Why women are less likely to receive CPR or survive cardiac arrest

Why are people with breasts less likely to receive CPR?

• Fear – people do not want to be accused of inappropriately touching someone.
• Personal objections – people may be uncomfortable having to touch someone’s breasts.
• Misleading information – because women may experience different/atypical signs and symptoms of a heart attack and so may not recognise that they are experiencing a heart problem. Consequently there may be a delay in contacting the emergency services.
• Religious and cultural sensitivities may make it appear inappropriate for a man to touch a woman.
• A misguided belief that women are more fragile and a man could do harm pushing on their chest when giving CPR.

How does this affect survival rates?

Statistically women are less likely to experience cardiac arrest than men. However they have a higher mortality rate from cardiac arrest. This is directly linked to unequal care given to men and women who are unconscious and not breathing and delays and reticence from the general public giving CPR to someone with breasts.

Men are 73% likely to receive bystander CPR, compared to 68% for women. Without immediate treatment a casualty will not survive cardiac arrest. This is why it is vital we break the fear and stigma around giving people with breasts CPR.

Education is key to redressing the balance?

Giving chest compressions and using an AED will require opening or cutting away someone’s clothing or removing a bra to reach the centre of their chest and to apply AED pads. This can be done sensitively and professionally and it should be extremely obvious that the sole reason for acting in this way is in order to save someone’s life. Even though you may feel uncomfortable doing this, it will give the person the best chance of survival. It is vital.

Adults with a Cardiac Arrest generally retain 3 or 4 minutes worth of residual oxygenated blood in their system. If someone is pushing hard and fast on their chest, to pump that blood around their body, this can keep their heart and lungs supplied with oxygenated blood for a few minutes and buy them some time.

However, after 3 or 4 minutes (without being given breaths) they will start to run out of oxygenated blood. Therefore, to keep the casualty oxygenated and give them the best chance of survival, the casualty should also receive breaths:

• Place the heel of your hand on the centre of the person’s chest (this may mean that your hands touch some of the breast, this is okay!) then place the other hand on top and press down by 5-6cm at a steady rate of 100 to 120 compressions per minute.
• After every 30 chest compressions, give two rescue breaths.
• Sufficient breaths should be given to inflate the chest.
• Deploy a defibrillator as quickly as possible.

Following a cardiac arrest, every passing minute without CPR or using a defibrillator reduces the chance of survival by up to 10 per cent. Knowing how to perform CPR and use an AED is essential and doing something is always better than doing nothing.