An Automated External Defibrillator (AED) is a portable medical device designed to treat individuals experiencing sudden cardiac arrest, a condition where the heart unexpectedly stops beating effectively. These devices analyze the heart’s electrical rhythm and, if necessary, deliver an electrical shock to restore a normal heartbeat. AEDs are designed for use by laypersons, not just medical professionals. Their user-friendly design includes clear audio and visual prompts to guide rescuers through the process.
Standard Pad Placement for Adults
For adults, the standard method for AED pad placement is known as anterior-lateral positioning. One pad should be placed on the upper right side of the chest, below the collarbone and to the right of the breastbone. The second pad is positioned on the lower left side of the chest, several inches below the nipple line and underneath the armpit area. This arrangement ensures the electrical current passes directly through the heart, maximizing the effectiveness of the shock.
Before applying the pads, prepare the patient’s chest. Remove all clothing from the chest area to expose the bare skin. If the skin is wet, quickly wipe it dry to ensure proper adhesion and prevent burns. Once the pads are placed, press them firmly onto the skin to ensure good contact.
The pads often have graphics or diagrams indicating the correct placement, serving as a visual guide during an emergency. Connecting the pads to the AED machine involves plugging their connectors into designated ports.
Adapting Placement for Specific Situations
When using an AED on children or infants, special considerations apply. For children under eight years old or weighing less than 55 pounds, pediatric pads should be used if available, as they deliver a reduced energy shock suitable for smaller bodies. These smaller pads are typically placed in an anterior-posterior configuration, with one pad on the center of the chest and the other on the back, between the shoulder blades. This front-and-back placement prevents the pads from touching each other. If only adult pads are available, they can still be used, but ensure they do not overlap by using the anterior-posterior placement.
For individuals with pacemakers or other implanted devices, such as implantable cardioverter-defibrillators (ICDs), avoid placing AED pads directly over the device. Position the AED pad at least an inch away from the implanted device to prevent interference and ensure the electrical current flows correctly through the heart.
If medication patches are present on the patient’s chest where a pad needs to be placed, remove the patch and quickly wipe the area clean. This prevents the patch from blocking the electrical current. For patients with excessive chest hair, the hair can sometimes interfere with pad adhesion. If significant hair is present, it may be necessary to quickly shave the area or press the pads down very firmly.
When attending to a patient with large breasts, lift the breast tissue and place the pad underneath to ensure full skin contact. This allows the pad to adhere properly to the rib cage, ensuring the electrical current effectively reaches the heart.
Why Correct Pad Placement Matters
Accurate AED pad placement is essential for the device to effectively deliver therapy. Proper positioning ensures the electrical current travels through the heart in the most direct and efficient pathway. If pads are improperly placed, the electrical current might not flow adequately through the heart, reducing the chance of successfully restarting a normal rhythm.
Correct placement is also necessary for the AED to accurately analyze the heart’s rhythm. Incorrectly positioned pads can hinder the device’s ability to interpret the electrical signals from the heart, potentially leading to an ineffective shock or preventing the AED from recommending a shock when one is needed. Improper placement can also pose safety concerns. Adhering to placement guidelines helps ensure both the effectiveness of the defibrillation and the safety of the patient and rescuer.