An automated external defibrillator (AED) is a portable device designed to deliver an electrical shock to the heart during sudden cardiac arrest. This shock can help restore a normal heart rhythm by disrupting erratic electrical activity. For an AED to be effective, the proper placement of its electrode pads on the patient’s body is of utmost importance. Correct pad positioning ensures the electrical current can effectively travel through the heart muscle.
Understanding Anteroposterior Placement
Anteroposterior (AP) pad placement involves positioning one AED pad on the front of the patient’s body and the other on the back. This arrangement creates an electrical pathway that passes directly through the heart.
This method differs from the more common anterior-lateral placement, where both pads are positioned on the front of the chest, one on the upper right and the other on the lower left side. The AP approach is specifically designed to maximize the current’s flow through the heart, which can be particularly advantageous in certain situations. This distinct positioning aims to ensure the electrical shock effectively reaches the cardiac tissue.
Step-by-Step Pad Placement
Before applying the pads, ensure the patient’s chest is exposed by removing any clothing or obstructions. The skin should be dry and free of excessive hair to ensure good pad adhesion. Proper contact between the pad and skin is necessary to prevent air pockets, which can reduce effectiveness and potentially cause burns.
For the anterior pad, place it on the upper right side of the chest, just below the collarbone, to the right of the sternum. This position targets the upper region of the heart. Ensure the pad is pressed firmly onto the skin.
The posterior pad should be placed on the patient’s back, between the shoulder blades and to the left of the spine, generally at heart level. It is important to confirm that the posterior pad does not touch the anterior pad, especially in smaller individuals. This careful positioning ensures the electrical current travels effectively through the heart.
When to Use Anteroposterior Placement
Anteroposterior placement is often recommended for infants and small children. This method helps prevent the pads from touching each other, which can happen with anterior-lateral placement on a smaller torso.
This pad placement can also be beneficial for patients with implanted medical devices, such as pacemakers or implantable cardioverter-defibrillators. Placing the pads in an anteroposterior configuration can help avoid direct placement over the device. The AP method can also be considered when anterior-lateral placement is challenging due to patient anatomy, such as in individuals with large breasts or significant chest hair.