Sudden Cardiac Arrest (SCA) is often mistakenly viewed as a medical emergency that only affects older adults. However, cardiac arrests can—and do—happen to infants, children, and young adolescents. When a child’s heart unexpectedly stops beating, every single second counts.
As a leading provider of first aid training courses in London, Practical First Aid (www.practicalfirstaid.co.uk) is dedicated to empowering parents, teachers, school staff, and community members with the knowledge required to save young lives.
In this comprehensive guide, we will unpack everything you need to know about using an AED for children. We will explore how automated external defibrillators work on younger patients, the critical differences between adult and paediatric treatment, and answer vital questions frequently found in Google’s People Also Ask section.
What is an AED?
An Automated External Defibrillator (AED) is a portable, sophisticated electronic device designed to diagnose life-threatening cardiac arrhythmias—specifically ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT)—in a patient.
Once the device analyses the heart rhythm, it determines whether an electrical shock is necessary. If required, the AED delivers a controlled therapeutic dose of electrical energy (a shock) to the heart. This shock momentarily stuns the heart, stopping the chaotic rhythm and allowing the body’s natural pacemaker to re-establish a normal, functional heart rhythm.
Is There an AED for Children?
Yes, there is an AED for children, but it is not necessarily a completely different machine. Most standard, modern public access defibrillators (PADs) are designed to be used on both adults and children. The primary difference lies in how the device delivers the electrical shock. Because a child’s body is significantly smaller and their heart muscle is more delicate, they require a lower electrical dose (attenuated energy) than an adult.
To achieve this, AEDs utilise two primary methods:
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Paediatric Defibrillation Pads: These are smaller, specialised electrode pads designed specifically for infants and children. They contain a built-in resistor within the cable that automatically attenuates (reduces) the energy delivered by the machine. While a standard adult shock is typically between 150 to 360 Joules, paediatric pads reduce this to around 50 to 80 Joules.
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Paediatric Switch or Key: Many modern AEDs feature a physical switch, button, or insertable “key” that converts the machine into paediatric mode. When activated, the machine uses the same set of pads (or specific universal pads) but programmatically alters its internal settings to lower the energy output and adjust its verbal coaching instructions for a child rescue.
Can Defibrillators Be Used on Children?
Yes, defibrillators can absolutely be used on children. In fact, they are a vital link in the Paediatric Chain of Survival.
While the underlying causes of cardiac arrest in children differ from adults—adults usually suffer from primary cardiac issues like ischaemic heart disease, whereas children more frequently suffer from respiratory arrest leading to secondary cardiac arrest (hypoxia)—the treatment for a shockable rhythm remains identical: high-quality cardiopulmonary resuscitation (CPR) combined with rapid defibrillation.
If a child is unresponsive and not breathing normally, you should deploy an AED immediately. If the child’s heart is in a shockable rhythm, the AED is the only tool capable of restoring a normal heartbeat.
What Age Can a Child Use an AED?
In the context of first aid and resuscitation guidelines (such as those laid out by the Resuscitation Council UK), paediatric protocols are explicitly defined by age and physical development:
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Infants Under 1 Year Old: Ideally, an AED with paediatric capabilities (pads or switch) should be used. If a paediatric-capable AED is unavailable, an adult AED can be used as a last resort.
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Children aged 1 to 8 Years Old: This is the primary demographic for paediatric AED settings. You should use paediatric pads or activate the paediatric switch/key.
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Children Over 8 Years Old (or over 25kg / 55lbs): At this stage, the child’s body mass is sufficient to handle adult-level electrical energy. You must use standard adult pads and adult energy settings. Do not use paediatric pads on a child over 8 years old, as the energy delivered will be insufficient to defibrillate their heart.
| Patient Age / Weight | Pad Type / Mode to Use | Energy Level |
| Infant (< 1 Year) | Paediatric (Adult if unavailable) | Attenuated (50-80J) |
| Child (1 – 8 Years) | Paediatric Mode / Pads | Attenuated (50-80J) |
| Child (> 8 Years or > 25kg) | Adult Mode / Pads | Full Adult (150-360J) |
Can You Use an AED on a Child Less Than 8?
Yes, you can, and you should. If a child under the age of 8 goes into cardiac arrest, utilizing an AED significantly increases their chances of survival.
When treating a child less than 8 years old, follow these step-by-step priority guidelines regarding equipment:
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Best Option: Use an AED with dedicated paediatric pads or a paediatric switch. This ensures the correct, reduced energy dose is delivered.
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Alternative Option: If you only have an adult AED without paediatric options, use the adult AED.
The Resuscitation Council UK and international resuscitation bodies explicitly state that it is far better to use an adult AED on a young child than to withhold defibrillation completely. A higher dose of electricity may carry a small risk of myocardial damage, but a cardiac arrest without defibrillation is universally fatal. Survival is the absolute priority.
Paediatric Pad Placement: How to Apply Pads on a Child
Proper pad placement is critical to ensure that the electrical current travels directly through the heart muscle. Because a child’s chest has a smaller surface area than an adult’s, standard pad placement can create a hazard where the two pads touch each other. Pads must never touch. If they touch, the electrical current will arc across the skin rather than passing through the heart.
[Image showing correct anterior-posterior (front and back) pad placement on a child]
For Infants and Young Children (Under 8 Years Old / Using Paediatric Pads)
If the pads risk touching on the front of the chest, you must use the Anterior-Posterior (Front and Back) placement:
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Front Pad (Anterior): Place one pad firmly in the centre of the child’s chest, directly over the breastbone (sternum).
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Back Pad (Posterior): Place the second pad firmly on the child’s back, right between the shoulder blades.
For Older Children (Over 8 Years Old / Using Adult Pads)
You can use the standard Anterior-Lateral (Front and Side) placement typically used for adults:
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Upper Right Pad: Place one pad on the upper right side of the chest, just below the collarbone.
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Lower Left Pad: Place the second pad on the lower left side of the chest, along the mid-axillary line (under the armpit).
Step-by-Step Guide: How to Use an AED on a Child
If you find yourself in an emergency situation involving a child, remain calm and follow these precise steps:
1. Danger
Ensure the area is entirely safe for yourself, the casualty, and any bystanders. Move away from standing water or structural hazards if necessary.
2. Response
Check for responsiveness. Gently tap the child’s shoulders and shout loudly (e.g., “Are you alright?”). For infants, you can flick the soles of their feet.
3. Shout for Help & Open the Airway
If there is no response, shout loudly for nearby assistance. Open the child’s airway by placing one hand on their forehead and gently tilting the head back while lifting the chin with two fingers (Head-Tilt, Chin-Lift).
4. Check Breathing
Look, listen, and feel for normal breathing for no more than 10 seconds. Ignore occasional gasps (agonal gasps), as these are not normal breathing.
5. Call 999 and Fetch the AED
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If you are alone and do not have a mobile phone, perform 1 minute of CPR before leaving the child to call 999 and retrieve an AED.
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If you have a mobile phone or a bystander is present, call 999 immediately, activate the speakerphone, and send the bystander to locate the nearest public access defibrillators.
6. Begin CPR (5 Initial Rescue Breaths)
Because cardiac arrest in children is predominantly respiratory in nature, always start CPR with 5 initial rescue breaths.
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Pinch the nose, seal your lips over the child’s mouth, and blow steadily for about 1 second until the chest rises.
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Following the 5 rescue breaths, perform 30 chest compressions (compressing the chest by one-third of its depth using one or two hands depending on the child’s size), followed by 2 rescue breaths. Continue this 30:2 cycle.
7. Switch on the AED and Apply Pads
As soon as the AED arrives, switch it on. The machine will instantly begin providing spoken, step-by-step instructions.
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Remove all clothing from the child’s chest.
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If the child is under 8, plug in the paediatric pads or flip the paediatric switch.
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Apply the pads to the child’s bare chest using the Anterior-Posterior (Front and Back) method if they are small, ensuring the skin is dry.
8. Heart Rhythm Analysis
The AED will instruct you to stop CPR while it analyses the heart rhythm (“Stop CPR. Do not touch the patient. Analysing rhythm.”). Ensure absolutely no one is touching the child during this window.
9. Delivering the Shock (If Advised)
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If a shock is advised: Ensure everyone is well clear of the patient. Loudly shout, “Clear!” Press the flashing shock button when prompted.
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If no shock is advised: Immediately resume CPR, starting with chest compressions.
10. Resume CPR
Immediately after the shock is delivered, resume chest compressions and rescue breaths (30:2). Do not remove the AED pads; the device will continue to re-analyse the heart rhythm every two minutes.
Causes of Cardiac Arrest in Children vs. Adults
Understanding why cardiac arrest occurs helps clarify why certain first aid steps differ.
In adults, cardiac arrest is frequently a sudden, primary electrical issue caused by a myocardial infarction (heart attack). The heart suddenly goes into ventricular fibrillation, meaning immediate defibrillation is paramount.
In contrast, paediatric cardiac arrest is rarely primary. It is usually the end-stage result of progressive tissue hypoxia (lack of oxygen) caused by respiratory failure or circulatory shock. Common root causes include:
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Severe asthma attacks or respiratory tract infections (e.g., croup, bronchiolitis).
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Choking or airway obstruction by foreign objects.
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Near-drowning incidents.
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Anaphylaxis (severe allergic reactions).
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Poisoning or drug ingestion.
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Sudden Infant Death Syndrome (SIDS).
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Congenital heart defects or underlying undiagnosed conditions like Hypertrophic Cardiomyopathy (often triggered by intense physical exertion).
Because oxygen depletion is almost always the driving force behind a child’s cardiac arrest, rescue breaths are critical. While “hands-only” CPR is promoted for untrained bystanders dealing with adult casualties, it is highly ineffective for children. Paediatric CPR must include rescue breaths.
Creating a Heart-Safe Environment: AEDs in Schools and Nurseries
Given that children spend a massive portion of their lives within educational facilities, having an automated external defibrillator on-site at schools, nurseries, and sports clubs across London is an absolute necessity.
Why Schools Need AEDs
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Protecting Students: Genetic cardiac anomalies can remain completely hidden until triggered by intense physical activity during PE lessons or sports matches.
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Protecting Staff and Visitors: Schools host hundreds of adults daily, including teachers, support staff, parents, and grandparents attending school plays or sports days.
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Community Assets: Many schools host evening clubs, turning the building into a local community hub. An accessible AED can save lives within the surrounding residential area.
Where to Store a Paediatric-Capably Equipped AED
An AED must be stored in a central, highly visible, and easily accessible location. It should never be locked away in an administrative office or principal’s cupboard. Ideal storage spaces include:
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Main school reception areas.
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Outside the gymnasium or sports hall.
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In a weatherproof, heated external cabinet on the school boundary wall, making it available to the general public 24/7.
Legal and Regulatory Landscape in the UK
In recent years, there has been a powerful legislative push to ensure all educational institutions across the United Kingdom are equipped with life-saving defibrillators. Following tireless campaigning by charitable foundations, the UK Department for Education committed to providing state-funded schools in England with at least one AED, ensuring total coverage.
From a liability standpoint, many individuals are fearful that using an AED incorrectly could lead to legal action. In the United Kingdom, no individual has ever been successfully sued for using an AED to try to save a life. AEDs are designed explicitly for use by members of the lay public. The machine’s internal software automatically ensures that a shock can only be delivered if the casualty is in a verified shockable rhythm.
You cannot accidentally shock someone whose heart is functioning normally, or someone who is dead from a non-shockable rhythm. The law fiercely protects the “Good Samaritan” who acts in good faith during a life-or-death crisis.
First Aid Training: Empowering London’s Communities
While modern public access defibrillators are brilliantly intuitive and talk you through every step, there is no substitute for practical, hands-on training. In a high-stress medical emergency involving a child, panic can cause hesitation. Panic is defeated by familiarity.
At Practical First Aid (www.practicalfirstaid.co.uk), we deliver bespoke first aid training courses across London and the Home Counties, specially tailored for individuals looking to safeguard children.
Our Specialised Paediatric Courses Include:
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Paediatric First Aid (12-Hour Course): Fully compliant with Ofsted and EYFS (Early Years Foundation Stage) requirements for nursery workers, childminders, and pre-school teachers.
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Emergency Paediatric First Aid (6-Hour Course): Ideal for parents, grandparents, and school staff requiring a fundamental understanding of child-specific emergencies.
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Basic Life Support (BLS) and AED Training: A concise, highly practical session focused exclusively on high-quality adult/paediatric CPR and confident defibrillator deployment.
Our interactive courses give participants the invaluable opportunity to practice chest compressions on infant and child manikins, configure training AEDs, and physically place paediatric pads. This hands-on experience builds the muscle memory and psychological resilience needed to act decisively when a crisis occurs.
FAQs About AED for Children
What happens if I use adult pads on a child under 8?
If no paediatric pads or settings are available, you must use adult pads. Position them in the Anterior-Posterior configuration (one on the front of the chest, one on the back) to ensure they do not touch. The AED will deliver a full adult dose of electrical energy. While this is higher than ideal, it is medically endorsed because it is a life-saving intervention.
What happens if I use paediatric pads on an adult?
You must never use paediatric pads on an adult or a child over 8 years old. The electrical energy output attenuated by paediatric pads (50-80 Joules) is far too low to successfully depolarise an adult-sized heart muscle. Using paediatric pads on an adult will result in an ineffective shock, failing to correct the fatal arrhythmia.
Can I use an AED on a wet child or in the rain?
Water conducts electricity. If a child has been rescued from water (such as a swimming pool or pond), you must quickly dry their chest skin using a towel or clothing before applying the pads. Ensure the pads adhere firmly to dry skin. If it is raining, attempt to shelter the child and the AED using an umbrella or canopy, but do not delay life-saving treatment.
Can you use an AED on an infant under 1 year old?
Yes, you can use an AED on an infant under 1 year old. It is preferable to use an AED that features a paediatric capability to reduce the energy dose. If an adult AED is all that is available, you may use it, ensuring accurate front-and-back pad placement so the pads do not overlap.
How often do AED pads and batteries need replacing?
AED pads and batteries both have a strict shelf life, typically ranging from 2 to 5 years, depending on the manufacturer. The gel on the pads dries out over time, making them unable to adhere properly to the skin or conduct electricity safely. Regular, weekly visual inspections of your workplace or school AED are essential to confirm that the status indicator light is green.
Summary: Key Takeaways for Paediatric Defibrillation
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AEDs Save Lives: Defibrillators are completely safe and highly effective when used on children experiencing sudden cardiac arrest.
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Age Thresholds: Use paediatric settings or pads for children aged 1 to 8 years old. For children over 8 years old, use standard adult settings and pads.
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Pad Placement Matters: For young children, use the Anterior-Posterior (front and back) placement method to prevent the electrode pads from touching.
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Prioritise Rescue Breaths: Paediatric cardiac arrests are usually caused by hypoxia. Always begin CPR with 5 initial rescue breaths before moving to chest compressions.
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Action Over Hesitation: If you only have an adult AED available for a young child, use it. Doing something is always infinitely better than doing nothing.
Be Prepared: Secure Your Training Today
Accidents and medical crises happen without warning. Being equipped with a public access defibrillator is only half the battle; knowing how to use it with confidence and precision is what truly bridges the gap between life and death.
Are you an educator looking to secure Ofsted-compliant training for your school staff? A parent wanting to protect their household? Or a business owner looking to create a heart-safe working environment in the capital?
