Would you know where to place automated external defibrillator (AED) pads if someone suddenly collapsed near you? Remember, even a small mistake can prove fatal in this situation as the victim continues to fight for his life. According to the American Heart Association, fewer than 10% of adults survive out-of-hospital cardiac arrests that occur in the United States each year. However, immediate defibrillator usage and proper AED PAD placement can increase a person’s chances of survival. Moreover, mastering AED pad placement is a core part of CPR/AED certification that employers and healthcare facilities expect. So, read on to learn everything, such as anterolateral and anteroposterior placements, so you’re not left guessing when seconds count.
Where to Place AED Pads During a Cardiac Arrest?
Every minute without defibrillation reduces survival chances by 7–10%. You can increase a victim’s odds of survival with your understanding of the correct AED placement, especially during a cardiac arrest. That’s why it’s recommended to follow standard placement protocols based on the patient’s age and body type. You’ll practice this step in detail during CPR/AED certification training.
Standard Pad Placement for Adults and Children Over 8 (Anterolateral)
Use the anterolateral position as the default for children aged 8 and above and adults:
- Pad 1: Place on the upper right chest, just below the collarbone
- Pad 2: Place a few inches below the armpit on the lower left side of the chest
The electrical current gets a direct path to pass through the heart muscle and restores a normal rhythm. Emergency responders or bystanders should aim to apply AED pads and deliver a shock as soon as possible, within 3 minutes of collapse.
Note: This method is preferred unless chest access is blocked (e.g., due to burns, medical devices, or heavy chest hair). In such cases, you may need to use anteroposterior placement, which we’ll explain in the next section.
Ensure Clean, Bare Skin for Pad Placement
You must apply the AED pads directly to bare, dry skin. Check for clothing, sweat, water, or ointments that can interfere with conductivity and reduce the effectiveness of the shock. If necessary, get a towel or use the edge of a garment to wipe the chest dry. If needed, shave a hairy chest quickly to avoid hassles in the process. If you can’t shave, press pads firmly; AED will still deliver a shock.
Get Rid of Metal Surfaces
If the patient is lying in a wet area or on a metallic surface, move them if it’s safe to do so. Conductive surfaces can create dangerous secondary shock paths. A few seconds of repositioning can make AED use much safer and more effective.
Read More: Is Your Team’s CPR Certification Up to Date? Mid-Year Audit Checklist
Are There Any Variations in AED Pads Placement?
Yes, while standard pad placements work for most scenarios, there are several exceptions you should be aware of. Factors like medical devices, trauma, body condition, or age may require you to adjust how and where you place AED pads. Here’s how to handle the most common variations:
- Pacemakers/ICDs: Look for a small lump under the left collarbone. Place the pad at least 2.5 cm (1 inch) away, not directly over the device.
- Chest Hair/Wet Skin: Shave only the pad area if hair prevents adhesion. Dry the wet or sweaty skin quickly. Don’t delay shock for more than 20 – 30 seconds.
- Burns/Trauma: Avoid injured tissue. Use anteroposterior placement, one pad on the chest center (sternum), the other on the back between the shoulder blades.
- Pregnancy: AEDs are safe. Place pads as usual. In late pregnancy, tilt the patient slightly to the left to ease blood flow.
- Obese/Barrel-Chested: Use anteroposterior placement for better current flow through the heart.
What to Do While the AED Is Analyzing the Heart Rhythm?
Once you place the AED pads on the victim and turn on the machine, the device will begin analyzing the heart rhythm. This is a critical step, and your role here is simple but extremely important: stay hands-off and follow prompts exactly. Here are the steps to follow:
Do Not Touch the Patient
Any movement during rhythmic analysis, such as compressions or accidental contact, can lead to incorrect readings. Stop all compressions immediately and make sure everyone nearby stands back. Many AEDs will announce: “Analyzing rhythm. Everyone, stay clear.” Make it a habit to verbally announce: “Clear, no one touches the patient.”
Wait for Voice Prompts
Most modern AEDs provide audio and visual cues. These prompts can easily guide you through the process. Wait for the machine to tell you whether or not a shock is advised. Most models give step-by-step voice instructions, such as “Apply pads,” “Analyzing,” “Shock advised,” or “No shock advised.” Some devices also include a metronome to help maintain the correct CPR rhythm. So, follow prompts exactly as they are given, no need to guess or rush.
Prepare for CPR
If the device says “No shock advised,” that doesn’t mean the victim is okay. It just means the heart rhythm isn’t shockable. Resume CPR immediately and give chest compressions at a rate of 100–120 per minute, depth of at least 2 inches for adults. Follow the 30:2 ratio if trained in rescue breathing. Continue until emergency medical services arrive or the AED re-analyzes.
Stand Clear During Shock Delivery
If the AED advises a shock, loudly announce “Clear!” and ensure that no one is touching the patient. Press the shock button as instructed and resume CPR immediately after you are done with the PAD placement. Don’t remove the AED pads after a shock. Leave them in place for continuous monitoring in case another rhythm analysis or shock is needed.
Common Mistakes to Avoid
- Talking Near The Victim: Vibrations from your voice can interfere with the AED’s ability to detect rhythm accurately.
- Accidental Contact: Even a hand on the shoulder or touching clothing can disrupt analysis.
- Performing CPR During Analysis: Never continue compressions until the AED has finished checking the rhythm.
- Leaning Over The Victim: Movement or pressure can create false readings.
- Crowding the Area: Too many people nearby make it harder to ensure no one is touching the patient.
Read More: CPR and First Aid in Coastal Work Environments: A Must-Have Skillset
How to Begin with Pediatric and Infant AED Pads Placement?
AEDs are not just for adults because they act as lifesaving tools for children and infants as well. However, you must make sure to follow the right pad size and placement techniques to avoid any mishap. Infants and children often have smaller chests and different physiology, so precise placement matters in these cases. Here are some additional things to keep in mind:
Who Should Use Pediatric Pads?
Pediatric AED pads are specifically designed for children under 8 years old or those weighing less than 55 pounds. They are designed to deliver a lower energy dose appropriate for smaller hearts. Do not use pediatric pads on adults. The reduced energy won’t be sufficient for defibrillation.
Infant AED Pad Placement
When you place AED pads on infants, especially those who are under 1 year, the safest and most effective method to use is the anteroposterior placement. One pad should be placed in the center of the chest and the other on the back between the shoulder blades. Ensure the pads do not touch or overlap. If they do, do not deliver a shock. Overlapping pads can cause the electrical current to “short-circuit” across the skin instead of passing through the heart. This can make the shock ineffective and potentially unsafe. Instead, continue CPR and wait for EMS.
Note: Not all AEDs are cleared for use on infants. If unsure, prioritize high-quality CPR until help arrives.
Pad Placement for Children 1 to 8 Years Old
If the chest of the child is large enough to prevent the pads from touching, you may use the standard anterolateral placement of AED pads. Make sure to place one pad on the upper right chest and one on the lower left side. Make sure pads don’t overlap, adjust to anteroposterior if needed.
Can Adult Pads Be Used on Children?
Yes. If pediatric pads are unavailable, use adult pads. It is far better than doing nothing. This involves an anteroposterior placement of AED pads, which means placing one pad in the center of the child’s chest and the other on their back, between the shoulder blades. This enables you to avoid overlap and ensure safe, effective shock delivery.
FDA Recommendation on AEDs for Infants
The FDA advises checking the AED labeling to confirm whether the device is cleared for use on infants under 1 year old. Not every AED model has this clearance. If the AED isn’t approved for infants, focus on high-quality CPR until EMS arrives.
What You’ll Learn in CPR/AED Certification
During CPR/AED certification training, you’ll learn:
- When to use pediatric pads versus adult pads
- Correct pad placement techniques for infants and children
- Hands-on practice with child and infant manikins to build confidence in real situations
This practical training ensures you’ll know exactly what to do, rather than relying on guesswork in emergencies.
What are the 7 Essential Steps to Using an AED?
Using an AED effectively means following a step-by-step process. Every action you take plays a key role in its successful outcome. On that note, here is a list of steps you must follow when using the defibrillator to revive victims:
Step 1: Assess the Scene and Victim
Ensure the environment is safe before approaching the victim. Look around for hazards like electrical wires, fire, or water. Once safe, approach the person and check for responsiveness by tapping their shoulders and shouting. Look for normal breathing, and if the person is unresponsive or only gasping, they are likely in cardiac arrest. If you already know the best position to be in during a heart attack, lay the person down accordingly.
Step 2: Call Emergency Services
Call 911 immediately, or direct someone nearby to do so. Provide accurate details about the location and the victim’s condition. Simultaneously, ask someone to bring the nearest AED if it isn’t already at hand. An early call ensures professional help is on the way while you assist the patient. Also, tell someone to retrieve the nearest AED while you stay with the patient. Early defibrillation dramatically improves survival rates, especially if delivered within 3 to 5 minutes.
Step 3: Use the AED Properly
Place the AED on the patient and turn it on as soon as it arrives. Most AEDs will automatically start giving audio prompts. Some may also have visual guides. Stay calm and follow these prompts exactly as they guide you through pad placement and analysis.
Step 4: Expose the Chest and Attach Pads
Quickly remove or cut away any clothing covering the chest. Make sure the chest is dry and, if needed, shave any excessive hair where the pads will be placed. Apply one pad to the upper right side of the chest just below the collarbone, and the other to the lower left side below the armpit.
Step 5: Let the AED Analyze
Once the pads are in place, the AED will begin analyzing the victim’s heart rhythm. Do not touch the person during this process, as any movement or contact may interfere with the analysis. Loudly announce “Stand clear!” and ensure everyone is away from the victim’s body.
Step 6: Deliver the Shock if Advised
If the AED advises a shock, confirm that no one is touching the victim. Announce “Clear!” again, and then press the shock button as prompted. Some AEDs are fully automatic, meaning they deliver the shock on their own after warning you to stand clear. Semi-automatic AEDs require you to press the shock button manually. Regardless of the type, do not delay CPR while figuring out the model; just follow the prompts. Remember: every delay lowers blood flow (perfusion) and reduces survival chances—so minimize interruptions.
Step 7: Resume CPR Immediately
Begin CPR again as soon as the shock is delivered or if the AED instructs that no shock is needed. Perform 30 compressions followed by 2 rescue breaths. Continue CPR until the AED prompts you to stop, emergency responders arrive, or the person starts showing signs of life.
| Quick Mnemonic to Remember the Steps: C-C-A-P-A-S-RCheck (scene & victim)Call (emergency services, get AED)Apply (turn on AED)Pads (expose chest, place pads)Analyze (let AED check rhythm)Shock (if advised)Resume CPR |
What to Do If the Person Starts Breathing Again
If the person begins breathing or regains consciousness, place them in the recovery position, on their side with their mouth open slightly angled downward to keep the airway clear and reduce aspiration risk. Stay with them and monitor their breathing until emergency responders arrive. Be prepared to start CPR again if breathing stops.
Learn More About AED PAD Placements
The knowledge about the correct AED pad placement is all about saving lives. If you are a first responder, you may have to assist an adult, child, or infant. Hence, being prepared and informed can help you improve survival outcomes during sudden cardiac arrest. Each step that you learn regarding PAD placements contributes to a higher chance of the person’s survival.
Most employers require valid CPR/AED certification for compliance and safety. So, get CPR/AED certified online today and practice real-life pad placement scenarios from your home. By learning these skills and techniques, you can be the reason someone gets a second chance at life.
