Most CPR manikins have no breasts, which contributes to women being less likely to receive life-saving first aid from bystanders, a study has found.
The study led by Dr Rebecca Szabo, head of the Gandel Simulation Service at the Royal Women’s Hospital in Melbourne, analyzed all manikin models on the global market designed for cardiopulmonary resuscitation training for adults.
Of the twenty different manikins, the researchers found that all had a flat torso, with only one model having a chest overlay. Eight were identified as male and seven had gender unspecified.
The study, published in the journal Health Promotion International, highlights the findings as an equality issue with implications for the economy human right to health.
Australian research published in June found women are less likely to receive life-saving resuscitation after cardiac arrest and are less likely to survive.
A study by St John Ambulance in Britain, published in October, found that women who suffer cardiac arrest in public are less likely than men to receive chest compressions from bystanders because people are “worried about their breasts being touched”. The study suggested that “unequal outcomes for women after cardiac arrest may occur in CPR training and CPR manikin design, related to implicit bias.”
Szabo, an obstetrician and gynecologist, began her research when she couldn’t find resuscitation manikins with breasts to train health care workers in life support for maternal cardiac arrest during pregnancy. She was concerned because the Delta Covid-19 wave in Melbourne in 2021 led to sicker patients and more ICU admissions.
“We ended up buying a boob plate online,” Szabo said. “It is similar to what a drag queen would wear and passes as a singlet. We put that on our manikin.”
Szabo said CPR technique for women is no different, and that training on manikins representative of both genders can “help people feel more comfortable … being confronted with a bra, breasts and something else” in a real emergency .
Breasts can also affect how defibrillator electrodes are applied, especially if there are breast implants or larger breasts, she said.
Although worse CPR outcomes for women are well documented, “our study nevertheless shows that little has changed in the diversity of available CPR training manikins worldwide,” Szabo said.
“Our study is the first of its kind to call this a gender and human rights issue, linking it to business human rights and the commercial determinants of health.”
The study authors urged CPR training providers and manufacturers to commit to improving the diversity of CPR training manikins, which they say should be the responsibility of those organizations.
“Governments, manufacturing companies, training institutions and those of us who purchase and use these important training products all play an important role in addressing this important issue that can improve outcomes for women,” said Szabo.
She said this is in line with the aims of the National Women’s Health Advisory Council, chaired by Australian Assistant Minister for Health Ged Kearney, “to tackle ‘medical misogyny'”, on a range of key issues including heart – and vascular diseases.
Prof Bronwyn Graham, national director of the Center for Sex and Gender Equity in Health and Medicine, which was opened in March by the George Institute for Global Health, said: “Szabo and colleagues’ findings are emblematic of widespread bias in health and medical ecosystem that has resulted in healthcare practices being optimized for the white male body; with harmful and sometimes fatal consequences for anyone who does not fit into this scheme.”
“It highlights the critical need for regulators at all stages of the health and medical pipeline – from basic research to the tools used to train healthcare providers – to implement policies that mandate a focus on sex and gender,” said them.
“Without such policies, these often insidious biases will persist, and we will continue to endanger the lives of women and girls and other marginalized sex and gender groups (including those with variations in sex characteristics, transgender and gender diverse people). daily damage.”