Now let's cover the use of the automated external defibrillator or AED on a child for the healthcare
professional. A couple things to talk about are the different size pads you might find
inside of an AED. There are adult sized pads, and there are infant or pediatric sized pads.
Pediatric sized pads are designed to be used in patients who weigh less than 55 pounds,
or approximately 25 to 27 kilos. If they are bigger than that, you would use the adult
pads. No one point to make. If the AED doesn't have infant pads and the patient is less than
55 pounds, you're still going to use the adult sized pads. It's better for the outcome of
the patient to use the larger pads than it is to not use the AED simply because we don't
have the right sized pads for the right sized patient. So keep that tucked away in the back
of your head as we go through this scenario. Now we're going to check for scene safety.
Gloves are on, rescue mask is available with a one way valve. But in addition, because
we're using an AED, we're going to make sure that there's no combustible gasses or liquids,
and no standing water that connects the patient's body to the rescuer's body. If either of those
two dangerous environments existed, we would pull or drag the patient to safety, pull them
out of that scenario so that we don't have to worry about explosive things, we don't
have to worry about electrocutions from water, we can now use the AED safely. Now people
ask me this quite a bit. What if their clothes are wet? What if they're still wearing their
bathing suit? That's okay. We don't have to take wet clothes off to be able to use an
AED, it's only standing water that we're really concerned about. Once we've bared the chest,
if their chest is wet, we can dry off their chest enough that the pads will adhere to
the skin of the chest, but other than that, they're fine. So let's begin with the other
skills. Our scene is safe, our gloves are on, my rescue mask is available, and now I'm
going to call out to my patient, are you alright? Are you okay? They don't respond. Now I'm
going to put a hand on the forehead and tap on the collar bone. Are you alright, are you
okay? They don't respond. Activate EMS, call 911 or call a code. If you tell a bystander
to go call 911 and come back, have them bring an AED if you don't already have one. In this
case, I brought the AED with me, and therefore I don't really have to have them bring one
to me. Now I'm going to go ahead and assess the child by head tilt chin lift, looking
for normal breathing, and checking for a carotid pulse. Remember that the carotid pulse is
located between the trachea and the sternocleidomastoid muscle in that valley that lies between those
two features. The patient does not have a pulse and the patient is not breathing normally.
I'm going to turn the AED on. I open up the shirt, I pull out the appropriate sized pads,
and I attach them to their chest as shown. One goes above the right chest, the other
goes mid axilary line on their left side, just below the breast. Make sure the pads
adhere well. Now, plug it in. Do not touch the patient. Clear. I'm going to push the
button. Now I go into my 30 chest compressions. A third of the depth of the chest at a rate
between 100 and 120 compressions per minute. After I do my 30 compressions, 25, 26, 27,
28, 29, 30, I use my mask, head tilt chin lift and deliver two rescue breaths. i know
they went in because I saw the chest rise and fall. 5, 6, 7, 8, 9, 10... 24, 25, 26,
27, 28, 29, 30. No matter where you're at, you stop what you're doing and let it analyze.
Everybody clear. I'm going to push the flashing button. Right back into my chest compressions.
And I'm going to do this 30 chest compressions for 2 rescue breaths and I'm not going to
stop until EMS arrives, until someone equally trained or higher takes over, or until this
child responds and revives.