AED Pad Placement for Infants: Step-by-Step Guide

Last Updated on August 29, 2026 by Nurseslab.in Editorial Team

If an infant is unresponsive and not breathing normally, call emergency services, begin paediatric CPR, and use an automated external defibrillator as soon as it is available. Follow the emergency call handler, current resuscitation training, and the AED manufacturer’s spoken and illustrated instructions.

Why Pad Placement Matters

An AED analyses the heart rhythm and advises a shock only when appropriate. Correct pad placement helps electrical current pass effectively through the heart. Because an infant’s chest is small, the pads must never overlap or touch. Paediatric pads or an AED with a paediatric setting are preferred when available, but adult pads may be used if paediatric pads are unavailable and can be positioned without contact.

Preferred Infant Position: Anterior–Posterior

For most infants, pads are placed front and back because this prevents overlap on the small chest. This is called anterior–posterior placement:

• Front pad: place one pad in the centre of the bare chest.
• Back pad: place the second pad in the centre of the back, between the shoulder blades.

Use the pictures printed on the pads or packaging because pad designs differ. Ensure both pads are fully attached and no part of one pad touches the other.

Step-by-Step AED Pad Placement

1. Confirm cardiac arrest. Check responsiveness and breathing according to your training. If the infant is not breathing normally, activate emergency help and begin CPR.
2. Send for the AED. If another rescuer is present, ask them to call emergency services and bring the AED while CPR continues. If alone, use a phone on speaker and follow the call handler’s instructions.
3. Switch on the AED. Open the device and press the power button if it does not start automatically. Listen carefully to every prompt.
4. Expose the chest. Remove or cut clothing quickly. The pads must attach directly to bare, dry skin.
5. Dry the skin. If the infant is wet, move away from standing water and dry the chest and back rapidly. Do not delay defibrillation unnecessarily.
6. Select paediatric mode if available. Attach paediatric pads, connect the paediatric key, or activate the child setting exactly as directed by the device.
7. Prepare the front pad. Peel off the backing and place the pad centrally on the chest, following its diagram. Press firmly so the full adhesive surface contacts the skin.
8. Prepare the back pad. Roll or lift the infant only as much as necessary, supporting the head and neck. Position the second pad centrally between the shoulder blades, then return the infant flat for CPR.
9. Check for separation. Confirm that the pads do not touch or overlap and that cables are connected correctly.
10. Resume or continue CPR. Keep interruptions as short as possible while pads are applied. If two rescuers are present, one should continue compressions whenever safe while the other positions the pads.
11. Clear for analysis. When the AED says it is analysing, stop CPR and make sure no one is touching the infant. Say clearly, “Stand clear.”
12. Deliver a shock if advised. Check again that everyone is clear. Press the flashing shock button if prompted, or allow an automatic AED to deliver the shock.
13. Restart CPR immediately. Resume compressions and ventilations as directed. Do not pause to check a pulse unless the AED or emergency professional instructs you.
14. Follow every prompt. Continue CPR and AED cycles until the infant shows signs of life, trained help takes over, you become unable to continue, or the scene becomes unsafe.

If Only Adult Pads Are Available

Use the adult pads rather than withholding defibrillation. Place them front and back so they do not touch. Follow the pictures and AED prompts. Do not cut, fold, trim, or alter the pads. If their size makes safe separation impossible, follow the emergency call handler’s and device manufacturer’s instructions.

Special Safety Considerations

• Medication patches: remove a patch with gloves, wipe the area, and place the pad away from it.
• Implanted devices: if a device is visible as a lump beneath the skin, do not place the pad directly over it; follow the pad diagram and position nearby.
• Water: do not analyse or shock while the infant is in water or anyone is touching them.
• Oxygen: keep free-flowing oxygen away from the chest during shock delivery and follow local resuscitation policy.
• Jewellery: do not delay care to remove ordinary jewellery unless it interferes with pad adhesion.
• Pad adhesion: replace a contaminated or poorly attached pad if a spare is immediately available, but minimise interruption to CPR.

Common Mistakes to Avoid

• Waiting for paediatric pads when an AED with adult pads is already available.
• Allowing pads to touch or overlap on the infant’s chest.
• Placing pads over clothing, moisture, or a medication patch.
• Stopping CPR for too long while opening the AED or attaching pads.
• Touching the infant during rhythm analysis or shock delivery.
• Removing pads after a shock; leave them attached for repeated analysis.
• Ignoring the device’s diagrams or spoken instructions.
• Delaying the emergency call or assuming an AED replaces CPR.

Quick Memory Aid

Infant: one pad on the front, one pad on the back, no touching, follow the AED.

Final Takeaway

For an infant in cardiac arrest, early CPR and prompt AED use are crucial. Use paediatric pads and a paediatric setting when available. Because the chest is small, the usual safe arrangement is anterior–posterior: one pad on the centre of the bare chest and one on the centre of the back between the shoulder blades. If only adult pads are available, use them front and back without overlap. Keep pauses in CPR brief, clear everyone during analysis and shock, and follow the device and emergency dispatcher at every step.

REFERENCES

1. Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
2. Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
3. Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
4. Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
5. Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
6. Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
7. AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
8. Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/

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