Automated External Defibrillators (AEDs) are designed to be user-friendly, accessible, and life-saving. Found in schools, airports, gyms, offices, and public buildings, these devices enable everyday people to intervene in cardiac emergencies. But while AEDs provide audio and visual prompts, knowing what are some special considerations when using an AED is essential for safe and effective use—especially when variables like wet surfaces, implanted devices, or pediatric patients come into play.
Whether you’re a healthcare provider, childcare worker, fitness coach, or concerned bystander, understanding these special scenarios helps ensure that your intervention not only saves lives but also avoids potential hazards.
What Are Some Special Considerations When Using an AED?
While the basics of AED use remain the same—attach pads, follow prompts, and deliver shocks when indicated—several circumstances require additional awareness. These include environmental conditions, patient-specific factors, and responder preparedness. Below are the most important considerations to keep in mind.
1. Wet or Metal Surfaces
Why It Matters: Water conducts electricity, and so does metal. Using an AED on a wet or conductive surface could create a shock path that includes the rescuer or others nearby.
What to Do:
- Quickly move the victim to a dry, non-metallic surface if possible.
- If that’s not feasible, remove excess moisture from the chest area and stand clear during shock delivery.
- Make sure no one is in contact with the victim or conductive materials at the time of the shock.
2. Implanted Devices (e.g., Pacemakers or Defibrillators)
Why It Matters: Implanted medical devices can interfere with AED pad placement and reduce shock effectiveness.
What to Do:
- Look for a hard lump under the skin in the upper chest area—this may indicate a pacemaker.
- Place the AED pad at least one inch away from the implant.
- Avoid placing the pad directly over the device.
3. Medication Patches
Why It Matters: Transdermal patches (like nitroglycerin or nicotine) may interfere with conductivity or cause skin burns during shock delivery.
What to Do:
- Remove the patch with a gloved hand, then wipe the area before attaching the AED pad.
- If time doesn’t permit, place the pad at a safe distance from the patch.
4. Pediatric Patients
Why It Matters: Children require lower-energy shocks and smaller pads for effective and safe defibrillation.
What to Do:
- Use pediatric AED pads and settings if available (usually for children under 8 years or under 55 lbs).
- If pediatric pads aren’t available, use adult pads, ensuring they don’t overlap. One pad goes on the front of the chest, and the other goes on the back between the shoulder blades.
5. Hairy Chests
Why It Matters: Excessive chest hair can prevent the pads from adhering properly, reducing the effectiveness of shock delivery.
What to Do:
- If a razor is available (some AED kits include one), quickly shave the pad placement area.
- If no razor is available, press one pad firmly down, then rip it off quickly to remove hair and apply a new pad.
6. Jewelry or Body Piercings
Why It Matters: Metal jewelry and piercings near the pad placement area may conduct electricity.
What to Do:
- Do not waste time removing jewelry, but avoid placing pads directly over piercings or metal items.
- Shift the pad placement slightly to ensure full contact with the skin.
7. Patient Movement or Shock Interference
Why It Matters: Movement can cause the AED to misread the heart rhythm, delaying or misdirecting shock administration.
What to Do:
- Ensure the patient is lying still on a firm surface.
- During rhythm analysis and shock, loudly state “Clear!” and confirm no one is touching the victim.
These practical and safety-focused considerations are covered in detail in this helpful guide on what are some special considerations when using an AED.
Why Training Is Essential
While AEDs are designed to be intuitive, nothing replaces proper training. Individuals trained in CPR and AED use are far more likely to recognize these unique scenarios and adapt accordingly. They also act faster and with greater confidence—two factors that significantly increase survival chances in cardiac emergencies.
That’s where Simple CPR comes in. Offering nationally accredited, online certification and recertification courses, Simple CPR equips professionals and everyday heroes with the knowledge they need to act safely and effectively. Their programs include real-world AED usage scenarios, including all the special considerations discussed in this article.
Whether you work in healthcare, education, fitness, or simply want to be prepared to help others, Simple CPR provides convenient, up-to-date training at your own pace and on your own schedule.
Conclusion: Be Prepared for Every Scenario
AEDs save lives—but only when used correctly and safely. Understanding what are some special considerations when using an AED ensures you’re prepared for more than just the textbook version of an emergency. From wet surfaces to implanted devices, these details can mean the difference between a smooth response and a hazardous misstep.
Preparation is more than carrying an AED—it’s knowing how, when, and where to use it. Train ahead of time, stay informed, and be ready to adapt in any situation. Your readiness could make all the difference.
