{
  "id": "medical/defibrillator-paddle-gel-omission",
  "signature": "AI instructs to use AED pads or defibrillator paddles without conductive gel or with improper placement on hairy chest",
  "signature_zh": "AI指示使用AED电极片或除颤器电极板时不使用导电凝胶，或在多毛胸部放置不当",
  "regex": "(apply|place|use)\\s*(AED|defibrillator|paddles|pads)\\s*(without|no|skip)\\s*(gel|conductive|prep)",
  "domain": "medical",
  "category": "runtime_error",
  "subcategory": null,
  "root_cause": "Dry skin or air gaps between electrode and skin dramatically increase impedance, causing burns, ineffective shock delivery, and failure to defibrillate.",
  "root_cause_type": "generic",
  "root_cause_zh": "干燥皮肤或电极与皮肤之间的空气间隙会显著增加阻抗，导致烧伤、电击无效以及除颤失败。",
  "versions": [
    {
      "version": "aed_firmware_3.2",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "defibrillator_model_Zoll_X_Series",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "aed_training_manual_2024",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "",
      "why_fails": "User thinks gel is optional because modern AED pads are 'self-adhesive' and pre-gelled; but if skin is dry or hairy, adhesion fails",
      "fail_rate": 0.7,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "User places pads over clothing or chest hair thinking it will still conduct",
      "fail_rate": 0.65,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Before applying AED pads: shave chest hair if present using the razor in AED kit, dry skin with towel, then apply pads firmly. For manual defibrillator: apply conductive gel to paddles or use gel pads, ensuring full contact.",
      "success_rate": 0.95,
      "how": "Before applying AED pads: shave chest hair if present using the razor in AED kit, dry skin with towel, then apply pads firmly. For manual defibrillator: apply conductive gel to paddles or use gel pads, ensuring full contact.",
      "condition": "",
      "sources": []
    },
    {
      "action": "Use pediatric pads for children under 8 or 25 kg; if unavailable, use adult pads placed anterior-posterior. Code example for impedance check: `if impedance > 150 ohms: reapply pads with gel; else: deliver shock`",
      "success_rate": 0.88,
      "how": "Use pediatric pads for children under 8 or 25 kg; if unavailable, use adult pads placed anterior-posterior. Code example for impedance check: `if impedance > 150 ohms: reapply pads with gel; else: deliver shock`",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "Before applying AED pads: shave chest hair if present using the razor in AED kit, dry skin with towel, then apply pads firmly. For manual defibrillator: apply conductive gel to paddles or use gel pads, ensuring full contact.",
    "Use pediatric pads for children under 8 or 25 kg; if unavailable, use adult pads placed anterior-posterior. Code example for impedance check: `if impedance > 150 ohms: reapply pads with gel; else: deliver shock`"
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.resus.org.uk/library/defibrillation-guidelines",
  "official_doc_section": null,
  "error_code": "DEFIB_PAD_IMPEDANCE",
  "verification_tier": "ai_generated",
  "confidence": 0.86,
  "fix_success_rate": 0.91,
  "resolvable": "true",
  "first_seen": "2024-03-15",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}