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CPR study points to need for better education, experts say

A recent study showing that fewer women receive CPR than men in public points to needed changes in education and training, experts said.

The study, from the Center for Resuscitation Science at Penn Medicine, found that 39 percent of women receive CPR from bystanders in public compared to 45 percent of men.

The researchers looked at more than 19,000 cardiac events using data from a network of regional clinical centers in the United States and Canada. What they found was that, while more men received CPR from bystanders in public, there was little difference in private settings. Thirty-five percent of women and 36 percent of men received CPR at home, according to a Penn Medicine news release.

The researchers did not delve into the possible causes for the disparity, but the center’s director and study’s senior author suggested that it likely has to do with bystanders’ hesitancy to touch or expose a woman’s body.

“Regardless of someone’s gender or how their body is shaped, delivering bystander CPR during cardiac arrest is absolutely critical, as it has been proven to double and even triple a victim’s chance of survival,” Dr. Benjamin Abella, said in the release.

Dr. Shon Chakrabarti, a local cardiologist and board president of the Hampton Roads American Heart Association, told the Daily Press the study is an indication that more needs to be done to empower bystanders and increase their comfort with performing CPR.

It’s our job … as leaders in medicine to, one, recognize these disparities, and, two, do something about it,” Chakrabarti said.

“Maybe we need to have some female mannequins,” he said. “Let’s have some mannequins that have breasts.”

Bystander CPR

Students are taught to remove clothing on a person’s chest area when performing CPR. This is done for a couple of reasons. The pads of an automated external defibrillator, or AED, must be applied directly to skin. But, more importantly, exposing the chest allows the bystander to ensure the hands are placed in the appropriate area, two fingers above the tip of the sternum, where the lower ribs meet.

Some might be uncomfortable exposing a woman’s chest in public, but experts recommend it to ensure compressions are most effective.

“The key to exposing is landmark,” Robert E. Lee, Newport News Fire Department Assistant Chief of EMS told the Daily Press.

It’s especially important with women because the bra could get in the way, making compressions less effective.

“That’s why it’s important to expose for the female perspective,” Lee said.

But the local experts said there are ways to help protect the patient’s privacy. Chakrabarti suggested it’s possible to perform compressions underneath the shirt, as long as it’s loose enough to move freely.

Both experts said the key is making sure the hands are in the correct position and can perform compressions appropriately. On an adult, that’s a rate of about 100 per minute at 2 inches deep.

Chakrabarti said experts are continually looking for ways to help more people become comfortable performing CPR. It’s a skill most people can easily learn, but many still hesitate. Fewer than half of all people who need it receive it, yet it can greatly increase a person’s chance of living after cardiac arrest.

The average survival rate for a person after cardiac arrest is just 10 percent, and only some of those who survive leave the hospital with full neurological function, Chakrabarti said. CPR helps ensure both survival and quality of life.

Compressing the chest circulates blood to the brain and other organs. Students are also trained to give rescue breaths and use an AED, a machine that can restore a normal heart rhythm. But the experts said the compressions are the most important component because it buys time for the patient until normal heart function can be restored.

The American Heart Association offers training in Hands-Only CPR, a less-complicated method for those who are concerned they can’t perform all functions.

A person can go a maximum of 10 minutes without compressions, but often it’s much less, according to Chakrabarti.

“It really is a ticking clock,” he said.

First responders typically give it a widow of six to eight minutes, according to Lee. He stressed that dispatchers can talk a person through performing CPR, so even people who are unsure of their abilities can still do it.

“Even if you’re only willing to do some compressions, that is more beneficial to the patient than not doing anything at all,” he said.

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