Prehospital Defibrillation Challenges in Victims Wearing Wetsuits: A Pilot Comparison of AED Pad Placement Strategies.

Objective

This pilot study compared the positions of the antero-lateral (standard) and antero-posterior (alternative) pads in a simulated cardiac arrest scenario in athletes wearing a wetsuit.

Methods

Seventeen undergraduate physical education students were instructed to attend to a simulated victim, with no signs of life, dressed in a wetsuit. In a randomized fashion, they were instructed to place the defibrillator pads in the standard position (antero-lateral) or in the antero-posterior option. The variables analyzed were the time required to perform the procedure and the difficulty and fatigue perceived by the rescuers.

Results

Thirty-four interventions were analyzed (17 with each technique), showing that with the antero-posterior option, the time required to expose the area was less (median 6.2 vs. 12.7 s, p = 0.001), but more time was required to dry it (median 31.0 vs. 18.4 s, p = 0.002). No significant differences were found between the two options in the total time from onset to first flush or in the perception of difficulty and fatigue.

Conclusions

In the case of caring for a cardiac arrest victim wearing a wetsuit, the alternative of placing the defibrillator pads in the antero-posterior position is not a significant advantage over the standard position. Both configurations may be considered acceptable in prehospital aquatic settings, depending on situational constraints and rescuer preference.