The use of an AED involves the following steps:

1. When an AED is available, the rescuers open the case and turn on the machine. Once the device is on, the AED guides them through the next steps.
2. The patient’s shirt is removed to expose the chest. The rescuer dries the skin if wet and removes any medication patches if present. The chest is felt for a hard pacemaker case or intravenous port under the skin in order to not place an AED pad on those areas.
3. The rescuer opens the AED pads and removes the backing.
4. The AED pads are applied to the chest in the positions recommended on the AED case. Usually, one pad goes on the upper right chest and the other on the lower chest over the ribs below the armpit.
   

   Proper placement of electrode pads.

5. The wires are then attached to the AED case. Many AEDs have wires already connected.
6. CPR is discontinued to allow the AED to analyze the rhythm. No one should touch the patient during this time.
7. If the AED advises checking the electrodes, the rescuer confirms that the pads are making good contact with the skin. For patients with hairy chests, it may be necessary to shave the chest to ensure good skin contact. Many AED kits include a razor for this purpose.
8. If the AED advises a shock, the rescuer calls out for everyone to clear away from the patient and ensures that no one is touching the individual before pressing the shock button to deliver the first shock.
9. CPR is immediately restarted and continued for 2 minutes. After 2 minutes of high-quality CPR, the AED then advises discontinuing CPR and repeating steps 6 through 8.