Abstract 19582: Placement of the Left Side AED Pad is Poor: Training on the Left Compared to the Right Side of a Manikin Does Not Improve Pad Placement

Abstract

Introduction: Placement of automated external defibrillators (AED) pads is poor, especially placement of the left apical pad is rarely achieved. Sitting on the right side of a victim in cardiac arrest may interfere with correct left side pad placement because the rescuer has to bend over the victim to reach the left mid-axillary line. In addition, the left arm of the victim may hamper access to the left lateral side of the thorax. Hypothesis: Training automated external defibrillation sitting on the left side of a manikin improves AED pad placement compared to sitting to the right. Methods: Laypeople participating in a first aid course were randomized to learn automated external defibrillation sitting on the left or right side of a manikin during AED training. After course completion participants operated a training AED (Lifepak® CR-T AED Trainer, PhysioControl) and placed AED pads according to instructions from the AED. Pads were placed on an anatomically realistic male resuscitation torso with arms (AMBU® Man, AMBU). Participants were instructed to sit on the same side of the manikin as trained. The distance from the center of AED pads to the recommended pad position was measured. Results: In total, 30 volunteers were included and randomized to AED training on the left (n=14, 43% male, age: 47.9 years) and right (n=16, 25% male, age: 46.7 years) side of a manikin. There was no difference in left pad placement when trained on the left or right side (distance to recommended left apical pad position (mean±sd): 5.8±2.1 cm vs 7.0±2.4, p=0.15). The left apical electrode was in all cases placed too medial. Only a minor part of participants (left trained (36%); right trained (31%)) moved the left arm of the manikin to place the left apical pad. No difference was observed with respect to right pad placement when trained on the left or right side respectively (distance to recommended right sternal pad position (mean±sd): 2.7±1.7 cm vs 1.8±0.8 cm, p=0.10). Conclusion: Training automated external defibrillation on the left side of a manikin does not improve pad placement compared to training on the right side. Placement of the left apical pad is poor and future training should emphasize correct left lateral pad placement.