[Niigata University of Health and Welfare] 24-Second Delay in Defibrillation: Study on 'Cutting' vs. 'Lifting' Clothing When Using an AED by Lay Rescuers
A study reveals that lifting clothing to expose the chest when using an AED is 24 seconds faster than using scissors to cut it, potentially impacting survival rates.
A research group at the Niigata University of Health and Welfare, including Associate Professor Kentaro Omatsu, Lecturer Gen Toyama, Professor Yutaka Takei, and several students and graduate researchers, conducted a randomized simulation study to examine how methods of handling clothing affect the time required for defibrillation by lay rescuers using an Automated External Defibrillator (AED). The results revealed a significant difference in time depending on the method used.
The findings were published in the European Resuscitation Council's international journal, Resuscitation Plus, on March 13, 2026.
■ About the Research
[Research Overview]
Survival rates for cardiac arrest depend heavily on rapid cardiopulmonary resuscitation (CPR) and early defibrillation. Proper placement of AED pads is crucial for effective defibrillation, which requires exposing the chest. It is recommended to remove clothing if it obstructs pad placement.
Although AED kits often include scissors, there has been insufficient evidence regarding whether laypeople can effectively use them to remove clothing and perform defibrillation quickly.
In this study, 40 university students without medical training participated in a simulation of a cardiac arrest scenario. Participants were randomly divided into two groups:
- A group that used scissors to cut the clothing.
- A group that exposed the chest by lifting or removing clothing without using scissors.
The results showed that the median time from turning on the AED to delivering a shock was 118 seconds for the group using scissors, compared to 91.5 seconds for the group that did not, confirming a statistically significant delay of approximately 24 seconds (p=0.004).
Conversely, there was no significant difference between the two groups regarding the accuracy of AED pad placement. Overall, the accuracy of pad placement was not consistently high, suggesting that errors in placement may occur when AEDs are used by laypeople.
This study is a simulation based on laypeople using an AED alone and does not evaluate procedures performed by medical professionals in emergency settings. Therefore, it does not negate the necessity for trained medical personnel to cut clothing to expose the chest when appropriate.
[Researcher Comment]
◆ Associate Professor Kentaro Omatsu, Department of Emergency Medical Services
While operating an AED itself is not difficult if one follows the voice guidance, removing clothing can be a very challenging task for those without training. Although scissors are often included in AED kits, using unfamiliar tools can lead to delays in treatment for the general public. We need to consider how to teach clothing management and the use of tools like scissors in AED training programs.
[Original Paper Information]
Kentaro Omatsu, Reishin Matsuyama, Neneka Kamitani, Genjiro Muro, Azusa Tsunemoto, Gen Toyama, Eiji Hori, Yutaka Takei. Effect of patient clothing removal with scissors on time to defibrillation by lay rescuers: A randomized controlled simulation trial. Resuscitation Plus. 28: 101281. 2026.