Bystanders More Likely to Perform CPR with Instructions from 911 Operators
Women are less likely to receive CPR than men without 911 intervention
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DURHAM, N.C. – Women are less likely to receive CPR from a bystander than men when stricken with a cardiac arrest outside of a hospital, Duke Health researchers found.
This disparity was eliminated, however, when 911 operators guided an emergency caller through CPR steps, helping ease apprehensions about administering chest compressions to women.
When guided by a 911 operator, bystanders performed CPR on women 44% of the time and on men 40% of the time. Without this guidance, bystander CPR dropped to 9% for women and 11% for men.
The findings were presented at the American Heart Association’s Resuscitation Science Symposium on Nov. 11. Researchers say it offers significant insight into improving the 10% rate of survival for people who experience cardiac arrest outside of a hospital.
“Prompt delivery of CPR doubles a patient's chance of survival from out of hospital cardiac arrest,” said Audrey Blewer, Ph.D., the study’s lead author and assistant professor in the Departments of Family Medicine and Community Health and Population Health Sciences at the Duke University School of Medicine.
“What encourages me from a research standpoint is that there are so many opportunities to increase that number, and that’s really a matter of everybody working together and working towards the chain of survival from cardiac arrest,” Blewer said.
To arrive at the findings, the team examined a database of nearly 2,400 emergency calls for cardiac arrest in North Carolina. They found that CPR was administered in 52% of all calls; of the cases where CPR was performed, 911 operators provided assistance 81% of the time.
The data for this study comes from the RACE CARS Trail, a seven-year collaboration between Duke Clinical Research Institute and other hospitals and emergency medical agencies across North Carolina, funded by the National Institutes of Health, and aimed at improving survival rates for cardiac arrest.
The study builds off previous research where Blewer and her colleagues found women were less likely to receive CPR no matter what neighborhood they were in.
“We know, based off of prior qualitative studies, some of the reasons why people are hesitant to do CPR on women center around the fear of being perceived as touching them inappropriately,” said Blewer.
“There's also that aspect of frailty,” Blewer said, adding that the average age of a person in need of CPR is around 63. “Some women are smaller. There are concerns, especially when the person in need of CPR is elderly, that whoever is performing CPR on them may be breaking the ribs, hurting them, harming them.”
Blewer points to CPR training as another area for potential revision, with the anatomy of the manikin remaining largely the same over the past 30 years. She hypothesizes that training on manikins with breasts may improve CPR delivery for women.
In addition to Blewer, study authors include Konstantin A. Krychtiuk, Harman Yonis, Monique A. Starks, Hayden B. Bosworth, Carolina Malta-Hansen, Stephen Lee Powell, Lisa Monk, Lisa A. Kaltenbach, Hussein R. Al-Khalidi, Steve Vandeventer, Bryan McNally, Sana M. Al-Khatib, Daniel Mark, and Christopher B. Granger.
The study received funding from the RACE-CARS Trial (5UH3HL146935) and BIRCWH (K12AR084231).
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