# How the hell do you put AED pads on backwards



## Tk11 (Jan 30, 2015)

Apperatly I did this? I'm in the basic emt lab class and we were testing out of cardiac arrest with AED. I'm doing cpr on the dummy, get the AED out turn it on, put it on the dummy and continue.. Then the lab aid says "look at your pads." I had them in the correct spots, I didn't know what the problem was. In class they never mentioned placing the pads on "backwards" even in the reading I never seen this. So I said to her "what's wrong with them." Then she tells me "They are backwards, buddy" (in like a wow.. you're an idiot, tone. Which I didn't like too much.) so I just switched the spots of them.

Well, that was an "auto fail." Because I didn't use the AED properly I guess. She failed me, I retook it 5 minutes later with a different lab aid and got everything right. But I still don't understand what she meant by backwards. Like I said they never mentioned the pads being placed on backwards before the test. She said look at the pictures on the pads they looked the exact same, so I don't know what the hell she meant. I couldn't ask because she had another student right behind me, and I forgot about it after.

So what would happen if they pads were placed on backwards and they were used on a patient? And how do they even go on backwards?


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## Chewy20 (Jan 30, 2015)

Youre thinking to much. Just put the damn pads on.


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## Ewok Jerky (Jan 30, 2015)

Like you put the apex pad where the other one goes and other one where the apex pad goes? 

It doesn't matter, you passed in the end. Plus it doesn't matter.


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## OnceAnEMT (Jan 30, 2015)

beano said:


> It doesn't matter, you passed in the end. Plus it doesn't matter.



Biggest lesson in life (or, one of the bigger ones): choose your battles.


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## Tk11 (Jan 30, 2015)

beano said:


> Like you put the apex pad where the other one goes and other one where the apex pad goes?
> 
> It doesn't matter, you passed in the end. Plus it doesn't matter.


I guess so.. Just wanted to know if it mattered because they never told us this.


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## NomadicMedic (Jan 30, 2015)

Wait til a medic shows you the "modified scrotal lead" to reduce artifact in tremulous patients.


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## Tk11 (Jan 30, 2015)

beano said:


> Like you put the apex pad where the other one goes and other one where the apex pad goes?
> 
> It doesn't matter, you passed in the end. Plus it doesn't matter.


I know it doesn't I just didn't know they could be backwards.. And if it matters. Don't want to kill anyone.


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## Ewok Jerky (Jan 30, 2015)

Nothing like not being told something until you muck it up on a test.

Obviously nobody told your skillz tester either because every AED I know it doesn't matter. We are talking about something used by the general public, who require a warning that the coffee they ordered is hot.


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## Chewy20 (Jan 30, 2015)

"Hey you need to put your eye up to the little glass piece on the zoll so it can scan your eye and work properly"


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## NomadicMedic (Jan 30, 2015)

Tk11 said:


> I know it doesn't I just didn't know they could be backwards.. And if it matters. Don't want to kill anyone.



If you're putting the pads on, they can't really get any deader.


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## Chewy20 (Jan 30, 2015)

DEmedic said:


> If you're putting the pads on, they can't really get any deader.


 
PEA to Asystole?


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## Ewok Jerky (Jan 30, 2015)

DEmedic said:


> If you're putting the pads on, they can't really get any deader.



Unless you are staff at a SNF calling in an "unresponsive" patient at 3am.


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## NomadicMedic (Jan 30, 2015)

Chewy20 said:


> PEA to Asystole?



Dead-ish, deader, deadest?

Again, if a EMT is putting on the pads, things have progressed down the fecal waterway.


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## Ewok Jerky (Jan 30, 2015)

Chewy20 said:


> PEA to Asystole?



AED would not shock PEA. Besides isn't PEA close enough to dead? Closer than alive anyways. But I guess if there is any room between alive and dead, there is the possibility to make some one deader.  Ok, I'm puttting down the scotch now. Thanks @Chewy20


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## Chewy20 (Jan 30, 2015)

beano said:


> AED would not shock PEA. Besides isn't PEA close enough to dead? Closer than alive anyways. But I guess if there is any room between alive and dead, there is the possibility to make some one deader.  Ok, I'm puttting down the scotch now. Thanks @Chewy20


 
Eh was kinda getting away from the AED and just saying more deader.


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## OnceAnEMT (Jan 30, 2015)

Chewy20 said:


> Eh was kinda getting away from the AED and just saying more deader.



Warm and asystole?


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## DesertMedic66 (Jan 30, 2015)

DEmedic said:


> Wait til a medic shows you the "modified scrotal lead" to reduce artifact in tremulous patients.


How is this the first time I have ever heard of this?!


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## Ewok Jerky (Jan 30, 2015)

Chewy20 said:


> Eh was kinda getting away from the AED and just saying more deader.


I dig.


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## NomadicMedic (Jan 30, 2015)

DesertEMT66 said:


> How is this the first time I have ever heard of this?!



http://www.ems1.com/ems-products/ap...s/430502-Top-Ten-Things-Kelly-Cant-Do-in-EMS/


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## Ensihoitaja (Jan 30, 2015)

DEmedic said:


> Dead-ish, deader, deadest?
> 
> Again, if a EMT is putting on the pads, things have progressed down the fecal waterway.



There's a big difference between mostly dead and all dead...


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## Tk11 (Jan 30, 2015)

beano said:


> Nothing like not being told something until you muck it up on a test.
> 
> Obviously nobody told your skillz tester either because every AED I know it doesn't matter. We are talking about something used by the general public, who require a warning that the coffee they ordered is hot.


This lady who tested me was a substitute for someone. The way she acted after I did it made me feel like I did something horribly wrong lol. I didn't think it mattered though, but she did since she "auto failed" me for not using the AED properly. I didn't stop to look at the pictures I just threw them on the dummy like I always did, then she tells me I did something wrong lol.


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## Tigger (Jan 31, 2015)

Well they are pretty clearly labelled with where they are supposed to be...

That said I don't think it really makes a difference with biphasic defibrillators? Or at least that was what I was told?


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## cprted (Jan 31, 2015)

There is actually a positive and negative pad.  I wouldn't say "it doesn't matter," better to say, "it doesn't matter that much."  If you're monitoring a rhythm through the pads, the rhythm will be upside down if the pads are reversed.  For an AED, like I said, it doesn't matter much.  VT upside down will still be recognized by the machine as VT and VF upside down will still be recognized as VF and shocked.


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## chaz90 (Feb 1, 2015)

Yeah, I don't see the big deal in putting them on the right way. Like we mentioned, biphasic defibrillators should work pretty much the same either way, but all views will be upside down. 

Just make sure you follow the clearly labelled placement instructions next time. This is no different than using an IV catheter that "expired" a few weeks ago. Will it make any difference in patient care, functionality, or outcome? Absolutely not. Will proctors be able to fail you for using out of date equipment? Sure will. Just play the game, put them on the right way, and move on. No harm no foul in failing an NREMT test station. I failed the paramedic static cardiology test station once. No idea how I managed to do that, and I like to think I'm pretty decent at reading EKGs (for a paramedic at least).


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## Trauma Queen (Feb 1, 2015)

Attention to detail is important in this job. Does it matter if they're slapped on the wrong spots? I'm not sure, I've always taken the two seconds to look at the pictures on the pads as to their proper locations, so I've never had to worry about it. 

As a student, and potentially new EMT, you need to pay attention to every detail. Its going to take time before you can knowledgeably go with the flow, and afford to just do a quick scan and not step-by-step through your skill sheet, but even then not noticing the "little stuff" can lead to some major problems. And especially when it comes to testing, you need to be on top of this stuff. 

Testing is black and white. Take the thirty seconds to make sure you're doing it right. It'll show later down the road when you're actually providing patient care.


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## cprted (Feb 1, 2015)

chaz90 said:


> Yeah, I don't see the big deal in putting them on the right way. Like we mentioned, biphasic defibrillators should work pretty much the same either way, but all views will be upside down.
> 
> Just make sure you follow the clearly labelled placement instructions next time. This is no different than using an IV catheter that "expired" a few weeks ago. Will it make any difference in patient care, functionality, or outcome? Absolutely not. Will proctors be able to fail you for using out of date equipment? Sure will. Just play the game, put them on the right way, and move on. No harm no foul in failing an NREMT test station. I failed the paramedic static cardiology test station once. No idea how I managed to do that, and I like to think I'm pretty decent at reading EKGs (for a paramedic at least).


It is about striving for best practice though, not just good enough.  Want to be taken seriously as a healthcare professional? Do it right.


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