An Automated External Defibrillator (AED) is a portable device designed to deliver an electrical shock to a person experiencing sudden cardiac arrest. This shock resets the heart’s electrical activity, restoring a functional rhythm. When cardiac arrest occurs, time is measured in seconds, as every minute of delay significantly reduces the chance of survival. The urgent need for speed often raises safety questions, particularly concerning metal objects like jewelry. The immediate action is always to apply the AED pads as quickly as possible to deliver the life-saving shock.
The Immediate Answer and Rationale
The definitive answer is that you should not delay applying the AED pads to remove jewelry. While metal conducts electricity, the speed of defibrillation is the most important factor in a cardiac emergency. Taking time to remove small, non-obstructive metal items causes a delay that significantly decreases the patient’s survival odds. The risk posed by a distant metal object is far outweighed by the risk of delaying the electrical shock.
Metal is a conductor of electricity, which is why safety protocols exist. If an AED pad is placed directly over a metallic object, or if two pads are connected by jewelry, the electrical current may not travel effectively through the heart. This can lead to inefficient shock delivery or cause electrical arcing. Electrical arcing results in serious skin burns beneath or around the metal object.
Protocol for Unremovable Jewelry
If jewelry, such as a piercing or a tight ring, cannot be removed quickly and safely, it should be left in place. Any delay in delivering the shock is detrimental, making it far more dangerous than the potential risk posed by the jewelry itself.
The primary action, if a metallic object is present, is to adjust the placement of the AED pads to avoid direct contact. If the jewelry is large or cannot be avoided, move it away from the intended pad site. For items that cannot be moved, like certain piercings, ensure the adhesive pads are applied fully to the bare skin while maintaining a safe distance from the metal.
Pad Placement and Proximity
Standard AED pad placement for an adult involves placing one pad on the upper right side of the chest, just below the collarbone, and the other pad on the lower left side of the rib cage. This placement ensures the electrical current passes directly through the heart muscle. Therefore, only metal objects located on the chest or upper torso near these sites are a concern.
The key is to maintain a safe buffer zone between the edge of the AED pad and any metal object or piercing. This safe distance is recommended to be at least one to two inches (2.5 to 5 centimeters). If a necklace or chest piercing falls within this proximity, the pad placement must be slightly shifted to preserve this distance. Jewelry located on other parts of the body, such as hands or feet, will not interfere with the defibrillation process and can be ignored.