontraditional responders is increasing. The likelihood for use of AEDs in smaller (<25 kg), younger (<8 years of age) patients is now a reality. This statement provides the rationale for development of AEDs, outlines questions about the efficacy and safety of AEDs used in smaller, younger children, and summarizes recent efforts to justify the use of existing or modified AEDs in smaller, younger children.

Rationale for AED Use
The primary determinant of survival from VF cardiac arrest is the time interval from collapse until defibrillation. Out-of-hospital defibrillation within the first 3 minutes of witnessed adult . . . [Full Text of this Article]

Address correspondence to Ricardo A. Samson, MD, Department of Pediatrics, 1501 N Campbell, Tucson, AZ 85724-5073. E-mail: rsamson@peds.arizona.edu

This article has been cited by other articles:

				D. Johnson Panel says new AEDs can be used on young children AAP News, January 1, 2004; 24(1): 22 - 22. [Full Text] [PDF]

				Update on the Use of Automated External Defibrillators in Children Journal Watch Pediatrics and Adolescent Medicine, November 10, 2003; 2003(1110): 8 - 8. [Full Text]

				R. I. Paul and D. A. Danford Automated External Defibrillator Use In Children AAP Grand Rounds, October 1, 2003; 10(4): 44 - 45. [Full Text] [PDF]

				AED Recommendations Revised to Include Children Journal Watch Emergency Medicine, July 30, 2003; 2003(730): 8 - 8. [Full Text]

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