What safety considerations should be used when delivering defibrillation to a child?

• A. Place pads anywhere on the chest; no risk
• B. Defibrillate only after 30 minutes of resuscitation
• C. Confirm pad placement, ensure no direct contact, minimize interruptions to CPR, and avoid placing pads over implanted devices if present
• D. Remove all jewelry before defibrillation

Answer: (C)

Safety in pediatric defibrillation centers on getting the energy where it needs to go while protecting everyone nearby. The pads must be placed correctly on dry skin in the recommended positions and firmly attached so the shock travels through the heart and not through clothing or gaps. Before shocking, visually confirm the pad locations and ensure they aren’t overlapped by any metal jewelry or implanted devices. It’s essential that no one is touching the patient when the shock is delivered to prevent transfer of current to rescuers and bystanders. And once the pads are in place and the patient is clear, interruptions to CPR should be kept to a minimum so perfusion isn’t unnecessarily interrupted. If an implanted device is present, place the pads away from it to avoid burns or interference with the device’s function. These steps together optimize both safety and the effectiveness of the defibrillation.