[Niigata University of Health and Welfare] 24-Second Difference in Delivering Electric Shock: "Cutting" vs. "Lifting" Clothing When Using an AED – A Study Simulating AED Use by the General Public

A research group at Niigata University of Health and Welfare—including Associate Professor Kentaro Omatsu, Lecturer Gen Toyama, Professor Yutaka Takei, fourth-year students Reishin Matsuyama, Neneka Kamitani, Genjiro Muro, and Azusa Tsunemoto, and graduate student Eiji Hori—conducted a randomized simulation study assuming a scenario where a member of the general public uses an AED (Automated External Defibrillator). The study examined the impact of different clothing removal methods on the time taken to perform defibrillation (electric shock). The results revealed that the method of handling clothing creates a difference in the time until defibrillation is delivered.

The results of this research were published in the European Resuscitation Council's international journal, "Resuscitation Plus," on March 13, 2026.

■ About the Research

【Research Overview】

The survival rate for cardiac arrest depends heavily on rapid cardiopulmonary resuscitation (CPR) and early defibrillation. Placing AED pads in the correct position is crucial for effective defibrillation, which requires exposing the chest. It is recommended to remove clothing if it obstructs pad placement.

However, although AEDs are often equipped with scissors, there has been insufficient knowledge regarding whether the general public can appropriately use scissors to remove clothing and perform defibrillation quickly.

In this study, 40 university students who had not received medical-professional-level resuscitation training participated in a simulation of a cardiac arrest scenario encountered by a layperson. 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 moving the clothing aside without using scissors.

The results showed that the time from turning on the AED to delivering the shock was a median of 118 seconds for the group using scissors, and 91.5 seconds for 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 that errors in placement may occur to a certain extent when AEDs are used by the general public.

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

【Researcher Comments】

◆ Associate Professor Kentaro Omatsu, Department of Emergency Medical Services

"While the AED itself is not difficult to operate if you follow the voice guidance, removing clothing can be a very difficult task for those without training. AED kits often include scissors for cutting clothing, but for the general public, operating unfamiliar tools can lead to delays in treatment. We need to consider how to teach the handling of clothing and the use of tools like scissors within 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.

https://doi.org/10.1016/j.resplu.2026.101281

【Researcher Information】

Niigata University of Health and Welfare, Faculty of Medical Technology, Department of Emergency Medical Services

Associate Professor Kentaro Omatsu

【Inquiries】

Niigata University of Health and Welfare, Admissions and Public Relations Department, Public Relations Division

Address: 1398 Shimami-cho, Kita-ku, Niigata City, Niigata Prefecture

TEL: 025-257-4459

【Niigata University of Health and Welfare】 https://www.nuhw.ac.jp/

As one of the few comprehensive medical universities in Japan, we consist of 6 faculties and 16 departments covering nursing, medicine, rehabilitation, nutrition, sports, welfare, and medical IT. By maximizing the advantages of being a comprehensive medical university, we enable students to practically learn "team medical care," which is essential in clinical settings. Additionally, we have established an organizational system for qualification acquisition and career support across the entire university, achieving top-class national examination pass rates and high employment records nationwide. Furthermore, leveraging our environment as a university with sports-related departments, we develop learning that integrates sports with medicine, rehabilitation, and nutrition.

＜About the NSG Group＞

The NSG Group is a corporate group consisting of 101 legal entities that develop a wide range of businesses, including health and sports, construction and real estate, food and agriculture, trading companies, advertising agencies, ICT, hotels, apparel, beauty, human resources services, and entertainment, with education and medical/welfare/nursing care businesses at its core. Aiming to make each region the "wealthiest and happiest town in the world," we are working from a private-sector standpoint to create businesses that revitalize local communities, based on the keywords of "people," "peace of mind," "work," and "attractiveness."

＜NSG Group Website＞
https://www.nsg.gr.jp/