Can I Use Adult AED Pads on a Child or Infant?

Hello Rescue Fans!AEDPadplace

I received a question via email about using an adult AED on a pediatric patient if there were no pediatric AED pads available.  The quick answer?  Yes, you can.  Remember, many newer AED’s are now attenuated and will usually give as much electricity as needed to accomplish de-fibrillation.  If at all possible, use an AED with pediatric pads and place them correctly on the chest and back of the pediatric patient.  If no pediatric pads are available, place the adult size AED pads on the front center of chest and in the middle of the child’s back approximately between the shoulder blades to ensure most effective de-fibrillation even with adult AED.  In the end, when a person is suffering sudden cardiac arrest, the majority of the time, they are in a some form of de-fibrillatable rythm and an AED is of great benefit,  even if the size of the pads don’t match.  Ages for the child ranges between 1-8 or first signs of puberty, after that, treat as an adult and if under 1 year of age, treat as an infant.  There’s some question as to the effectiveness of de-fibrillation in infants under 1 year.  See the above links for more details regarding this subject.

I hope this helps.

Keep On Rescuing!

Should CPR and AED’s Be Required In Schools?

Students Train Free!

Every couple of minutes, someone suffers sudden cardiac arrest.  95% of these victims are dead before they make it to the Emergency Room doors.  In North Carolina, the Governor is trying to change that statistic.  She’s signed a bill that requires all highschoolers to be CPR trained prior to receiving their diploma.    Is it a good or bad idea and why do you feel the way you do?
Keep in mind that has already implemented a program that offers CPR training and certification to all high school students for FREE! and the program reported that over 3000 high schoolers this year alone have already been trained and certified. If you know of any school desiring to implement a similar program, please contact and ask for the Student CPR department.

Question: Why Dont We Check ABC’s Anymore?

In this blog,

I answer a question that came in about why we don’t teach lay rescuers to check for pulses after AED shock. This student thought that we were trying to trick them but in reality, the new standards are what may be tricky. Here’s my answer, I hope it helps.

Hi Shelley,

Thank you for taking the time to comment about the training. I’m writing In regards to your question about AED use and then checking for “signs of life” vs checking for Airway, Breathing and Circulation. Id like to assure you that as wrong as it may seem to do CPR without checking for pulses first, the training you received from ProFirstAid.comis based upon the latest guidelines set forth by the American Heart Association and are correct.

The old standards were to shock with AED Training and then assess for Airway, Breathing and Circulation, if no pulse give CPR. The new standards have eliminated pulse checks for lay rescuers in order to simplify and hopefully reduce pulse check “mistakes”. This is designed to shorten time from arrival of help to first chest compression.

Now, if your feeling a little confused, don’t feel bad… many of us do when there are changes. Be assured that most people who are unconscious, not breathing normally and have received a shock are most probably in cardiac arrest and CPR is called for. Besides, studies show that chest compressions when not needed rarely ever cause severe harm. Better to error on the side if giving CPR.

This however, is the reason for change in training and per the AHA standards it is accurate.

I’d be happy to explain further and in more details if you like.

Best Wishes,

Roy Shaw, paramedic, instructor

Can Anyone Use An AED?

In this mobile vlog, Roy wanted to address the AED question asked by two different people at almost the same time. Though there may be slightly different legal rules in the U.K. Compared to the U.S., both countries follow closely related ILCOR recommendations/guidelines. Always check your local laws to be sure, but in this episode, Roy addresses what the 2010 guidelines changed and why you can probably use an AED without any formal training. Let him know what you think of his more mobile format. He’s trying a new app that would allow him to record and post from almost anywhere and anytime. Not as finished as the in-studio videos but let’s him be more efficient. He will use the other format too but will sneak in some simpler ones when time is crunched. Your comments will be appreciated. Send comments to:

The RoyOnRescue Team


Did I Do CPR Wrong?

In this episode of RoyOnRescue,  Roy answers an email that was just sent in regarding a person who provided CPR for a cardiac arrest victim but it was different than how the two other certified responders where doing CPR.  Please tell me we don’t give rescue breaths anymore, I hope I did the right thing, “God forbid my way was wrong”.  Roy answers this question in a way that explains how all three of the rescuers did the “Right Thing”.  Be sure to watch this episode to learn how compression only and complete CPR are beneficial for the cardiac arrest victim.

16 Year Old Dies Suddenly On Basketball Court!

In this episode, Roy talks about a terrible tragedy where a 16 year old athlete made the winning shot, was greeted by teammates on the basketball court and suddenly collapsed in sudden cardiac arrest. Later it is revealed that the young man had a not so un-common condition. Learn how to recognize symptoms surrounding this condition, how to respond to an emergency that arises from this condition and how to detect it before it may be too late.
Our hearts go out to the family and friends of this young man. May God bless and comfort them all.

RoyOnRescue Team

What’s an AED?

In this episode of RoyOnRescue, I answer a question from a viewer who asked me to explain what an AED is. The area of cardiology is an extremely interesting subject and electrical therapies are really fun to explain but how to do it in a short amount of time? I thought I’d give it a try and explain how AED’s work and how they can help a heart beat normally again all in a fraction of the time I usually take to explain it. I hope it makes sense and sheds a bit of light on the life saving gift called an AED.

Be sure to keep the questions coming and send them to:

Best wishes and keep on rescuing!


CPR on Airbeds and Shocking a PaceMaker

We had a student write in about different situations that can make it really difficult to do CPR and use an AED on someone.  I thought I’d include the scenarios and then give a little help on some ways to make it all go as well as possible.

The person writes: I have patients in oversized  beds, usually air beds.  I am a nurse in a nursing home and have this discussion frequently with my CNA staff so they know what to do.  You’d be surprised how many licensed staff attempt CPR in a bed.  Question, can an AED be used on a person with a pacemaker or indwelling defibrillator?


Well, these two different situations do throw a small curve ball but nothing that we can’t work through together.   First, let’s talk about the airbeds.  In the medical field, we are constantly finding ways to decrease bed sores and pneumatic air beds are one of them.  When a patient needs CPR compressions there is a golden rule that shoulds be followed.   Chest compressions work best on a hard flat surfaces.  This does not mean that the patient must be moved to a different surface everytime, but it does mean that the surface must be hard/stiff and flat in order to maximize the depth and consistency of the chest compressions.

With airbeds, we usually see them built with a deflate or CPR button?  Or a way to deflate them quickly.  Even the air/sand beds have this feature so make yourself familiar with it and you will instantly have that hard flat surface we are talking about.  If it is a normal hospital or patient bed and the person is not able to be moved safely to the floor, we should have quick access to a CPR board or a back board which will usually stiffen the surface enough for good compression depth.  It’s always a good idea to practice all of these steps to make sure you know just what you are going to do if the emergency arises.

Secondly,  Defibrillators of every type are able to be used with internal pacemakers and internal defibrillators.  When we place the pads of a defibrillator on  a person’s chest, the placement is usually upper right pectoralis region and left lower mid axillary chest.  This will be below the left pectoralis muscle  or breast and mid line with the left armpit.  See under AED video training for a demonstration.  If the Pads or paddles are placed in these locations, they will clearly miss the most popular location for an internal defibrillator or pace maker.  Even if for some strange reason the pacemaker is in an abnormal location and you will have to place the pad over the device.  Be sure to seal it to the chest well and follow the AED training procedures.  We would want to move necklaces from the path of electricity and we will wipe off any nitro paste or other medicine patches from the area’s we place the electrode pads.

If you work in a hospital setting, be sure to ask your educators what the hospital or facility procedure or protocol is if you have any doubt on this advice.

I hope this was helpful and keep the good questions coming.  I’ll be looking forward to your emails.

Best Wishes,


Roy W. Shaw, EMT-Paramedic

Can a Ball Hitting My Childs Chest Kill Him?

In some cases it has!  The velocity of an object striking one’s chest can cause a phenomenon that could disrupt the normal beating heart.  If this happens, everyone standing by should hope they can recognize it, and treat it.  Here’s how I got on this subject.

An email came in to our offices asking about more information regarding what happens when a child is struck in the chest or abdomen ,ith a ball, puck, bat or other hard object.

Sports can be fun but not when someone gets seriously hurt or dies.  One type of injury that is a real concern to everyone is cardiac arrest secondary to  chest trauma from a blunt object.  This can happen when a baseball, soccer ball, basketball, hockey puck, bat or person hits another persons chest with a great deal of velocity or force.(   In some cases, it is suspected that if a ball or other object hits a person chest over the top of the location of the heart, the strike works somewhat like a technique that was once used to mechanically cardiovert a heart called a precordial thump(  This technique used force vs. electricity to create some form of rhythm or Arrhythmia/ Ventricular Fibrillation in order for the heart to be corrected so as to regain a purposeful and organized heart rhythm.  This technique though used rarely today, may be the effect that is causing sudden cardiac arrest in children and adults who are involved in a chest trauma from sports.   If this does happen, the person may collapse immediately and stop breathing with no palpable(you can’t feel it) pulse. If the person is in cardiac arrest or is not showing signs of life,  911/Activation of EMS and CPR should be started immediately and an AED may be very useful if the person is in a shockable condition.  If an AED is not present, CPR will be done continuously without interruption unless the person becomes conscious and begins to move or attempts to speak(signs of life).   Be on guard, bruising, punctured lung or other underlying conditions could cause the person to return to a state of cardiac arrest so frequent reassessments will be required until the person is turned fully over to the care of emergency medical services.   The best cure for this injury is prevention.  Many companies are designing and selling chest guards and protective devices to help prevent this condition from happening.( A well trained professional or volunteer coaching team in CPR and First Aid ( be highly suggested and an AED can be purchased for less than a laptop today.(

In comparison another condition related to a blunt trauma to the abdomen is a condition nick named, “getting the wind knocked out”.  This condition usually occurs when a person receives a blow to the upper center abdomen which is approximately where we provide inward and upward abdominal thrusts for a choking victim.  This area is physiologically perfect for compressing the diaphragm and compressing the lower lobes of the lungs.  This forces residual air out of the lungs and feels scary.  Normally, after a few minutes of one trying to breath deeply, fighting hard for that first real deep breath, the spasm releases in the diaphragm and air is gradually brought back into a normal state.  Complications related to this fairly common condition could include ruptured or torn internal organs.  If a person is hit hard enough, as in situations where a bat or object was used, or the lower half of a steering wheel which is common in unrestrained, non airbag vehicular accidents, the trauma could rupture/tear internal organs and even the descending aorta.  If the Aorta is torn or ruptured, it is well know to be a usually fatal injury as time to surgery is quite a few minutes away and one can loose enough blood internally to die from hypovolemia.  A condition where there is not enough blood to circulate oxygenated blood or maintain an adequate blood pressure  which leads to death if not corrected.  Treatment for this more serious condition is activation of emergency medical services while providing CPR, Shock Therapy( and minimization of movement.  A way to prevent this injury is to avoid the types of conditions that could present it.  Another way is to incorporate an aggressive core strength training program which will build strength in the abdominal muscles so as to help protect against sport related injuries.

It is important to consult with your health care professional or physician before beginning any intense workout program and if you are at all concerned that you or someone you know may have internal injuries, call 911/EMS and seek medical help.

Most of the signs and symptoms related to an internal injury in the chest or abdomen are severe pain that disables a person from performing normal behaviors.  Tender abdomen to touch, distending(bulging) belly, rigid or hard belly) bruising or marks over the abdomen or chest, shortness of breath or difficulty breathing, pale, cool, sweaty, increased anxiety, increased respiratory rate, dizziness, fear of dying and unconsciousness.  If any of these signs or symptoms are present or appear after an injury, activate the Emergency Medical Services immediately and/or seek medical help right away.

I hope this answers the question and I hope the next time you are by someone who is struck in the chest or simply gets the wind knocked out of them, you’ll better know what it is, what to do, and how to help.

Best Wishes,

Roy Shaw, EMT-P, RoyOnRescue

Tweet:  @royonrescue

P.S.  Here’s a link to  a real life scenario.  It’s worth the read Mom and Dad.

What if Someone Passes Out? What Do I Do Next?

Ever wonder why someone passes out unexpectedly?   More importantly, ever wonder what to do if someone passes out?  Today, Roy Shaw, EMT-Paramedic answers a question that was sent to him where someone who really cares about rescue asks, “How do I handle a situation where someone has passed out?”  Roy explains what is happening when someone passes out and how to apply basic first aid in order to help.  So, the next time someone goes unconscious for any reason, you may know what to do.