Difference between Males and Females during CPR
In Australia, Females or people with breasts are 27% less likely to receive CPR outside of the Hospital than males, most often because people do not want to potentially touch the chest or breast tissue of a member of the public or are unsure where to do CPR on someone with breast so won't do it.
With a current chance of survival of 10% with all genders, this is an alarming rate.
So, what are the differences between CPR on people with breasts and those without?
The location of compressions.?
With CPR, the location of compression is advised to be the centre of the chest between the nipple line of a patient.
For people with breasts, this nipple line isn't always the right location. With a range of breast sizes or a potential lack of nipples, this is not always achievable. And with the hesitation people have of touching the breast tissue, this can be an issue.
The best way to find the correct location on any patient, no matter the age, size, or gender, is to put your hand under the patient's armpit, then slide the hand across the chest until the heel of the hand is in the centre of the chest. This will give the first aider the most accurate location without looking for the nipple line on a patient.
Applying an Automated External Defibrillator (AED)
The second difference is with exposing a patient's chest when applying an automated external defibrillator or AED to a person's chest. It is well documented that an AED, when a shock is required, can increase a patient's chance of survival by 70%, so it is vital to people in these situations.
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When applying an AED, the patient's chest must be completely exposed, removing all clothing, jumpers, shirts, and even bras. This is where hesitation or lack of action comes into play. It has always been a public norm for males to expose their bare chest and nipples in public, so exposing a male has never come with any hesitation or lack of action. However, with the sexualisation of the female breasts and nipples over the years and their exposure in public being seen as inappropriate, there tend to be more hesitations with exposing women during CPR. This is where we start to see lower survival rates for females and those with breasts. People are afraid to expose the chest due to fear of inappropriate behaviour and potential consequences.?
But we need to remember that a large proportion of females have the same nipples as males but more fatty tissue around them. It is just skin at the end of the day. So, what can we do to change this public perception and improve female CPR rates? When doing first aid treatment on a patient, first aiders are covered by the "Good Samaritan Law" here in Australia, and no one has been successfully prosecuted when giving first aid treatment. So this should not be a deterrent to the public performing first aid.
We can always do our best to protect the privacy or modesty of people requiring first aid treatment. But at the end of the day, this person needs to have the AED applied properly, so removing all clothing and exposing the chest is far more important.
With CPR, no matter who the person is, what sex they are, having breast tissue or lack of it, CPR is always going to be the same: the same location, the same depth, the same rate.?
We need to be confident to push past the bra and past what we think may be inappropriate or sexualised and remember we are trying to save a life. This person needs lifesaving treatment of CPR, and that is what we are doing.?
References
Health and Safety & First Aid Training | CSCS Card & NVQ Support | Quality Manager at GEM
1 年Sad to see and it would be beneficial to have more manikins that have torsos like this to improve peoples perception around CPR on female patients.