2025 UK Resuscitation and ERC Guidelines on AED Pad Placement

The latest 2025 Resuscitation Council UK (RCUK) and European Resuscitation Council (ERC) updates have introduced important changes to the recommended placement of AED pads for adults, children, and infants. These updates are based on new evidence intended to improve the effectiveness of defibrillation and increase survival rates.

Why AED Pad Placement Has Changed

For many years, AED pads have included diagrams showing where to place them on the chest. However, with the release of the new guidelines, these diagrams may now be out of date.

This is because AED pad manufacturers still hold large quantities of older stock, and it could take up to five years for all pads in circulation to reflect the updated placements. Until then, the diagram on the pad may not match the new recommended positions.

For the best chance of a successful shock, you should follow the latest RCUK and ERC guidance, even if the printed diagram suggests something different.

Updated AED Pad Placement for Adults

For adults, the new recommended placement is:

• Left-side pad: Position this pad under the left armpit. This placement improves the pathway of the electrical shock across the heart.
• Right-side pad: This pad remains in the traditional position on the upper right chest.

Important note for female casualties: avoid placing the right-side pad over breast tissue; adjust slightly if needed to maintain full contact with the skin.

Updated AED Pad Placement for Children (Under 25 kg or Approx. Under 8 Years)

For smaller children, the recommended placement has also changed:

• Front pad: Place it on the chest but slightly offset to the child’s left side, rather than directly centred.
• Back pad: The rear pad position remains the same as before.

For older children and adolescents, AED placement remains the same as adult positioning (front and back, standard locations).

New Guidance for Infants

One of the most notable updates is the introduction of clear guidance on AED use for infants. Many rescuers may not have been taught this previously, but AEDs can and should be used on infants in cardiac arrest.

The new recommended placement is:

• Back pad: Place one pad in the centre of the infant’s back.
• Front pad: Position the second pad on the chest, slightly offset to the infant’s left side.

This placement ensures an effective shock pathway while accommodating the much smaller chest size of an infant.

Key Takeaway

Always follow the latest Resuscitation Council UK and ERC guidelines rather than relying solely on the diagrams printed on AED pads. These changes are designed to improve defibrillation effectiveness and provide the best possible outcome for the casualty.

Whether you are treating an adult, a child, or an infant, knowing the correct AED pad placement can be life-saving.