In October 2007, The American Academy of Pediatrics issued new recommendations for the use of automated external defibrillators (AEDs) for ventricular fibrillation in children from birth to 8 years of age.1 Although ventricular fibrillation (VF), the most common rhythm requiring defibrillation, is not as common in infants and children as it is in adults, it does occur and requires prompt intervention. Previous guidelines recommended use of an AED for children 1 to 8 years of age.2

As soon as possible after cardiac arrest, defibrillation should be provided with either an attenuated adult-dosage AED tested for efficacy and safety in children or an AED specifically designed for use in young children and infants, depending on which device is available first. If neither of these is available, a standard nonattenuated adult-dosage AED should be used.1

Evidence-based energy dosage recommendations for defibrillation in infants and children are scant.1 There is a wide therapeutic range of defibrillation doses because the immature heart is less susceptible to energy-related damage. The risk of not defibrillating must be balanced against the theoretical risk of myocardial damage from using a fixed-dose adult ATE.1

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