Cardiac arrest in an infant is a life-threatening emergency that requires immediate action. An infant is a child from birth through 12 months of age. If an infant is unresponsive and not breathing normally, start CPR, activate emergency medical services, and use an automated external defibrillator (AED) as soon as one becomes available.
An AED checks the heart’s electrical rhythm and delivers a shock when it detects a rhythm that may respond to defibrillation. The device uses voice prompts, visual instructions, and pad diagrams to guide rescuers through the process.
You can use an AED on an infant in cardiac arrest. When available, use pediatric or infant-specific pads or the pediatric setting recommended for that AED. Because an infant has a small chest, place the pads carefully so they do not touch or overlap.
Always follow the instructions for the specific AED you are using. Pad placement and pediatric features can vary between devices. Do not delay CPR or emergency care while trying to achieve a “perfect” setup.
Can an AED Be Used on an Infant?
Yes. You can use an AED on an infant who is unresponsive and not breathing normally in cardiac arrest. The AED analyzes the infant’s heart rhythm and determines whether a shock is appropriate. Use the AED as soon as it becomes available while CPR and emergency medical care continue.
Adult vs. Pediatric/Infant AED Pads and Settings
AEDs use different approaches for infants and children. If you’re learning how AED use differs across pediatric emergencies, our guide to understanding AED use in pediatric emergencies provides additional context. Some devices use separate pediatric or infant pads, while others provide a pediatric mode or another energy-reducing system.
When available, use the pediatric or infant option recommended by the AED manufacturer. Check the pad illustrations and follow the device’s voice and visual prompts throughout the process.
Where Should AED Pads Go on an Infant?
Place AED pads on the infant’s bare, dry skin and make sure they do not touch or overlap. The infant’s size determines which pad configuration works best.
Anteroposterior (Front-and-Back) Pad Placement
Use an anteroposterior, or front-and-back, configuration when the infant’s chest is too small to place the pads on the front and side without touching.
- Place one pad on the front of the infant’s chest.
- Place the other pad on the infant’s back, between the shoulder blades.
- Keep enough space between the pads so they do not touch or overlap.
- Press both pads firmly against clean, dry skin.
- Follow the placement diagram supplied with the AED or its pads.
This configuration can help you maintain adequate separation when an infant’s small chest makes front-and-side placement difficult.
Anterolateral (Front-and-Side) Pad Placement
Anterolateral, or front-and-side, placement may work when the infant is large enough to keep the pads separated and the AED’s instructions allow this configuration.
- Place one pad on the front of the chest.
- Place the second pad on the side of the torso.
- Make sure the pads remain separated and do not overlap.
- Follow the AED’s specific placement diagram if it provides one.
The key goal is to position both pads correctly, maintain firm skin contact, and keep the pads from touching. When the infant’s chest is too small to achieve this with front-and-side placement, use the front-and-back configuration when the AED manufacturer recommends it.
Step-by-Step: Applying AED Pads to an Infant
If an infant is unresponsive and not breathing normally, act quickly. Follow your CPR training, emergency dispatcher instructions, and the AED’s prompts.
Check the Infant
Check whether the infant responds and whether they are breathing normally. If the infant remains unresponsive and is not breathing normally, treat the situation as an emergency.
Activate Emergency Medical Services
Call your local emergency medical service or have someone else make the call. If another person is available, ask them to bring an AED while you begin the resuscitation response.
Start CPR
Begin CPR according to your training and any instructions from the emergency dispatcher. Continue CPR until the AED is ready to analyze the infant’s heart rhythm.
Expose and Dry the Chest
Remove clothing from the infant’s chest so you can apply the pads directly to bare skin. If the chest is wet, quickly dry it before applying the pads.
Turn On the AED
Turn on the AED as soon as it becomes available. Listen to its voice prompts and check its visual instructions or pad diagrams.
Select the Pediatric or Infant Option
If the AED provides pediatric or infant pads or a pediatric setting, use the option recommended by the manufacturer. Never cut, trim, fold, or otherwise modify the pads.
Apply the Pads
Place the pads according to the AED’s instructions. Choose a front-and-back configuration when the infant’s chest is too small for front-and-side placement without the pads touching, provided the device instructions support that configuration.
Make sure each pad sticks firmly to the skin and that the pads do not touch or overlap.
Stand Clear During Analysis and Shock
When the AED analyzes the rhythm or prepares to deliver a shock, make sure nobody touches the infant. Follow the device’s instructions and clearly tell everyone to stand clear.
Resume CPR
After the AED delivers a shock or advises that no shock is needed, follow its prompts. Resume CPR when instructed and continue until emergency medical professionals take over or the infant shows clear signs of recovery.
Important Safety Considerations
Keep these points in mind when applying AED pads to an infant.
Keep the Pads Separated
An infant’s small chest can make pad placement challenging. Never allow the pads to touch or overlap. If front-and-side placement does not leave enough space, use the front-and-back configuration when the AED manufacturer recommends it.
Avoid Placing a Pad Directly Over an Implanted Device
If you can clearly identify an implanted medical device, such as a pacemaker or implanted defibrillator, avoid placing an AED pad directly over it. Position the pad according to the AED manufacturer’s instructions while maintaining adequate separation.
Apply Pads to Dry Skin
Moisture can interfere with pad adhesion. If the infant’s chest is wet, quickly dry the skin before applying the pads. Do not spend unnecessary time drying the infant if doing so would significantly delay resuscitation.
Never Modify AED Pads
Do not cut, trim, fold, or alter AED pads to make them fit an infant. Use the pediatric equipment or setting recommended for the device.
Follow the AED’s Instructions
AEDs can differ in pad design, pediatric settings, and placement recommendations. Follow the voice prompts, visual instructions, and diagrams provided with the specific device.
Leave Properly Applied Pads in Place
Once you apply the pads correctly, leave them in place unless the AED or medical professionals tell you to remove or reposition them. Avoid unnecessary interruptions to CPR and AED use.
What If Pediatric AED Pads Aren’t Available?
If pediatric or infant pads are not immediately available, do not delay resuscitation while searching for them. Start or continue CPR and use an AED as soon as one becomes available.
Follow the Available AED’s Instructions
Some AEDs support pediatric patients through adult pads, a pediatric mode, or an energy-reducing system. If pediatric pads are unavailable, follow the manufacturer’s instructions for the AED you have.
Do not assume that every AED handles infants in the same way. Check the device instructions to determine whether and how you should use the available pads.
Never cut, trim, fold, or modify adult pads to make them fit. If the manufacturer permits adult pads for an infant, position them according to the device’s instructions and make sure they do not touch or overlap.
Keep Emergency Care Moving
Have someone activate emergency medical services and retrieve an AED while you begin CPR, if possible.
The priority is to provide prompt CPR and defibrillation when indicated. Do not wait for pediatric pads if doing so would significantly delay lifesaving treatment.
In an actual emergency, follow the AED’s voice and visual prompts and the instructions provided by emergency medical professionals.
Common Mistakes to Avoid When Placing AED Pads on an Infant
A few simple mistakes can interfere with effective AED use. Keep these common errors in mind:
- Letting the Pads Touch or Overlap: An infant’s small chest may not provide enough room for standard front-and-side placement. If the pads would touch, use the alternative configuration recommended by the AED manufacturer.
- Applying Pads to Wet Skin: Quickly dry the infant’s chest before applying the pads. Avoid unnecessary delays.
- Applying Pads Over Clothing: AED pads need direct contact with bare skin. Remove or cut away clothing from the chest so you can apply the pads correctly.
- Modifying the Pads: Never cut, trim, fold, or otherwise alter AED pads. Use the pad type and configuration recommended by the manufacturer.
- Delaying CPR or AED Use: Do not spend excessive time trying to achieve an exact or “perfect” pad position. Use the recommended configuration that keeps the pads properly separated and follow the AED’s instructions promptly.
- Ignoring the AED’s Prompts: Let the AED guide you through rhythm analysis, shock delivery, and CPR. When the device tells everyone to stand clear, make sure nobody touches the infant.
Importance of Safe AED Pad Placement on an Infant
In short, for an infant in cardiac arrest, start CPR, activate emergency medical services, and use an AED as soon as it becomes available. Use pediatric or infant pads or the pediatric setting when the AED manufacturer recommends them.
Place the pads on bare, dry skin and make sure they do not touch or overlap. If the infant’s chest is too small for front-and-side placement, use front-and-back placement when the AED’s instructions recommend it.
Most importantly, follow the instructions for the specific AED you are using and do not delay lifesaving care while trying to achieve perfect pad placement.
This information provides general education and does not replace hands-on infant CPR/AED training. In an actual emergency, follow the AED’s prompts and instructions from emergency medical services.
To build the practical skills and confidence needed to respond effectively, consider hands-on training through Same Day CPR. Explore flexible blended-learning courses in BLS, ACLS, and PALS. Complete the online coursework at your convenience, then attend an in-person session for hands-on practice and skills training. Strengthen your CPR and AED skills, gain practical experience, and stay prepared to act confidently in an emergency.
