[Niigata University of Health and Welfare] AED Use: 'Cutting' vs. 'Lifting' Clothing Creates a '24-Second Difference' in Delivering Electric Shock - Research Assumes AED Use by the General Public

A research group led by Associate Professor Kentaro Omatsu, former lecturer Gen Toyama, Professor Yutaka Takei, and fourth-year students Reishin Matsuyama, Neneka Kamitani, Genjiro Muro, Azusa Tsunemoto from the Department of Emergency Medical Care at Niigata University of Health and Welfare, along with graduate student Eiji Hori, conducted a randomized simulation study assuming a scenario where the general public uses an AED (Automated External Defibrillator). They examined the impact of clothing handling methods on the time to defibrillation (electric shock). The results revealed that the method of handling clothing creates a difference in the time to defibrillation.

These research findings were published on March 13, 2026, in the international journal 'Resuscitation Plus' by the European Resuscitation Council.

■About the Research

【Research Overview】

Survival rates from cardiac arrest largely depend on prompt cardiopulmonary resuscitation and early defibrillation. Applying AED pads in the correct position is crucial for effective defibrillation, which requires exposing the chest. When clothing obstructs pad placement, removing the clothing is recommended.

However, while AEDs often come with scissors, there has been insufficient knowledge regarding whether the general public can appropriately remove clothing using scissors and perform defibrillation quickly.

In this study, 40 university students who had not received resuscitation education at a healthcare professional level participated in a simulation assuming a scenario where the general public encounters cardiac arrest. Participants were randomly divided into two groups:

• Method of cutting clothing using scissors

• Method of exposing the chest by lifting clothing without using scissors

The results showed that the time from turning on the AED to delivering defibrillation was a median of 118 seconds for the group that used scissors and 91.5 seconds for the group that did not, indicating a delay of approximately 24 seconds based on statistical estimation (p = 0.004).

On the other hand, no significant difference was observed between the two groups in the accuracy of AED pad placement. Furthermore, the overall accuracy of pad placement was not necessarily high, suggesting that errors in pad placement may occur to some extent when the general public uses an AED.

This study is a simulation research assuming a scenario where the general public uses an AED alone and does not evaluate procedures performed by healthcare professionals at emergency scenes. Therefore, it does not negate the necessity of trained healthcare professionals cutting clothing to expose the chest.

【Researcher's Comment】

◆ Kentaro Omatsu, Associate Professor, Department of Emergency Medical Care

AEDs themselves are not difficult to operate by following voice guidance, but removing clothing can be a very challenging task for untrained individuals. While AED kits often include scissors for cutting clothing, the operation of unfamiliar tools by the general public can lead to delays in treatment. It is necessary to consider how to teach the handling of clothing and the use of scissors and other tools 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 with scissors versus lifting on the time to defibrillation by lay rescuers using an AED: A randomized simulation study. Resuscitation Plus. 2026;26:100410.