Defibrillator on a Child: What You Need to Know

Cardiac arrest in children is rare, but when it happens, immediate action is critical. Using a defibrillator on a child can be the difference between life and death.

Defibrillators analyse the heart’s rhythm and, when necessary, deliver a controlled electrical shock to help restore a normal heartbeat.

In medical guidance, a child is typically defined as someone aged 1–8 years or weighing under 25 kg. Children above this threshold are generally treated using adult defibrillator settings. Infants under one year require special consideration.

Although defibrillators are often associated with adult emergencies, their use in children follows clear, evidence-based guidance and is suitable for members of the public. Understanding how and when to use a defibrillator on a child improves survival and supports confident bystander action.

Why Using a Defibrillator on a Child Matters

While cardiac arrest is less common in children than adults, early defibrillation significantly improves survival when a shockable rhythm such as ventricular fibrillation is present.

In paediatric cases, cardiac arrest is often triggered by respiratory failure or trauma rather than an underlying heart condition. However, when defibrillation is indicated, rapid use is lifesaving.

The Resuscitation Council UK confirms that defibrillators are safe for use on children and should never be withheld due to age or size. Survival chances fall by approximately 7–10% per minute without defibrillation.

Modern defibrillators include safeguards and voice prompts that guide even untrained users, making them appropriate for schools, leisure centres and public places.

Age, Weight & Pad Considerations

Choosing the correct pads and placement depends on the child’s age and size. UK guidance is clear:

Children Over 8 Years or Over 25 kg

Use standard adult pads and settings. Place one pad on the upper right chest and the other on the lower left side, as with adults.

Children Aged 1–8 Years or Under 25 kg

Use paediatric pads if available. These reduce the shock energy to a safer level using an in-line attenuator.

If pads risk overlapping, place them in an anterior–posterior position (one on the chest, one on the back).

Infants Under 1 Year

Defibrillation is not routine but may be used if no alternative is available and a shockable rhythm is suspected. In community settings, AED use with paediatric pads is acceptable when no manual defibrillator is present.

Pad Placement Summary

• Anterior–lateral: Use when pads fit without touching
• Anterior–posterior: Use if pads overlap or the chest is small

Diagrams on pad packaging and AED voice prompts will guide correct placement.

Energy Dosing & Attenuation

Children require lower defibrillation energy than adults. This is delivered automatically when paediatric attenuator pads are connected.

Recommended Energy Levels

• Children aged 1–8 years: Typically attenuated to 50–75 joules
• Manual defibrillation (clinical settings): 4 J/kg body weight
• Children over 8 years or 25 kg: Full adult dose

If Paediatric Pads Are Not Available

• Use adult pads without delay
• Switch to anterior–posterior placement if pads touch

UK guidance confirms that the risk of delaying defibrillation is far greater than the risk of using adult pads on a child.

Built-In Safety Features

Most AEDs automatically detect paediatric pads and adjust shock energy and voice prompts accordingly.

Practical Use: Step-by-Step (CPR + Defibrillator)

If a child is unresponsive and not breathing normally, begin CPR immediately and use a defibrillator as soon as it becomes available.

1. Check responsiveness and breathing
   • Tap and shout
   • If unresponsive, call 999 or send someone to call
2. Start CPR
   • Give 5 rescue breaths if trained
   • Follow with 30 chest compressions
   • Compress to one third of chest depth
3. Attach the defibrillator
   • Turn it on and follow prompts
   • Apply paediatric pads if available
4. Allow rhythm analysis
   • Ensure no one is touching the child
5. Deliver shock if advised
   • Press the shock button if prompted
   • Resume CPR immediately afterwards
6. Continue CPR
   • 30 compressions to 2 breaths
   • Follow AED prompts every 2 minutes

Special Situations & Common Misconceptions

Infants Under 1 Year

AED use is acceptable in emergencies when no manual defibrillator is available. Do not delay treatment due to age.

Wet or Metallic Surfaces

Defibrillation is safe if the chest is dry and pads are not in contact with water or metal.

Common Myths

• “I could hurt the child” — AEDs only shock when necessary
• “Training is required” — AEDs guide you step by step
• “Adult pads must never be used” — Delays are more dangerous

Did You Know?

Fewer than 10% of out-of-hospital paediatric cardiac arrests receive defibrillation before emergency services arrive — yet survival more than doubles when defibrillation occurs within 3 minutes.

Final Thoughts

Defibrillators can and should be used on children experiencing cardiac arrest. While paediatric pads are preferred, their absence should never delay action.

Clear signage, visible placement and integrated paediatric accessories remove hesitation and save time. Most importantly, attempting to help is always better than doing nothing.