AED: Safe Use, Pads, and Special Situations
Purpose and Early Use
An AED analyzes the heart rhythm and delivers a shock only when a shockable rhythm is detected. Survival improves with early CPR and early defibrillation, so the AED should be applied as soon as it is available - do not wait to finish a cycle of CPR first if the device is on hand.
Standard Steps
Turn the AED on and follow its voice prompts. Bare and dry the chest, then attach pads to the upper right chest and the lower left side (or as pictured on the pads). Make sure no one is touching the person while the AED analyzes and while it delivers a shock, and announce "clear" before pressing the shock button. Immediately resume compressions after a shock or after a "no shock advised" message.
Traps to Expect
- Water: move the person away from standing water and dry the chest before applying pads.
- Medication patches: remove a patch from the pad site and wipe the area.
- Implanted device: avoid placing a pad directly over a visible implanted pacemaker or defibrillator; offset the pad.
- Hairy chest: if pads do not adhere, the AED may prompt you; shaving or using a second set of pads may be needed.
- Pediatric use: use pediatric pads or the pediatric setting for a child under 8 or under about 55 lb (25 kg) if available; if not, use adult pads, ensuring they do not touch each other.
- Moving vehicle or metal surface: stop the vehicle and avoid contact with metal that could conduct current.
Rule of Thumb
Follow the prompts, clear the patient, and get back to compressions. The AED will not shock a rhythm that does not need a shock, so using it is safe when the steps are followed.