Heart failure: Why women have a worse chance

Every year in Austria, approximately 15,000 cases of sudden cardiac arrest occur, a condition where the heart abruptly ceases to function, halting blood flow and depriving vital organs of oxygen. According to Dr. Mario Krammel, head physician of Vienna’s professional rescue services and president of the organization PULS, Association Against Sudden Cardiac Death, the survival chances drop by ten percent with each passing minute without resuscitation. Women face particularly grim odds compared to men, with studies indicating that in public spaces in the United States, 45 percent of men receive CPR after cardiac arrest, while only 39 percent of women do. This disparity has been further underscored by research conducted by the Medical University of Innsbruck in March, which found that the quality of CPR performed on female mannequins was significantly lower than on male ones. The depth of chest compressions on the female models was less than the recommended five to six centimeters. The issue stems partly from misconceptions and unfounded fears among potential rescuers. Dr. Krammel explains that some individuals hesitate due to concerns over sexual harassment when performing CPR on women. However, these fears are baseless, he insists. He emphasizes that if someone, regardless of gender, is unresponsive and not breathing normally, immediate action is crucial. Initiating chest compressions can double or triple their chance of survival. To address these concerns, the PULS association released a video titled “Is THIS sexual harassment?” on YouTube, clarifying the legal aspects of resuscitating women. Legal expert Barbara Auracher-Jäger states in the video that touching a woman's breasts solely for the purpose of reviving her does not constitute sexual harassment and is not illegal. She adds that such actions do not violate a person's dignity, as they are purely aimed at life-saving measures. Furthermore, Auracher-Jäger notes that removing a bra during resuscitation efforts, if necessary for effective CPR, is not a violation of dignity either. Any injuries sustained during resuscitation, she says, would not carry legal implications. Dr. Krammel acknowledges that both men and women can suffer rib fractures during CPR, but these injuries are generally harmless and heal completely. If rescuers fail to press deeply enough on a woman’s chest, it could reduce her chances of survival. Deep compression is essential to establish minimal blood circulation, ensuring the heart and brain receive vital oxygen. Despite these clear guidelines, some rescuers might feel uncomfortable dealing with a bra during CPR. Dr. Krammel suggests that while it is possible to perform compressions with a bra still on, the presence of undergarments might lead to less forceful compressions due to discomfort. Additionally, placing defibrillator pads correctly becomes more challenging. For this reason, he recommends removing the bra as demonstrated in the PULS video. Until recently, training courses primarily used male mannequins, but this is changing. More courses now include female mannequins, reflecting a growing awareness of the need for inclusive training materials. Dr. Krammel stresses that in life-threatening situations, there should be no misplaced shame in touching a woman to save her life. Such hesitation can cost lives. The emphasis is on swift and decisive action, regardless of the patient's gender, to maximize the chances of survival. The ongoing efforts to educate the public and improve training methods aim to bridge the gap in survival rates between genders, ensuring that everyone receives timely and effective assistance when needed.