Gabriel Weston: Looking out for others
BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l2388 (Published 04 June 2019) Cite this as: BMJ 2019;365:l2388All rapid responses
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Dear Editor,
This recent piece by Weston provided a fantastic reminder of the importance of early cardiopulmonary resuscitation (CPR) and defibrillation, and the gender inequalities present in relation to treatment and outcomes in cardiac conditions. I would like to draw readers attention to another factor in this inequality.
Bystanders may be concerned about performing CPR on a woman, for fear of being accused of sexual assault, or inappropriate touching (Perman et al., 2019), with defibrillator use being hampered by a reluctance to remove clothing which is demonstrated by both male and female rescuers (Kramer et al., 2015)! As clinicians it is vital that we take every opportunity to address this, and other, perceived barriers to undertaking these lifesaving interventions for women. Further education around CPR in women and the use of female manikins may be the first step to addressing this issue.
Perman, S. M., Shelton, S. K., Knoepke, C., Rappaport, K., Matlock, D. D., Adelgais, K., Havranek, E.P. & Daugherty, S. L. (2019). Public Perceptions on Why Women Receive Less Bystander Cardiopulmonary Resuscitation Than Men in Out-of-Hospital Cardiac Arrest. Circulation, 139(8), 1060-1068.
Kramer, C. E., Wilkins, M. S., Davies, J. M., Caird, J. K., & Hallihan, G. M. (2015). Does the sex of a simulated patient affect CPR?. Resuscitation, 86, 82-87.
Competing interests: No competing interests
Re: Gabriel Weston: Looking out for others
In support of Dr Mallinson's response I offer the following experience.
Last month I was the host of a defibrillator familiarisation session held in our Christadelphian Hall. It was led by a Community Defibrillation Trainer from the Yorkshire Ambulance Service. During a lively question and answer session one man in the audience asked if there was a risk of being accused of assault from starting compressions on a woman's chest or exposing skin to attach defibrillator pads. He was assured that this does not happen and it was emphasised that the alternative is the certain death of the woman.
This called to mind the time 50 years ago when I as a teenager attended a youth group's first aid training session. Our instructor recalled the time when he was being trained by the Red Cross. There was a simulated casualty: a woman bleeding from a thigh wound. The students were invited to demonstrate what they would do but hesitated to apply pressure to the bleeding point. "She's bled to death because she's a woman," was the comment from that trainer. After several students had baulked at the issue, the model casualty was told he, for it was he, could get up.
Competing interests: No competing interests