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One paddle or pad is placed on the midaxilliary line over the 6th left intercostal space and the other on the right parasternal area over the 2nd intercostal space [Class A; LOE III-2]. Acceptable alternative positions are the anterior-posterior (for paddles and pads) and apex-posterior (for pads).
In patients with an implantable device, place the pad > 8 cm away from the device, or use an alternative pad position. Also consider an alternate pad position when the patient is in the prone position (bi-axillary), or in a refractory shockable rhythm (see below).
ecommendations. This section provides guidelines on the prevention of and ALS treatments for both in-hospital cardiac arrest and out-of-hospital. cardiac arrest. Adult advanced life support (ALS) includes the advanced interventions that follow basic life support (BLS) and use of an automated external defi.
4.1 Pad placement – Adults. Effective pad placement ensures that a shock is delivered on an axis through the heart. Place pads on the exposed chest in an anterior-lateral position: one pad slightly below the collar bone on the person’s right chest and one pad on the person’s left side below the arm pit (Figure 1).
Attach the electrode pads to the person's (who has sustained cardiac arrest) bare chest according to the position shown on the AED or on the pads. If more than one rescuer is present, continue CPR whilst the pads are being attached.
each can be placed in either position. Other acceptable pad positions include: • One electrode anteriorly, over the left precordium, and the other electrode on the back behind the heart, just inferior to the left scapula (antero-posterior). • One electrode placed in the mid-axillary line, approximately level with the V6 ECG electrode or
Start CPR and send for an AED as soon as possible. If trained and able, combine chest compressions and rescue breaths, otherwise provide compression-only CPR. If an AED arrives, switch it on and follow the instructions. Minimise interruptions to CPR when attaching the AED pads to the victim.
