Interaction between bystander sex and patient sex in bystander cardiopulmonary resuscitation for Out-of-Hospital cardiac arrests

Lee, Gyeongmin; Ro, Young Sun; Park, Jeong Ho; Hong, Ki Jeong; Song, Kyoung Jun; Shin, Sang Do

doi:10.1016/j.resuscitation.2023.109797

Cited by 6 publications

(2 citation statements)

References 30 publications

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“…This was based on previous literature 2 ; however, a Korean report found that the gender of the rescuer affected rates of CPR provision where investigators found that women were less likely to provide bystander CPR to men compared with male rescuers. 14 Of note, this study determined that women who were bystanders to a cardiac arrest were primarily in a private location (95.9%), as opposed to rendering aid in a public location. While the authors do uncover an interesting finding, these bystanders are different from those we analyzed in our study, where we clearly described a scenario occurring in a public location (where it can be assumed the victim is unknown).…”

Section: Discussionmentioning

confidence: 88%

Examining the Impact of Layperson Rescuer Gender on the Receipt of Bystander CPR for Women in Cardiac Arrest

Shelton,

Rice,

Knoepke

et al. 2024

Circ: Cardiovascular Quality and Outcomes

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BACKGROUND: Women who suffer a witnessed out-of-hospital cardiac arrest receive bystander cardiopulmonary resuscitation (CPR) less often than men. To understand this phenomenon, we queried whether there are differences in deterrents to providing CPR based on the rescuer’s gender. METHODS: Participants were surveyed using a national crowdsourcing platform. Participants ranked the following 5 previously identified themes as reasons: rescuers are afraid to injure or hurt women; rescuers might have a misconception that women do not suffer cardiac arrest; rescuers are afraid to be accused of sexual assault or sexual harassment; rescuers have a fear of touching women or that their touch might be inappropriate; and rescuers think that women are faking it or being overdramatic. Participants were adult US residents able to correctly define CPR. Participants ranked the themes if the rescuer was gender unidentified, a man, and a woman, in variable order. RESULTS: In November 2018, 520 surveys were completed. The respondents identified as 42.3% women, 74.2% White, 10.4% Black, and 6.7% Hispanic. Approximately half (48.1%) of the cohort knew how to perform CPR, but only 7.9% had ever performed CPR. When the rescuer was identified as a man, survey participants ranked fear of sexual assault or sexual harassment and fear of touching women or that the touch might be inappropriate as the top reasons (36.2% and 34.0% of responses, respectively). Conversely, when the rescuer was identified as a woman, survey respondents reported fear of hurting or injuring as the top reason (41.2%). CONCLUSIONS: Public perceptions as to why women receive less bystander CPR than men were different based on the gender of the rescuer. Participants reported that men rescuers would potentially be hindered by fears of accusations of sexual assault/harassment or inappropriate touch, while women rescuers would be deterred due to fears of causing physical injury.

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Section: Discussionmentioning

confidence: 88%

Examining the Impact of Layperson Rescuer Gender on the Receipt of Bystander CPR for Women in Cardiac Arrest

Shelton,

Rice,

Knoepke

et al. 2024

Circ: Cardiovascular Quality and Outcomes

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show abstract

“…Our study has limitations. We were limited in our ability to control for unmeasured confounders that could explain the observed sex-based disparities (e.g., bystander characteristics, perceived frailty, comorbidities) [43, 44]. We controlled for this to some extent by excluding arrests with a DNR order and nursing home/medical facility arrests where females were overrepresented.…”

Section: Discussionmentioning

confidence: 99%

Females are less likely to receive bystander cardiopulmonary resuscitation in witnessed out-of-hospital cardiac arrest: An Australian perspective

Munot,

Bray,

Redfern

et al. 2023

Preprint

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BackgroundBystander cardiopulmonary resuscitation (CPR) plays a significant role in survival from out-of-hospital cardiac arrest (OHCA). This study aimed to assess whether bystander CPR differed by patient sex among bystander-witnessed arrests.MethodsData on all OHCAs attended by New South Wales (NSW) paramedics between January 2017 and December 2019 was obtained from the NSW Public Health Risks and Outcomes Registry (PHROR). This observational study was restricted to bystander-witnessed cases with presumed medical aetiology. OHCA from arrests in aged care, medical facilities, and cases with an advance care directive (do-not-resuscitate) were excluded. Multivariate logistic regression was used to examine the association of patient sex with bystander CPR. Secondary outcomes were OHCA recognition, bystander AED applied, initial shockable rhythm, and survival outcomes.ResultsAmong the 4,491 bystander-witnessed cases, females were less likely to receive bystander CPR in both private residential (Adjusted Odds ratio [AOR]: 0.82, 95%CI: 0.70-0.95) and public locations (AOR: 0.58, 95%CI:0.39-0.88). Recognition of OHCA in the emergency call was lower for females, particularly in those who arrested in public locations (84.6% vs 91.6%-males, p=0.002) and it partially explained the association of sex with bystander CPR (∼44%). There was no significant difference in OHCA recognition by sex for arrests in private residential locations (p=0.2). Females had lower rates of bystander AED use (4.8% vs 9.6%, p<0.001) however, after adjustment for arrest location and other covariates, this relationship was attenuated and no longer significant (AOR: 0.83, 95%CI: 0.60-1.12). Females were significantly less likely to record an initial shockable rhythm (AOR: 0.52, 95%CI: 0.44-0.61). Although females had greater odds of event survival (AOR: 1.34, 95%CI: 1.15 – 1.56), there was no sex difference in survival to hospital discharge (AOR: 0.96, 95%CI: 0.77-1.19).ConclusionOHCA recognition and bystander CPR provision differs by patient sex in NSW. Given their importance to patient outcomes, research is needed to understand why this difference occurs and to raise awareness of this issue to the public.CLINICAL PERSPECTIVEWhat is new?Female OHCA patients in New South Wales, Australia were less likely to receive bystander CPR, irrespective of arrest location.In public locations, recognition of OHCA during the emergency call was lower in women and this partly explained the observed sex difference in bystander CPR provision.What are the clinical implications?Public education campaigns and training programs that address bystander response should consider sex differences as a potential barrier to bystander CPR in OHCAFuture research that examines reasons for lower rates of bystander response in women and ways of addressing this barrier could help address sex disparities in the future.

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Racial and ethnic disparities in bystander resuscitation for out-of-hospital cardiac arrests

Pu,

Yang,

Chai

2024

Heart & Lung

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Interaction between bystander sex and patient sex in bystander cardiopulmonary resuscitation for Out-of-Hospital cardiac arrests

Cited by 6 publications

References 30 publications

Examining the Impact of Layperson Rescuer Gender on the Receipt of Bystander CPR for Women in Cardiac Arrest

Examining the Impact of Layperson Rescuer Gender on the Receipt of Bystander CPR for Women in Cardiac Arrest

Females are less likely to receive bystander cardiopulmonary resuscitation in witnessed out-of-hospital cardiac arrest: An Australian perspective

Racial and ethnic disparities in bystander resuscitation for out-of-hospital cardiac arrests

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