An Automated External Defibrillator (AED) is a portable device used to deliver an electrical shock to interrupt an abnormal, life-threatening heart rhythm during sudden cardiac arrest. While AEDs feature clear voice prompts, a common physical obstacle to effective operation is excessive chest hair. Immediate action is necessary to ensure the device’s electrode pads make proper contact with the skin.
Why Chest Hair Prevents Effective AED Use
The functionality of an AED relies on a complete electrical circuit between the device and the patient’s heart. Chest hair creates a physical barrier, preventing the adhesive gel on the electrode pads from fully adhering to the skin. This lack of direct contact significantly increases electrical impedance, which is the resistance to the flow of the defibrillating current. High impedance means the electrical energy is less likely to reach the heart muscle, resulting in a failed or ineffective shock.
The hair acts as insulation, causing the electrical charge to dissipate or arc around the pads. This poor energy transfer can cause minor, superficial burns where the pad attempts to make contact. The AED may also fail to analyze the heart rhythm correctly, repeatedly prompting the user to “check pads.”
The Primary Solution: Rapid Hair Removal
The primary method for preparing a patient with a hairy chest is to quickly remove the hair from the areas where the pads will be placed. Most AED units are equipped with a preparation kit, often containing a disposable razor and trauma shears. The rescuer should first use the shears to quickly cut away any clothing to expose the chest fully.
The disposable razor should be used to shave only the specific patches of skin where the electrode pads are meant to go, typically the upper right chest and the lower left side of the rib cage. Shaving only the necessary areas minimizes preparation time. After shaving, any loose hair or moisture must be quickly wiped away with a towel or gauze found in the kit to ensure a clean, dry surface for pad adhesion. The pads can then be firmly applied to the smooth skin, maximizing the chance of a successful shock delivery.
Contingency Plan: The Double Pad Technique
If the razor is missing, damaged, or shaving is too slow or ineffective, the double pad technique can be employed. This procedure relies on using the first set of electrode pads as a makeshift depilatory strip. The rescuer applies the first set of pads firmly to the standard placement locations on the upper right chest and lower left rib cage.
Once the pads are securely in place, the rescuer must quickly and forcefully rip them off the patient’s chest, taking a significant amount of hair with them. This sacrifice of the first set of pads creates two hair-free patches of skin in the precise locations needed for defibrillation. A fresh, second set of electrode pads is then immediately applied to the now-cleared areas. This action establishes the direct skin contact required for the AED to analyze the heart rhythm and deliver an electrical shock.