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©2013 UpToDate ® Print Email Anterior/apex position of electrode paddles with a supine patient The anterior/apex position is most practical in the emergency setting and is typically used. The paddle or electrode pad held in the rescuer's left hand is placed to the right of the sternum below the clavicle. The paddle or electrode pad held in the rescuer's right hand is placed in the left midaxillary line, lateral to breast tissue, at the level of the nipple. If paddles are used, they must be applied with considerable, firm and steady pressure. Reproduced with permission from: Scarfone RJ, Cho CS. Cardioversion and Defibrillation. In: Textbook of Pediatric Emergency Procedures, 2nd ed, King C, Henretig FM (Eds), Lippincott Williams & Wilkins, Philadelphia 2008. Copyright © 2008 Lippincott Williams & Wilkins. file://www.lww.com