AED Pacemaker Pad Placement — ORE Part 1 MCQ

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EasyPharmacology & TherapeuticsAED Pacemaker Pad PlacementORE Part 1

A patient with an implanted cardiac pacemaker develops cardiac arrest in the dental surgery. An AED is available. Which action is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Apply pads away from the device, then follow AED prompts

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

A is correct. An implanted pacemaker is not a reason to withhold AED use during cardiac arrest. Apply the pads in the usual positions while avoiding placement directly over the palpable generator; position a pad at least 8 cm from the device where possible, then follow the AED prompts without delaying defibrillation. The available UK NHS guidance states that external defibrillation remains necessary for malignant arrhythmias and that pads should ideally not lie over an implanted device. B is inappropriate because current passing directly over the generator may damage or interfere with it. C and E dangerously delay potentially life-saving defibrillation. D is impossible in this setting and is not required.

Reference: Worcestershire Acute Hospitals NHS Trust, Management of patients with intra-cardiac device attending for surgery, section: “Patients with ICD or CRTD patient for out of hours emergency surgery” and “Patients with ICD or CRTD for elective surgery”, current document accessed July 2026. https://apps.worcsacute.nhs.uk/KeyDocumentPortal/Home/DownloadFile/1576