From the American Heart Association
"The AHA Basic Life Support course recommends that rescuers do not need to remove a person’s jewelry as long as it does not come into contact with the AED pads. Pad placement recommendations can be found in the 2020 AHA Guidelines for CPR and ECC.
Early defibrillation and CPR is the key to survival. No evidence exists to show that it is necessary to remove the metal items (jewelry) from a person’s chest.
As a reminder, if a cardiac arrest victim has an implanted medical device, you should not place a pad directly on top of any metal item on the victim’s chest. You should place the pads at least one inch away because the patch may block delivery of energy from the electrode pad to the heart. This also applies to clothing/undergarments.
Both adult and pediatric electrodes come packaged with simple graphics showing placement that will optimize the delivery of current. Electrode placement may vary by manufacturer, therefore, a rescuer should review the electrode's instructions before placing the pads. Alternative pad positions may be considered based on individual patient characteristics. The use of self-adhesive defibrillation pads is probably the best way to minimize the risk of sparks igniting during defibrillation. If manual paddles are used, gel pads are preferable to electrode pastes and gels because the pastes and gels can spread between the two paddles, creating the potential for a spark. Placing the pads over the metal object will not cause harm to the provider."
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