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Where Should AED Pads be Placed in the Anteroposterior and Anterolateral Placement

An automated external defibrillator (AED) is a portable device used to provide defibrillation to out-of-hospital cardiac arrest (OHCA) patients, so it is designed to be smart and easy to use for a population with no medical background or AED training. By detecting abnormal heart rhythm and delivering electric shocks to the heart through AED pads under the right conditions, AED equipment is able to restore the normal heart rhythm for sudden cardiac arrest (SCA) patients. In particular, disposable AED pads made of plastic, metal, and conductive adhesive are an important shock delivery medium for external defibrillation and are critical to the success of defibrillation. 

During the rescue of SCA patients, if the AED pads are not properly placed, the AED device may not accurately analyze the heart rhythm, the current may not accurately reach the heart to provide enough energy to defibrillate, and even the high-energy current may cause damage to other parts of the body, which will greatly reduce the efficiency and effectiveness of defibrillation and miss the best rescue time. Therefore, learning the correct anteroposterior AED placement and anterolateral AED pad placement is critical for both professionals and non-professionals, as it is conducive to performing a more competent SCA rescue.

Anteroposterior and Anterolateral AED Pad Placement

When performing an SCA rescue or attending AED training, you may hear the common terms “anterior-posterior” and “anterolateral” played by automated external defibrillation equipment. If you don’t have any prior medical background, you may not be sure what these terms actually mean. 

In this context, the anteroposterior and anterolateral terms are primarily used in anatomy to describe the standard position of body orientation. When the patient is lying on his or her back, the side of the patient’s face and chest facing you is called the anterior, while the back against the floor or the operating table is the posterior, which is what we call the anterior-posterior. The term anteroposterior AED pad placement refers to the placement of an AED pad on the front of the patient’s body and one on the back when in the case of using an AED on a child.

As for “anterolateral”, the anterior is the same as above that the side of the patient’s face and chest facing you while lying on his or her back, while the left and right side of the body opposite the arms are lateral. Anterolateral AED pad placement refers to the placement of an AED pad on the front and side of the patient’s body when in case of the use of an AED on adults.

Difference between AED Pad Placement for Children and Adults?

After learning about the basic terminology of AED pad placement, let’s move on to where to place AED pads on a patient. AED pads typically come in two sizes: adult AED pads and pediatric AED pads. Pediatric AED pads are for infants and children under eight years old. They have a built-in attenuation mechanism that receives the full energy from the AED unit but reduces the energy to a lower level before delivering the shock to the child and infant. In addition, some AED brands offer AED solutions that automatically switch to a corresponding child mode for lower energy delivery based on the posted AED pads. If the AED device is used cannot be switched to “child mode”, the American Heart Association (AHA) recommends the default adult setting for AED use in children.[1] Next, we are going to introduce the AED pad placement for children and adults.

  • Anteroposterior AED pad placement for infant and children

AED placement for children is very different from that for adults. In the case of sudden cardiac arrest in infants and children under eight years of age, the rule of anteroposterior AED pad placement should be followed, i.e., one pad is placed in the center of the child’s chest, and the other pad is placed in the center of the upper back. It is important that the AED pads do not touch each other, as this may interfere with the transmission of the shock.

  • Anterolateral AED pad placement for Adult

As mentioned earlier, anterolateral AED pad placement is used primarily in the context of an AED on an adult SCA patient. The general rule is to lay the patient flat on a level surface and place one pad on the upper right side of the chest and the other laterally on the lower left side of the chest (or left side the chest cavity). This creates a pathway through the heart muscle that allows that current to impinge on the heart, resulting in successful defibrillation. For pregnant women in sudden cardiac arrest, it is safe to use AEDs, which are approved by the American Heart Association.[2] Therefore, the AED pad placement on a pregnant woman also follows the same rules as anterolateral AED pad placement: place one pad above her right breast and place the other pad laterally on the left side of her chest.

Usually, the AED equipment you use will tell you in detail the anteroposterior AED pad placement and anterolateral AED pad placement through audio prompts and visual diagrams, so responders have no need to panic or be afraid to perform a rescue at all due to no ideas on where to place the AED pads. In addition, some AED manufacturers, such as Mindray AED, have even added some user-friendly design to their AED solutions, i.e., their AED pads are also marked with a simple graphic indicating where the corresponding position should AED pads be placed on adults and children. When users get the Mindray AED device, they can operate it according to the voice and visual diagrams, but also according to the graphic instructions on the AED pads.

Conclusion

Knowing the anterolateral AED pad placement for adults, anteroposterior AED pad placement for children, and the function of AED pads exert great influence on successful rescue for SCA patients. Since you have figured out that, as a manager of your community or service site, are you considering AED equipment for an AED training or AED program? Whether you plan to equip your community, business, or service site with AED equipment or conduct AED training, an intelligent and user-friendly AED solution should be considered first. Mindray AED solutions are the perfect choice for combining both. Depending on the type of AED pads affixed, Mindray AEDs can intelligently switch modes to effectively avoid excessive energy transfer to children or less energy to an adult. Moreover, in addition to voice and picture guidance on the machine, Mindray’s AED pads have graphic instructions to assist responders more calmly and effectively in treating out-of-hospital SCA patients and improving the out-of-hospital SCA survival rate. Coupled with Mindray AED, responders are at ease with SCA rescue with the comprehensive guidance of anterolateral and anteroposterior AED pad placement.

References:

[1] Use of Automated External Defibrillators for Children: An Update. AHA Journal. Circulation, Vol 107, Issue 25. July 1, 2003. Pages 3250 – 3255. Available at: https://www.ahajournals.org/doi/10.1161/01.cir.0000074201.73984.fd (Accessed: 8 January 2022)

[2] Statement is first to address cardiac arrest during pregnancy. 6 October, 2015. Available at: https://www.heart.org/en/news/2018/05/01/statement-is-first-to-address-cardiac-arrest-during-pregnancy

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