A woman jogger suddenly collapses in front of you in a park, and there is no one else around. After phon911 on your cell speakerphone you check for breathing for ten seconds-she is not breathing, or only gasping. What you do next depends on whether you are a man, or a woman.
According to a recent survey from the American Heart Association (AHA), men who suffer out-of-hospital cardiac arrest in a public location receive cardiopulmonary resuscitation (CPR) from a bystander 45% of the time. Women, in comparison, receive bystander CPR in only 39% of cases. As a result, men have a 23% higher survival rate [1].
For the last sixty years since CPR training curriculums were first established by the AHA in 1963, instructions have been to remove clothes above the waist before beginning compressions. Now, the recommendation is to leave clothes on for bystanders until the AED (Automated External Defibrillator) is available.
The technique for doing chest compressions on a woman is exactly the same as for a man.
Thankfully, now The American Heart Association (AHA) is taking steps to update education, and awareness to increase survival rates for women with Bystander CPR.
Leaving the clothes on until the AED arrives is less shocking, saves precious time, and adds a layer of protection between the rescuer and the patient until the gloves arrive in the AED rescue kit.
How to find the correct hand-placement for CPR through clothes.
By far the most common mistake observed by AHA instructors is incorrect hand placement for performing compressions. Often times this mistake happens repeatedly even by medical professionals who have been certified many times before. If you are too low on the sternum the tip (Xiphoid Process) will break off, and instead of pumping their heart you would be pumping the liver.
To find the correct hand placement with clothing on, or off, reach across to the opposite side of the person under their armpit and then bring the heal of your hand back a few inches to the center of the chest over the sternum. Try it on yourself and you will see that you can feel the sternum through clothes. If you are unable to feel the sternum through a brassiere, then it would be necessary to remove the clothes.
This technique puts the heel of your hand directly on the sternum over the heart, and when done correctly on a woman your hand will be touching her breast. Knowing this information in CPR training classes could certainly help men understand what to expect, and to help facilitate this awareness, AHA Training Centers/ Sites will be required to have at least one female manikin by June 2025.
Remember to renew your AHA certification every two years, and even if you are not current, ‘Even the worst CPR is better than no CPR’, and any woman would be fine with ‘her life in your hands’.
By Roy Gordon, AHA CPR instructor/EMT Updated Feb 1st 2025
———————————————————Revive CPR 148 Townsend St., San Francisco, CA.
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