Basic resuscitation: AED pads with an implanted device: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Basic resuscitation: AED pads with an implanted device

Sample item

An adult in ventricular fibrillation has a visible bulge under the left clavicle from an implanted pacemaker. How should AED pads be placed?

APlace the pad clear of the device and do not delay the shockBPlace a pad directly over the deviceCRemove the device surgically firstDWithhold the shock because of the device

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Place the pad clear of the device and do not delay the shock

Pads placed directly over an implanted pacemaker or defibrillator may reduce shock delivery and can damage the device. The pad is moved a few centimetres away, or placed in the anteroposterior position, and defibrillation is not delayed.

Option by option

A. Place the pad clear of the device and do not delay the shock (correct)
Correct. Moving the pad away from the generator allows effective defibrillation without delay.
B. Place a pad directly over the device
A pad over the generator may block current delivery and harm the device.
C. Remove the device surgically first
Surgical removal is impractical and would delay treatment of arrest.
D. Withhold the shock because of the device
A shock should not be withheld, as ventricular fibrillation is fatal without defibrillation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is A, Place the pad clear of the device and do not delay the shock. Pads placed directly over an implanted pacemaker or defibrillator may reduce shock delivery and can damage the device.

Why is "Place a pad directly over the device" not the answer?

A pad over the generator may block current delivery and harm the device.

Why is "Remove the device surgically first" not the answer?

Surgical removal is impractical and would delay treatment of arrest.

Why is "Withhold the shock because of the device" not the answer?

A shock should not be withheld, as ventricular fibrillation is fatal without defibrillation.

What concept does this question test?

It tests Basic resuscitation: AED pads with an implanted device in Anaesthesia. The pad is moved a few centimetres away, or placed in the anteroposterior position, and defibrillation is not delayed.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Basic resuscitation: AED pads with an implanted device?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.