How should pads be placed for a child or older infant during defibrillation?

• A. Anterior-lateral placement (one pad on the right chest, one pad on the left side)
• B. Anterior-posterior placement
• C. Posterior-anterior placement
• D. Lateral-posterior placement

Answer: (A)

Defibrillation works best when the shock travels directly through the heart. Placing one pad on the right chest and the other on the left side (anterior-lateral position) creates a clear, horizontal current path through the ventricles, delivering energy where it’s needed most and minimizing skin resistance or pad overlap. This setup is quick to apply and practical during CPR, which is why it’s the standard approach for infants and children.

The alternative of placing pads on the chest and back (anterior-posterior) can also deliver a shock through the heart, but it’s typically less straightforward to apply during an active resuscitation and access issues can complicate rapid pad placement. Therefore, the anterior-lateral arrangement is preferred in a typical pediatric defibrillation scenario.