Defibrillator Paddles: Do Not Rub Together – Correct Use & Safety

Myth: “Rub Paddles Together to Build Charge”

False. This is a dangerous movie trope. Modern defibrillators (manual or AED) store energy in capacitors. Rubbing paddles does nothing and risks:

• Discharging energy into the operator
• Damaging paddle contacts
• Delaying shock delivery
• Creating false sense of readiness

Correct Procedure (Manual Defibrillator)

1. Apply conductive gel/pads to paddles (or use self-adhesive pads).
2. Select energy (Joules) per protocol (e.g., 200 J biphasic for VF/pVT).
3. Charge (press charge button).
4. Clear everyone: “All clear!” – visual + verbal check.
5. Place paddles firmly: Apex (left mid-axillary, 5th ICS) + Sternum (right upper sternal border).
6. Apply 25 lbs pressure each paddle.
7. Press discharge buttons simultaneously (both hands).
8. Immediately resume CPR (2 min) → reassess rhythm.

AED (Automated External Defibrillator)

• Turn on → attach pads → “Analyzing…” → follow voice prompts.
• No manual charging; no paddle rubbing.
• Pads are single-use, pre-gelled.

Safety Essentials

• Oxygen source >1 m away during shock.
• No one touching patient/bed during discharge.
• Check paddle/general cable integrity daily.
• Document rhythm, energy, number of shocks, patient response.

Bottom Line

Never rub paddles. Charge, clear, place firmly, discharge simultaneously. AEDs automate the process—just follow prompts.