An Automated External Defibrillator (AED) is a portable electronic device designed to treat sudden cardiac arrest, a condition where the heart unexpectedly stops beating effectively. These devices analyze the heart’s rhythm and can deliver an electrical shock to help restore a normal heartbeat. Correct placement of the AED pads is essential for the device to function effectively and for a successful outcome.
Understanding Anteroposterior Placement
Anteroposterior (AP) pad placement refers to positioning one AED pad on the front (anterior) of the chest and the other on the back (posterior) of the body. This method creates an electrical pathway through the heart for shock delivery. While anterior-lateral placement (front and side) is a common alternative, AP placement helps the electrical current effectively reach the heart. This approach optimizes current flow through the heart muscle, potentially resetting its electrical activity.
Step-by-Step Guide for Anteroposterior Pad Placement
Before applying the pads, ensure the individual’s chest is bare and dry, removing any clothing or moisture. If excessive chest hair is present, it may need to be trimmed or shaved for proper pad adhesion and electrical conduction. Once the skin is prepared, peel the backing off the first pad.
Place the first AED pad on the upper right side of the chest, just below the collarbone. This is the anterior pad. Ensure it adheres firmly to the skin.
Next, peel the backing off the second pad. Position this posterior pad on the left side of the individual’s back, between the shoulder blade and the spine, directly behind the front pad. Make sure the pads do not touch each other, especially on smaller individuals.
Connect the pads to the AED device by plugging the connector into the designated port. Follow the AED’s voice prompts and visual instructions, as they will guide you through the analysis and potential shock delivery.
Situations Requiring Anteroposterior Placement
Anteroposterior pad placement is used when standard anterior-lateral placement might be less effective or impossible. For individuals with implanted medical devices like pacemakers or implantable cardioverter-defibrillators (ICDs), the AP position can help avoid placing pads directly over the device. Pads should be placed at least 1-3 inches (3 cm) away from the pacemaker to prevent interference or potential damage.
This placement is also beneficial when significant breast tissue is present, as it allows pads to be positioned beneath the breast, ensuring better contact and reducing impedance. The AP method is also advantageous for excessive chest hair that cannot be quickly removed, or if wounds, metal objects, or medication patches obstruct standard pad placement. For infants and young children, anteroposterior placement is often the primary method to ensure effective current delivery without pads overlapping due to their smaller size.