Korea's updated CPR guidelines say bra removal unnecessary for defibrillator use
Published: 30 Jan. 2026, 11:50
![Lee Chang-hee, a professor of emergency medical services at Namseoul University, demonstrates how to attach automated external defibrillator pads without removing a woman’s undergarments, in line with the revised cardiopulmonary resuscitation guidelines, on Jan. 29. [YONHAP]](https://koreajoongangdaily.joins.com/data/photo/2026/01/30/5443db26-8649-446d-804d-8fade8c89b7c.jpg)
Lee Chang-hee, a professor of emergency medical services at Namseoul University, demonstrates how to attach automated external defibrillator pads without removing a woman’s undergarments, in line with the revised cardiopulmonary resuscitation guidelines, on Jan. 29. [YONHAP]
Korea’s updated cardiopulmonary resuscitation (CPR) guidelines released on Thursday now tell rescuers not to remove an unresponsive woman’s undergarments when using a defibrillator, a change aimed at boosting automated external defibrillator (AED) use.
The revised guidelines, announced by the Korea Disease Control and Prevention Agency (KDCA) and the Korean Association of Cardiopulmonary Resuscitation, reflects the latest domestic and international research as well as input from 16 professional organizations, building on the previous revision issued in 2020. Experts reviewed international CPR consensus statements and related studies to formulate the recommendations.
In the basic life support section, the guidelines propose that emergency call handlers actively instruct callers on how to use AEDs in order to increase defibrillator use rates.
AED use has been shown to be lower for female cardiac arrest patients, partly due to concerns about physical contact. To address this, the new guidelines recommend adjusting undergarments, such as bras, rather than removing them, and attaching AED pads directly to the bare chest while avoiding breast tissue.
Specifically, rescuers are advised to move the undergarment aside and place one pad between the right collarbone and the nipple, and the other on the left side of the chest.
Lee Chang-hee, a professor at Namseoul University who participated in drafting the revisions, said experiments showed that “not removing undergarments did not significantly affect pad placement or the effectiveness of the electrical shock.”
![Lee Chang-hee, a professor of emergency medical services at Namseoul University, demonstrates the two-thumb encircling hands technique for infant chest compressions in accordance with the revised cardiopulmonary resuscitation guidelines on Jan. 29. [YONHAP]](https://koreajoongangdaily.joins.com/data/photo/2026/01/30/b4f6415a-8abe-445b-af0c-675cbd18c25a.jpg)
Lee Chang-hee, a professor of emergency medical services at Namseoul University, demonstrates the two-thumb encircling hands technique for infant chest compressions in accordance with the revised cardiopulmonary resuscitation guidelines on Jan. 29. [YONHAP]
The standard CPR sequence generally begins with chest compressions. However, for cardiac arrest caused by drowning, the guidelines state that conventional CPR including rescue breathing should be performed. Rescuers without ventilation training are advised to provide chest-compression-only CPR, while trained emergency medical personnel should begin with rescue breathing.
For infants under one year old, previous guidelines recommended the two-finger compression method for a single rescuer and the two-thumb encircling technique for two or more rescuers. The revised guidelines now recommend the two-thumb encircling method regardless of the number of rescuers.
The KDCA said that the two-thumb method allows for more consistent compression depth and force and reduces finger pain and fatigue.
If an infant’s airway is blocked by a foreign object, abdominal thrusts are not recommended due to the risk of internal injury. The revised guidelines add palm-heel thrusts to the existing recommendations of back blows and chest thrusts, both to be administered five times each.
“We hope these revisions will expand CPR performance by the public and improve survival rates for cardiac arrest patients,” KDCA Commissioner Lim Seung-kwan said. He added that the agency will actively inform relevant institutions and the public of the changes and ensure they are fully reflected in CPR education materials and on-site practice.
The revised guidelines are available for download on the KDCA website.
This article was originally written in Korean and translated by a bilingual reporter with the help of generative AI tools. It was then edited by a native English-speaking editor. All AI-assisted translations are reviewed and refined by our newsroom.
BY HYEON YE-SEUL [[email protected]]
with the Korea JoongAng Daily
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