Women are less likely to undergo cardiopulmonary resuscitation than men. Training on breast mannequins could be helpful

If someone’s heart suddenly stops beating, this may have happened minutes of life. Performing cardiopulmonary resuscitation may augment their chances of survival. Cardiopulmonary resuscitation keeps blood pumping, delivering oxygen to the brain and vital organs until specialized treatment arrives.

However, research shows that bystanders are less likely to intervene to perform cardiopulmonary resuscitation if the person is a woman. AND latest Australian study analyzed 4,491 cardiac arrest cases between 2017 and 2019 and found that bystanders were more likely to perform CPR on men (74%) than on women (65%).

Could this be partly because CPR training mannequins (so-called dummies) do not have breasts? Our new research we looked at mannequins available around the world to train people to perform CPR and found that 95% of them were flat-chested.

Anatomically, breasts do not change the cardiopulmonary resuscitation technique. However, they can influence whether people try to do so – and hesitation at these key moments could mean the difference between life and death.

Differences in heart health

Cardiovascular diseases – including heart disease, stroke and cardiac arrest – are the most common diseases main cause of death for women around the world.

But if a woman goes into cardiac arrest outside the hospital (meaning her heart stops pumping air properly), that’s actually what happens. 10% less likely receive cardiopulmonary resuscitation than a man. Women too less likely survive cardiopulmonary resuscitation and are at greater risk of brain damage following cardiac arrest.

These are just some of the many health inequalities experienced by women, as well as transgender and non-binary people. Compared to men, their symptoms they are more likely to be rejected or misdiagnosed, or it may take longer to receive a diagnosis.

Reluctance of the witness

There is also growth evidence women are less likely to start cardiopulmonary resuscitation compared to men.

This may be partly due to the concerns of those being accused of sexual harassmentworry may cause damage (in some cases based on the belief that women are more “breakable”) and discomfort associated with touching women’s breasts.

Bystanders can also get into trouble recognition the woman has a cardiac arrest.

Even in simulated scenarios, researchers found that interveners were less likely to remove women’s clothing prepare for resuscitationcompared to men. And there were women less likely to receive Cardiopulmonary resuscitation or defibrillation (an electrical charge to restart the heart) – even if the training was in the form of an online game that did not require touching anyone.

There is evidence of how people behave in resuscitation training scenarios reflects what they do in real emergency situations. This means it is extremely significant to train people to recognize cardiac arrest and prepare for intervention, regardless of gender or body type.

Attached to men’s bodies

Very Cardiopulmonary resuscitation training resources depict male bodies or do not specify gender. If bodies do not have breasts, it is a male default.

For example, the year 2022 test looking at CPR training in North, Central, and South America, it was found that the majority of available mannequins were white (88%), male (94%), and slim (99%).

This research reflects what we see in our work when we train other healthcare professionals to perform cardiopulmonary resuscitation. We noticed that all the mannequins available for training are flat chested. One of us (Rebecca) had difficulty finding training mannequins with breasts.

Single mannequin with breasts

Our new research we checked what cardiopulmonary resuscitation mannequins are available and how diverse they are. In 2023, we identified 20 cardiopulmonary resuscitation mannequins in the global market. Mannequins are usually torsos without a head and without arms.

Of the 20 available, five (25%) were sold as “female”, but only one of them had breasts. This means that 95% of available CPR training mannequins were flat-chested.

We also looked at other diversity characteristics, including skin tone and larger bodies. We found that 65% had more than one skin tone available, but only one had a larger body. Further research is needed on the impact of these aspects on bystanders when performing CPR.

Breasts do not change cardiopulmonary resuscitation technique

Cardiopulmonary resuscitation technique does not change when someone has breasts. The barriers are cultural. And although you may feel uncomfortable, starting cardiopulmonary resuscitation as soon as possible can save your life.

Signs that someone may need cardiopulmonary resuscitation include not breathing properly or completely or not responding to you.

Perform effective cardiopulmonary resuscitationyou should:

• place the heel of your hand in the center of your chest

• place your second hand on top of the first and interlace your fingers (keep your arms straight)

• press firmly to a depth of about 5 cm before releasing

• press your chest with a frequency of 100-120 beats per minute (you can sing a song) in your head to support you keep time!)

What about a defibrillator?

You don’t have to remove someone’s bra to perform CPR. But you may need to do so if a defibrillator is required.

AND defibrillator is a device that uses an electrical charge to restart the heart. An underwired bra may cause minor skin burns when the debrillator pads apply an electrical charge. However, if you can’t take your bra off, don’t let it delay your care.

What should change?

Our research highlights the need for a wide range of breast CPR training mannequins, as well as a variety of body sizes.

Training resources need to better prepare people to intervene and perform CPR on people with breasts. We also need greater education on the risk of developing and dying from heart disease in women.