Where should the second pad be placed in the anterolateral configuration?

In the anterolateral configuration for placing pads during an automated external defibrillator (AED) application, the second pad should indeed be placed to the side of the left nipple. This positioning is key as it allows the electrical current from the defibrillator to effectively travel through the heart in a diagonal path, facilitating the optimal delivery of a shock if needed. Proper pad placement ensures that the device is able to analyze the heart's rhythm accurately and deliver the shock in a way that maximizes the chances of restoring a normal rhythm.

Other placements, while they may seem plausible, do not provide the same efficacy. For example, placing a pad on the right side of the upper chest or in the center of the abdomen would not create the correct electrical pathway necessary for effective defibrillation. Similarly, placing a pad at the back above the left shoulder would fail to create the appropriate contact points needed for analyzing the heart's rhythm or delivering a shock.