New Electrodes Allow Use of AEDs to Treat Small Children and Infants

Originally Published MDDI April 2003

NEWSTRENDS

by Gregg Nighswonger

Increased access to automated external defibrillators (AEDs) is believed to be increasing survival rates following cardiac arrest. But sudden cardiac arrest can strike anyone—including children. 

Treatment of small children and infants poses a number of special difficulties. It is vital, for example, to deliver appropriate energy levels to younger, smaller patients. Human factors issues are also critically important. Yet new generations of AEDs are being designed with pediatric and infant patients in mind and may soon see broad use. 

The first AEDs cleared by FDA for use on children, were limited to those older than eight years and weighing more than 55 pounds. In 2001, the Heartstart AED was the first device cleared to treat smaller, younger patients. The Heartstart, manufactured by Philips Medical Systems (Andover, MA), uses special pads that attenuate delivered energy. 

In addition, Medtronic Physio-Control (Redmond, WA) received FDA clearance last February to market its infant/child electrodes for use with AEDs for children younger than eight years old. Says Jon Tremmel, president of Medtronic Physio-Control, “The infant/child electrodes extend our AED solutions to all patients, including those eight and younger. 

While we hope that few young patients will be candidates for this therapy, we want to provide the safest and most effective use of an AED for them.”

Intended for use on the firm's biphasic Lifepak 500 and CR Plus AEDs, the infant/child electrodes reduce the energy to levels appropriate to use on infants and small children. The devices reduce the adult energy level by a factor of 4. They also allow pediatric patients to be treated using an escalating energy protocol in the AED. This means that the device first uses a small shock, followed by stronger ones if the lower energy levels are ineffective.

In January, Cardiac Science Inc. (Irvine, CA) received clearance to market its pediatric electrode pad system that enables the firm's Powerheart AED to be used on children younger than eight. The electrodes are smaller than standard pads and also have a built-in energy-attenuating mechanism. 

Among the factors supporting development of pediatric AED systems is the increasing effort to expand access to AEDs within public schools. According to Cardiac Science president and CEO Raymond W. Cohen, “The school market is expanding rapidly in both the U.S. and the U.K., and we anticipate additional legislation, similar to New York State [requiring on-premises AEDs], which will continue to drive adoption of AEDs in schools.” 

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