AED Electrode Pad Placement Guide

Key Takeaways

AED pads are typically applied using the “anterolateral placement method”: one pad is placed on the upper right chest, just below the collarbone, and the other on the lower left chest, below the armpit. This is the default pad placement for all adults and applies to almost every adult cardiac arrest situation. Children and infants require a different placement pattern, as detailed below.

Why Correct AED Pad Placement Matters

Correct pad placement is essential for several key reasons:

• Maximizes Shock Effectiveness:Placing pads correctly ensures the electrical current travels directly through the heart, maximizing the chances of restoring a normal rhythm.
• Minimizes Skin Burns:Proper pad placement on clean, dry skin ensures optimal adhesion, preventing current diversion and reducing the risk of thermal burns.
• Ensures Bystander and Rescuer Safety:Following standardized placement guidelines helps prevent accidental shock transmission to rescuers or bystanders.

How to Place AED Pads Correctly

Standard AED Pad Placement for Adults

For adults and children age 8 and older, use anterolateral placement:

• Pad 1: Upper right chest, just below the collarbone, to the right of the breastbone
• Pad 2: Lower left side of the chest, below the armpit (mid-axillary line)

The second pad should be placed a few inches below the armpit rather than on the front of the chest; improper front placement is a common mistake that reduces shock effectiveness.See figure for adult AED pad placement.

Adult AED pad placement diagram for male and female

AED Pad Placement for Children and Infants

Children and infants often have chests that are too small for adult pad placement, so a "front-and-back" (anterior-posterior) placement is typically used: place one pad in the center of the chest and the other on the upper back between the shoulder blades.Refer to the illustration for correct pediatric AED pad placement.

AED pad placement diagram for children and infants

Safety Notice: In the absence of a pediatric AED, an adult AED may be used as an alternative. According to the American Heart Association (AHA), delivering a shock with adult pads is far better than providing no shock at all. 

AED Pad Placement for Special Populations

For special patient populations—such as individuals with implanted cardiac pacemakers, nipple piercings, or chest wounds—a special front-and-back (anterior-posterior) placement is required, as the standard adult anterior-lateral placement is not suitable. AED pad placement locations for special populations are shown in the figure below.

AED Pad Placement for Special Populations

If you cannot recall the correct AED pad placement, there is no need for concern. Clear placement diagrams are printed directly on most pads and accompanying instructions.

Special Considerations for AED Pad Placement

• Pacemakers and Implanted Cardioverter-Defibrillators (ICDs)

An implanted pacemaker or ICD feels like a small, hard lump under the skin, usually located in the upper chest. Place the AED pad at least 1 inch (2.5 cm) away from the device. Do not delay defibrillation to locate a pacemaker—simply apply the pads and allow the AED to analyze the heart rhythm.

• Excessive Chest Hair

Excessive chest hair reduces pad-to-skin contact and may cause electrical burns. If the pads do not adhere properly:

1. First, press firmly down on the pads.
2. If a razor is available in the AED kit, quickly shave the application area.
3. Alternatively, apply a set of spare pads, press down firmly, and quickly peel them off to remove the hair, then apply a new pair of pads.

• Wet Skin

Water and sweat reduce pad adhesion and can divert electric current. Always wipe the chest dry with a towel or cloth before applying the pads. If the victim was rescued from water, move them to a dry surface and thoroughly dry their chest first.

• Transdermal Medication Patches

Medication patches on the chest can block electrical current or cause skin burns. Put on gloves, remove any patch in the pad placement area, and wipe the skin clean before applying the pad. If the patch cannot be removed quickly, place the pad at least 1 inch away from it.

• Jewelry and Metal Objects

Remove body jewelry and metal accessories from the placement area before applying AED pads, as conductive metals can divert electrical current.

• Pregnancy

According to American Heart Association (AHA) guidelines, AED use on pregnant women in cardiac arrest is safe and essential. Pad placement is identical to that for any standard adult. When calling emergency services, inform the dispatcher that the patient is pregnant so responding teams can prepare accordingly.

If you want to learn about AED usage and key precautions for operators, check out this article: When Should You Clear the Victim During AED Use?

Common Mistakes in AED Pad Placement

Understanding common AED pad placement errors helps improve resuscitation success rates and reduce the risk of injury. Here is a summary of frequent pad placement mistakes.

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Summary

AED pad placement is not one-size-fits-all and must be adjusted based on the victim’s body type and health status. For standard adults, the anterolateral placement is typically used: place one pad on the upper right chest (just below the collarbone) and the other on the lower left chest (along the mid-axillary line below the armpit). If you are unsure or forget the exact placement, refer to the diagrams printed directly on the AED pads or in the instruction manual. Prior to performing emergency care, contact emergency medical services (EMS) immediately and provide detailed information about the victim to ensure the most effective response.

Disclaimer
This article is for general educational purposes and does not replace hands-on CPR/AED certification training. In a real emergency, always follow the voice prompts of the specific AED device you are using, and call emergency services immediately. If you have not been trained, consider taking an official CPR/AED course from a recognized provider.

FAQ

Q1 Which Aed Pad Placement Is Used for Infants?

For infants (up to 1 year old), always use an anterior-posterior pad placement. Position one pad in the center of the chest on the sternum, and the second pad in the center of the back between the shoulder blades. This front-and-back placement ensures the pads do not touch or overlap on a smaller chest wall.

Q2 What Is a Correct Approach for Aed Pad Placement?

Correct AED pad placement depends on the patient's age and body size: for adults and children aged 8 or older (or weighing over 25 kg), use the anterolateral placement by applying one pad to the upper right chest below the collarbone and the other below the left nipple on the side of the chest; for infants and children under 8 years old (or weighing under 25 kg), use the anterior-posterior placement by applying one pad directly to the center of the chest on the sternum and the other to the center of the upper back between the shoulder blades, ensuring the two pads never touch or overlap so the electrical current can pass accurately through the heart.

Q3 Considerations for AED pad placement on a pregnant individual?

For a pregnant individual, AED pad placement is identical to standard adult placement: one pad on the upper right chest below the collarbone, and the other on the lower left side of the chest below the armpit. Defibrillation is completely safe for both the mother and fetus, so proceed immediately without delay.

Q4 Where can I find detailed AED pad placement guides online?

Detailed AED pad placement guides are available in the manufacturer’s user manual and on the official websites of health and emergency response organizations (such as the AHA, Red Cross, and FDA).

Q5 Dealing with excessive chest hair for AED pad application?

1. Press firmly: Apply strong pressure directly over the pads to stick them to the skin.
2. Shave if needed: If the AED case includes a razor, quickly shave the two pad areas.
3. Use the "Rip" method: If no razor is available but you have a second set of pads, stick the first set firmly over the chest hair and quickly rip them off to strip the hair, then apply the fresh second set to the bare skin.

Do not delay shocks! — if pads stick and the AED can analyze, proceed immediately.

References

1. First Aid for Free. Correct AED Pad Placement. Describes standard adult pad positioning and pacemaker adjustments. https://www.firstaidforfree.com/correct-aed-pad-placement/
2. Stryker Emergency Care. AED Pad Placement Guide. Covers anterolateral vs. anterior-posterior placement and pediatric considerations. https://www.stryker.com/us/en/emergency-care/news/2024/aed-pad-placement-guide.html
3. AED Total Solution. AED Pad Placement: Step-by-Step Guide for Adults, Children and Infants. Detailed step-by-step application process, including pacemakers and medication patches. https://www.aedtotalsolution.com/aed-pad-placement/
4. AED Pad Placement . Covers jewelry, chest hair, and pediatric pad guidance. https://www.heartsmart.com/blogs/aed-pad-placement/