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.