How to ensure women get equal access to CPR

The whole subject of CPR on women has been problematic for a while.

So it was great to see the issue being address directly at the recent NIFAT conference in Adelaide.

The theme of “they’re boobies not barriers” is a great one because it focuses on the key reason why women are less likely than men to receive CPR when they really need it.

Studies show that women are around 10% less likely to receive CPR when they need it compared to men. These figures are worse when the incident occurs in a public place and the CPR needs to be delivered by a passerby.

And the figures for women receiving AED treatment vs men are even worse with only half the number of women who require it receiving it compared to men.

This is unfortunate but understandable. However the problem can be fixed by addressing the misunderstandings surrounding it.

Bystander hesitancy to deliver CPR affect women most

There is also some available research to show that bystanders can be reluctant to administer ANY first aid, let alone CPR, to any stranger, even if they are trained.

COVID had an impact on this with some people still having a residual hesitancy of touching strangers.

Also some people are worried about legal ramifications if their attempts at providing first aid or CPR go wrong or fail. Could they be sued for example?

In this environment you can easily understand why a male bystander who sees a female stranger in need of CPR having some reluctance to touch the woman on her chest, which is exactly where he needs to go in order to deliver CPR.

“What if I get accused of sexual assault?” might be the thought in the back of the person’s mind.

While this might seem reasonable, the reality is this, if you think about it. What woman, whose life you have just saved by administering her the vital CPR she needed is really going to worry that you touched her breasts? She will just be glad to be alive!

But also there are Good Samaritan Laws in Australia that protect someone attempting to help a stranger in distress or need. Provided you are trying to do the right thing with the right intentions the law will protect you.

How to apply CPR to a woman – compress her chest not her breasts

The simple truth is that you apply CPR to a woman in exactly the same way as you do to a man.

The whole point is to compress the chest. You press down directly on the lower half of the breast bone.

For a woman who will be lying on her back this means there is very little difference between what you do to her and a man.

YOU DO NOT NEED TO REMOVE HER BRA FOR CPR.

And since you will be pressing down in the middle of her chest you will have very little contact with her breasts as these tend to separate away from the middle of her chest when she’s laying on her back.

So just follow standard CPR procedure. And don’t worry about the fact she is a woman.

Additional confusion around using AEDs on women

Modern AEDs are very simple to use. They tend to have vocal instructions and diagrams on them that tell you exactly what to do.

Where to place the pads and when to push the buttons, all this is simple and straightforward.

Generally when using an AED on a man, there are no additional confusions. You peel off the backing of the pads and place them where indicated.

But it’s understandable that when it comes to a woman, a lot of people, especially males, might be confused as well as reluctant to use one on a woman, especially if she is a complete stranger.

What do I do about her bra? Do I place the pad under her breast or on top of it? Can I touch her breasts to move them out of the way?

You can see the confusion.

The good news is that the answer is simple. You place the pads in exactly the same position as you would for a man.

One goes on the upper right part of the chest, below the collarbone and to the right of the breastbone.

The other one goes on the lower left side of the chest ribs, positioned to the SIDE of or UNDERNEATH the left breast.

Like with men, the pads must be adhered DIRECTLY to the SKIN.

So that means ANY clothing in the way must be removed, cut or torn away as needed or at least moved out of the way, including her bra and/or any top, shirt or upper part of her dress.

So just like you might have to rip open a man’s shirt or tear his T-shirt, the same applies to a woman.

If she has a bra on, and it is IN THE WAY remove it. If it is NOT IN THE WAY and you can still easily place the pad in direct contact with her skin, then you do NOT need to remove the bra.

And make sure you place the pad UNDER her breast, especially if it is large. AED pads placed on top of the breast will not work.

Remember if you save a woman’s life she is NOT going to be upset you ruined her bra or tore her favourite dress.

Do not let modesty get in the way of saving someone’s life.

So the key thing to remember are that you will NOT get in trouble attempting CPR on a woman. If it saves her life she will only be thankful.

For CPR treat her chest the same as a mans and go for the centre breastbone for compressions. Leave her bra in place and don’t worry about her breasts.

For AED ensure the side pad goes UNDER the left breast and not onto clothing including her bra. Remove any clothing necessary in the area that is IN THE WAY including her bra.

As the new saying goes “Remember they are boobies not barriers”. And let’s make sure women get the life-saving CPR and AED treatment they need.

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