AED With Pacemaker — ORE Part 1 MCQ

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ModeratePharmacology & TherapeuticsAED With PacemakerORE Part 1

A patient with an implanted pacemaker becomes unresponsive, is not breathing normally and requires CPR in the dental surgery. What is the most appropriate use of an AED?

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Correct answer: A — Apply it promptly; keep pads clear of the pacemaker and follow its prompts

Explanation lettering: D = shown as B · B = shown as C · E = shown as D · C = shown as E

A is correct. In suspected cardiac arrest, an AED must be applied without delay despite the presence of a pacemaker. UK ambulance-service guidance states that AED use should never be withheld because a casualty has a pacemaker. Identify the palpable generator, usually beneath a clavicle, and avoid placing an electrode pad directly over or in contact with it; place the pad clear of the device and follow the AED prompts. B is incorrect because a pacemaker is not a contraindication to defibrillation. C is unsafe and impractical: no attempt should be made to turn off the device. D would cause an unacceptable delay to time-critical resuscitation. E is false: pacemakers do not prevent cardiac arrest or all shockable rhythms.

Reference: South Central Ambulance Service NHS Foundation Trust. Public Access Defibrillator Information Pack, 2023, pp 6 and 8. https://www.scas.nhs.uk/wp-content/uploads/2023/03/SCAS-PAD-Information-Pack.pdf