[Niigata University of Health and Welfare] '24-Second Difference' in Delivering Defibrillation Between 'Cutting' and 'Pulling Up' Clothes: A Study Simulating AED Use by Laypersons

A research group including Associate Professor Kentaro Omatsu, Lecturer Gen Toyama, Professor Yutaka Takei, 4th-year students Reishin Matsuyama, Neneka Kamitani, Genjiro Muro, Azusa Tsunemoto, and graduate student Eiji Hori from the Department of Paramedicics at Niigata University of Health and Welfare, conducted a randomized simulation study simulating a scenario where a layperson uses an AED (Automated External Defibrillator). They examined the impact of the clothing removal method on the time to deliver defibrillation (electric shock). The results revealed a difference in the time to defibrillation depending on how the clothing was handled.

This research finding was published in the international journal "Resuscitation Plus" by the European Resuscitation Council on March 13, 2026.

■ About the Research
[Research Overview]
The survival rate of cardiac arrest heavily depends on prompt cardiopulmonary resuscitation and early defibrillation. Applying AED pads to the correct position is crucial for effective defibrillation, requiring the chest to be exposed. If clothing interferes with pad placement, removing the clothing is recommended.

However, while AEDs often come with scissors, there was insufficient knowledge regarding whether laypersons could appropriately remove clothing using scissors and perform rapid defibrillation.

In this study, a simulation was conducted involving 40 university students who had not received resuscitation education at the level of medical professionals, simulating a scenario where a layperson encounters cardiac arrest. Participants were randomly divided into two groups and used an AED by either:

• Cutting the clothes using scissors
• Exposing the chest by pulling up the clothes without using scissors

As a result, the time from turning on the AED to defibrillation was a median of 118 seconds in the group that used scissors, and 91.5 seconds in the group that did not, confirming a statistically estimated delay of approximately 24 seconds (p = 0.004).

On the other hand, no significant difference was observed between the two groups regarding the accuracy of AED pad placement. Furthermore, the overall accuracy rate of pad placement was not necessarily high, indicating the possibility that a certain degree of placement error occurs when laypersons use AEDs.

This study is a simulation simulating a situation where a layperson uses an AED alone, and it does not evaluate emergency treatments performed by medical professionals. Therefore, it does not deny the necessity for trained medical professionals to cut clothing to expose the chest.

[Researchers' Comments]
◆ Associate Professor Kentaro Omatsu, Department of Paramedicics
Operating an AED itself is not difficult if you follow the voice guidance, but removing clothing can become an extremely difficult task if you are untrained. AED kits often include scissors to cut clothing, but operating unfamiliar tools can lead to delays in treatment for laypersons. We need to consider how to teach the handling of clothing and the use of tools like scissors in AED education.

[Original Paper Information]
Kentaro Omatsu, Reishin Matsuyama, Neneka Kamitani, Genjiro Muro, Azusa Tsunemoto, Gen Toyama, Eiji Hori, Yutaka Takei. Effect of patient clothing removal wi