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

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.