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4 Defibrillation
4.3 Applying the adhesive electrodes
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FRED easy
Step 3
Applying the electrodes to the patient’s chest
Adult and paediatric electrodes
Large electrodes
The large adult electrodes with a surface area of 80 cm² are used for adults and chil-
dren weighing 25 kg or more.
Small electrodes
The small paediatric electrodes with a surface area of 42 cm² are used for children
weighing less than 25 kg (younger than 8 years of age).

Risk of skin burns/equipment damage — Do not apply the defibrillation pads on
top of:
– the sternum or clavicle,
– the nipples,
– an implanted pacemaker or defibrillator device.

Skin covered in sea water, sand, sunscreen, or skin or body care products may
impair electrode contact or cause the electrodes to become disconnected.
Fig. 4.4
Electrode application sites
Fig. 4.5
Electrode application sites for
children
Electrode placement is the same for adults and for children (see Fig. 4.5 Electrode
application sites for children ). The device automatically distinguishes between adult
electrodes and paediatric electrodes.
1. Before applying the adhesive electrodes, verify that the application sites on the
patient’s chest are clean and dry.
2. The skin must be cleaned by rubbing the application points vigorously with a dry
cloth. Do not use alcohol or alcohol wipes. This could significantly increase the
contact impedance between the electrodes and the skin.
3. Carefully shave the application sites if the patient’s chest is hairy.
4. Apply the positive electrode at the right sternal edge at the level of the 2
nd
inter-
costal space. Do
not
apply the positive electrode on top of the clavicle (uneven
surface).
5. Apply the negative electrode on the left axillary line at the level of the 5
th
intercos-
tal space.
The electrodes must have good contact with the patient’s skin. Air bubbles under the
electrodes must be avoided. To avoid air bubbles, place one edge of the adhesive
electrode to the patient's chest, then gradually smooth it out toward the other edge to
remove any air.
6. Place the electrodes on the patient's chest so that the connections point to either
side of the patient in order not to hinder CPR.
Fig. 4.6
Application sites for small chil-
dren
When defibrillating small children, it is recommended to choose the anterior-posterior
position to avoid short-circuiting the electrodes.