- Email: [email protected]
Automatic external defibrillators for cardiac arrest in children
Resuscitation 53 (2002) 319 www.elsevier.com/locate/resuscitation
Letter to the Editor Automatic external defibrillators for cardiac arrest in children Kenward et al. [1] suggest that automated external defibrillators (AEDs) have limitations in the management of cardiac arrest in children because the preset energy levels are designed for adults and limit their application to children /8 years. However, there is an AED available (Philips ForeRunner 2) that has been approved by the US FDA which allows first responder to defibrillate children. Specially designed paediatric defibrillation electrodes reduce the delivered adult defibrillation energy (150 J, biphasic waveform) to approximately 50 J. At present, there are no data available about performance of the Philips ForeRunner 2 in children. But in a porcine model this device showed 100% defibrillation success with no post-resuscitation injury in animals with body masses of 3.5 /25 kg after 7 min of untreated ventricular fibrillation [2]. The use of a single level of energy therefore seems to be appropriate for children B/ 8 years. It has also been shown recently that arrhythmia detection with this type of AED is accurate for children.
The sensitivity to paediatric VF rhythms was 95.9% and the specificity for all non-shockable rhythms 100% [3]. Therefore, manual defibrillators need not remain the only option for paediatric areas in-hospital because the modified AED may be a safe alternative that can be used by all trained first responders.
References [1] Kenward G, Castle N, Hodgetts TJ. Should ward nurses be using automatic external defibrillators as first responders to improve the outcome from cardiac arrest? A systematic review of the primary research. Resuscitation 2002;52:31 /7. [2] Tang W, et al. Pediatric fixed energy biphasic waveform defibrillation using a standard AED and special pediatric electrodes. Circulation 2000;102:II-437. [3] Cecchin F, et al. Is arrhythmia detection by automatic external defibrillator accurate for children?: sensitivity and specificity of an automatic external defibrillator algorithm in 696 pediatric arrhythmias. Circulation 2001;103:2483 /8.
Christian W. Helbok Department of Anaesthesia and Intensive Care Medicine, General Hospital Linz, Krankenhausstraße 9, A-4020 Linz, Austria E-mail: [email protected]
0300-9572/02/$ - see front matter # 2002 Elsevier Science Ireland Ltd. All rights reserved. PII: S 0 3 0 0 - 9 5 7 2 ( 0 2 ) 0 0 0 2 9 - 1
Letter to the Editor Automatic external defibrillators for cardiac arrest in children Kenward et al. [1] suggest that automated external defibrillators (AEDs) have limitations in the management of cardiac arrest in children because the preset energy levels are designed for adults and limit their application to children /8 years. However, there is an AED available (Philips ForeRunner 2) that has been approved by the US FDA which allows first responder to defibrillate children. Specially designed paediatric defibrillation electrodes reduce the delivered adult defibrillation energy (150 J, biphasic waveform) to approximately 50 J. At present, there are no data available about performance of the Philips ForeRunner 2 in children. But in a porcine model this device showed 100% defibrillation success with no post-resuscitation injury in animals with body masses of 3.5 /25 kg after 7 min of untreated ventricular fibrillation [2]. The use of a single level of energy therefore seems to be appropriate for children B/ 8 years. It has also been shown recently that arrhythmia detection with this type of AED is accurate for children.
The sensitivity to paediatric VF rhythms was 95.9% and the specificity for all non-shockable rhythms 100% [3]. Therefore, manual defibrillators need not remain the only option for paediatric areas in-hospital because the modified AED may be a safe alternative that can be used by all trained first responders.
References [1] Kenward G, Castle N, Hodgetts TJ. Should ward nurses be using automatic external defibrillators as first responders to improve the outcome from cardiac arrest? A systematic review of the primary research. Resuscitation 2002;52:31 /7. [2] Tang W, et al. Pediatric fixed energy biphasic waveform defibrillation using a standard AED and special pediatric electrodes. Circulation 2000;102:II-437. [3] Cecchin F, et al. Is arrhythmia detection by automatic external defibrillator accurate for children?: sensitivity and specificity of an automatic external defibrillator algorithm in 696 pediatric arrhythmias. Circulation 2001;103:2483 /8.
Christian W. Helbok Department of Anaesthesia and Intensive Care Medicine, General Hospital Linz, Krankenhausstraße 9, A-4020 Linz, Austria E-mail: [email protected]
0300-9572/02/$ - see front matter # 2002 Elsevier Science Ireland Ltd. All rights reserved. PII: S 0 3 0 0 - 9 5 7 2 ( 0 2 ) 0 0 0 2 9 - 1