Bystander CPR, which is performed by someone who witnesses a cardiac arrest emergency, is simple and easy to do. At minimum, you just need to push hard and fast on the center of the chest. However, unfortunately, the odds of receiving bystander CPR are 27% lower for women than for men.
Why Women Receive Less CPR
There are several common questions and misconceptions about performing CPR on women that may contribute to these disparities, including:
Will you hurt or assault a woman by performing CPR?
- It is important to remember that, when someone suffers cardiac arrest, their heart suddenly stops beating properly. They are essentially dead and it is not possible to cause further harm by performing CPR or using an AED.
- While CPR can lead to injuries ranging from bruises to broken ribs, the worst and most harmful thing you can do is nothing. Without immediate CPR and treatment from an AED, victims of Sudden Cardiac Arrest will die.
- Good Samartian Laws in all 50 States help provide protection for rescuers that perform CPR (or use an AED) in an effort to save a life. Therefore, there are legal protections for individuals who take action and administer CPR to a person in need.
Do breasts get in the way of CPR?
- Chest compressions during CPR require that you push down on the center of the chest (see below for how to perform CPR) and therefore touch the breasts if the patient has breasts. Breasts, however, do not “get in the way” or present a barrier to performing effective CPR. The presence of breasts should never prevent an individual from administering lifesaving chest compressions.
- The technique required to perform CPR is the same for all adult body types. CPR instructor Tammy Turner, who is an advocate for teaching CPR using manikins representing diverse bodies, empowers her students to “look[…] at the person and not the parts.”
Is it appropriate to give a woman CPR in public?
- Yes, it is appropriate! There is a taboo against exposing the chest of person with breasts in public. However, when it comes to Sudden Cardiac Arrest, it is critical to push against this taboo and take the necessary action to save lives by administering CPR.
- As Dr. Sarah Perman at the University of Colorado School of Medicine states, “providing this lifesaving procedure for women should be normalized, and not sexualized.”
Are women at risk of Sudden Cardiac Arrest?
- Yes, women of all ages can suffer from cardiac arrest. It can even happen to young people. Understanding that both women and young folks can experience cardiac arrest is important in preparing to respond and save lives for everyone.
Alongside these questions and misconceptions, current CPR training practices may also contribute to women receiving less CPR. In particular, almost all CPR training manikins are flat-chested. Most students do not learn how to perform CPR on manikin torsos with breasts and, therefore, may be less prepared to respond to a patient with breasts. Dr. Audrey Blewer, a leader in resuscitation research at the Duke University School of Medicine, elaborates on the issue of CPR training manikins.
"Gender disparities likely result from a variety of sources, including previous bystander CPR training. Up until a few years ago, most every manikin that people were trained on were these half-torso manikins with the male anatomy. That’s what people are being exposed to rather than discussing or even seeing the female torso with breasts. While CPR training and education is critical, it is also important to raise awareness about these known gender disparities with the lay public. These disparities potentially show our gender biases as a society. The more we can do to address public awareness and change both training and messaging will really make a difference in the future to improve outcomes from sudden cardiac arrest."
Dr. Audrey Blewer.
Duke University School of Medicine
Innovation Promotes CPR for Women
The Womanikin, created by JOAN in partnership with the United States of Women, is a t-shirt-like attachment with breasts that is slipped over traditional, flat-chested CPR training manikins. The goal of this CPR manikin is to encourage people to provide CPR to individuals with breasts. With this attachment, the United States of Women hopes to challenge outdated education and drive gender equality in resuscitation.
Avive Solutions Inc. shows a similar commitment to gender equality. The graphics on Avive’s next-generation defibrillator intend to directly combat gender disparities among CPR recipients.
"Our mission is to significantly increase survival rates from cardiac arrest, and part of that is being intentional about combating disparities in resuscitation through our product design. In this case, during early user testing of our product, we observed that untrained bystanders slowed their response, and were overall more hesitant, when responding to a woman in cardiac arrest. In an effort to remove barriers and encourage gender equality, we made one small, yet impactful, design decision to develop the first AED with electrode pad graphics that depict breasts."
Avive Solutions Inc.
Avive similarly draws upon research showing that those wearing bras are less likely to receive effective AED treatment. A 2015 study conducted by Canadian psychologists at the Universities of Laval and Calgary found that only 42% of participants removed the manikin’s bras as required for proper AED use. Avive recognizes these disparities and will be the first AED unit to audibly instruct responders to “expose the patient’s bare chest, including bra” in their next-generation defibrillator.
How to Perform CPR On Women
Finally, knowing about these gender disparities, it is important to learn how to save lives for everyone. CPR technique is the same for all adult body types. Performing CPR is no different or more challenging if the patient has breasts. There are three basic steps for saving a live of someone experiencing cardiac arrest: Call, Push, and Shock!
CALL – Step 1: Recognize Sudden Cardiac Arrest & Call 911
If you see someone suddenly collapse and they are not responsive and not breathing normally OR if you find someone who is not responsive and not breathing normally, immediately activate the emergency response system by calling 911. While you are calling 911, begin hands-only CPR and request that someone else retrieve an Automated External Defibrillator (AED).
PUSH – Step 2: Perform Hands-Only CPR
Perform hands-only CPR by pushing hard and fast on the center of the chest. See below for graphics depicting how to perform the following CPR steps:
- Place the heel of one hand on the center of the person’s chest.
- Place the heel of the other hand on top of the first hand, lacing your fingers together.
- Position your body so that your shoulders are directly over your hands. Keep your arms straight.
- Push hard and fast. Compress the chest at least 2 inches deep at 100-120 compressions per minute (or to the beat of one of these songs!)
- Perform chest compressions until emergency medical services arrive.
- Pro Tip: CPR can be tiring, so if there is another responder present, take turns! Just make sure the patient is constantly receiving high-quality chest compressions.
SHOCK – Step 3: Use an AED to Restart the Heart
Follow the audio and visual AED instructions to safely deliver a lifesaving defibrillation shock. See step-by-step instructions for how to use an AED below!