Casualty related

• GTN patches are explosive and should be removed prior to defibrillation; transdermal patches or ointments may redirect energy away from the heart.

• If the patient has a pacemaker, the relevant paddle should be placed at least 12-15 cm from the device (Resuscitation Council UK 2000a).

• Ensure that there is no direct contact between defibrillation paddles and external pacing wires. Body jewellery, metal objects and medallions must be removed from the chest (Liddle et al. 2003).

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