Women are less likely to receive CPR than men. Training on manikins with breasts could help

10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

If someone’s heart suddenly stops beating, they may only have minutes to live. Doing CPR (cardiopulmonary resusciation) can increase their chances of survival. CPR makes sure blood keeps pumping, providing oxygen to the brain and vital organs until specialist treatment arrives.

But research shows bystanders are less likely to intervene to perform CPR when that person is a woman. A recent Australian study analysed 4,491 cardiac arrests between 2017–19 and found bystanders were more likely to give CPR to men (74%) than women (65%).

Could this partly be because CPR training dummies (known as manikins) don’t have breasts? Our new research looked at manikins available worldwide to train people in performing CPR and found 95% are flat-chested.

Anatomically, breasts don’t change CPR technique. But they may influence whether people attempt it – and hesitation in these crucial moments could mean the difference between life and death.

Pixel-Shot/Shutterstock

Heart health disparities

Cardiovascular diseases – including heart disease, stroke and cardiac arrest – are the leading cause of death for women across the world.

But if a woman has a cardiac arrest outside hospital (meaning her heart stops pumping properly), she is 10% less likely to receive CPR than a man. Women are also less likely to survive CPR and more likely to have brain damage following cardiac arrests.

People cross a busy street in lined with trees in Melbourne.
Bystanders are less likely to intervene if a woman needs CPR, compared to a man. doublelee/Shutterstock

These are just some of many unequal health outcomes women experience, along with transgender and non-binary people. Compared to men, their symptoms are more likely to be dismissed or misdiagnosed, or it may take longer for them to receive a diagnosis.

Bystander reluctance

There is also increasing evidence women are less likely to receive CPR compared to men.

This may be partly due to bystander concerns they’ll be accused of sexual harassment, worry they might cause damage (in some cases based on a perception women are more “frail”) and discomfort about touching a woman’s breast.

Bystanders may also have trouble recognising a woman is experiencing a cardiac arrest.

Even in simulations of scenarios, researchers have found those who intervened were less likely to remove a woman’s clothing to prepare for resuscitation, compared to men. And women were less likely to receive CPR or defibrillation (an electric charge to restart the heart) – even when the training was an online game that didn’t involve touching anyone.

There is evidence that how people act in resuscitation training scenarios mirrors what they do in real emergencies. This means it’s vital to train people to recognise a cardiac arrest and be prepared to intervene, across genders and body types.

Skewed to male bodies

Most CPR training resources feature male bodies, or don’t specify a sex. If the bodies don’t have breasts, it implies a male default.

For example, a 2022 study looking at CPR training across North, Central and South America, found most manikins available were white (88%), male (94%) and lean (99%).

A woman's hands press down on a male manikin torso wearing a blue jacket.
It’s extremely rare for a manikin to have breasts or a larger body. M Isolation photo/Shutterstock

These studies reflect what we see in our own work, training other health practitioners to do CPR. We have noticed all the manikins available to for training are flat-chested. One of us (Rebecca) found it difficult to find any training manikins with breasts.

A single manikin with breasts

Our new research investigated what CPR manikins are available and how diverse they are. We identified 20 CPR manikins on the global market in 2023. Manikins are usually a torso with a head and no arms.

Of the 20 available, five (25%) were sold as “female” – but only one of these had breasts. That means 95% of available CPR training manikins were flat-chested.

We also looked at other features of diversity, including skin tone and larger bodies. We found 65% had more than one skin tone available, but just one was a larger size body. More research is needed on how these aspects affect bystanders in giving CPR.

Breasts don’t change CPR technique

CPR technique doesn’t change when someone has breasts. The barriers are cultural. And while you might feel uncomfortable, starting CPR as soon as possible could save a life.

Signs someone might need CPR include not breathing properly or at all, or not responding to you.

To perform effective CPR, you should:

  • put the heel of your hand on the middle of their chest
  • put your other hand on the top of the first hand, and interlock fingers (keep your arms straight)
  • press down hard, to a depth of about 5cm before releasing
  • push the chest at a rate of 100-120 beats per minute (you can sing a song) in your head to help keep time!)

https://www.youtube.com/embed/Plse2FOkV4Q?wmode=transparent&start=94 An example of how to do CPR – with a flat-chested manikin.

What about a defibrillator?

You don’t need to remove someone’s bra to perform CPR. But you may need to if a defibrillator is required.

A defibrillator is a device that applies an electric charge to restore the heartbeat. A bra with an underwire could cause a slight burn to the skin when the debrillator’s pads apply the electric charge. But if you can’t remove the bra, don’t let it delay care.

What should change?

Our research highlights the need for a range of CPR training manikins with breasts, as well as different body sizes.

Training resources need to better prepare people to intervene and perform CPR on people with breasts. We also need greater education about women’s risk of getting and dying from heart-related diseases.

Jessica Stokes-Parish, Assistant Professor in Medicine, Bond University and Rebecca A. Szabo, Honorary Senior Lecturer in Critical Care and Obstetrics, Gynaecology and Newborn Health, The University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Don’t Forget…

Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

Recommended

  • Long COVID is real—here’s how patients can get treatment and support
  • When “Normal” Health Is Not What You Want
    The article discusses common sleep issues and offers solutions. It mentions mouth taping as a method to promote nose-breathing and addresses waking up during the night.

Learn to Age Gracefully

Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • Most People Try The Wrong Way To Unshrimp Their Posture (Here’s How To Do It Better)

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Many people try to correct posture by pulling the shoulders back and tucking in the chin, but that doesn’t work. Happily, there is a way that does! Kinesiologist Kyle Waugh demonstrates:

    Defying gravity

    The trick is simple, and is about how maintaining good posture needs to be unconscious and natural, not forced. After all, who is maintaining singular focus for 16 waking hours a day?

    Instead, pay attention to how the body relates to gravity without excessive muscle tension, aligning the (oft-forgotten!) hips, and maintaining balance. The importance of hip position is really not to be underestimated, since in many ways the hips are a central axis of the body just as the spine is, and the spine itself sits in the hips.

    A lot of what holds the body in poor posture tends to be localized muscle tensions, so address those with stretches and relaxation exercises.

    For a few quick tests and exercises to try, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    6 Ways To Look After Your Back ← no video on this one, just 6 concepts that you can apply to your daily life

    Take care!

    Share This Post

  • Homeopathy: Evidence So Tiny That It’s Not there?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Homeopathy: Evidence So Tiny That It’s Not There?

    Yesterday, we asked you your opinions on homeopathy. The sample size of responses was a little lower than we usually get, but of those who did reply, there was a clear trend:

    • A lot of enthusiasm for “Homeopathy works on valid principles and is effective”
    • Near equal support for “It may help some people as a complementary therapy”
    • Very few people voted for “Science doesn’t know how it works, but it works”; this is probably because people who considered voting for this, voted for the more flexible “It may help some people as a complementary therapy” instead.
    • Very few people considered it a dangerous scam and a pseudoscience.

    So, what does the science say?

    Well, let us start our investigation by checking out the position of the UK’s National Health Service, an organization with a strong focus on providing the least expensive treatments that are effective.

    Since homeopathy is very inexpensive to arrange, they will surely want to put it atop their list of treatments, right?

    ❝Homeopathy is a “treatment” based on the use of highly diluted substances, which practitioners claim can cause the body to heal itself.

    There’s been extensive investigation of the effectiveness of homeopathy. There’s no good-quality evidence that homeopathy is effective as a treatment for any health condition.❞

    The NHS actually has a lot more to say about that, and you can read their full statement here.

    But that’s just one institution. Here’s what Australia’s National Health and Medical Research Council had to say:

    ❝There was no reliable evidence from research in humans that homeopathy was effective for treating the range of health conditions considered: no good-quality, well-designed studies with enough participants for a meaningful result reported either that homeopathy caused greater health improvements than placebo, or caused health improvements equal to those of another treatment❞

    You can read their full statement here.

    The American FDA, meanwhile, have a stronger statement:

    ❝Homeopathic drug products are made from a wide range of substances, including ingredients derived from plants, healthy or diseased animal or human sources, minerals and chemicals, including known poisons. These products have the potential to cause significant and even permanent harm if they are poorly manufactured, since that could lead to contaminated products or products that have potentially toxic ingredients at higher levels than are labeled and/or safe, or if they are marketed as substitute treatments for serious or life-threatening diseases and conditions, or to vulnerable populations.❞

    You can read their full statement here.

    Homeopathy is a dangerous scam and a pseudoscience: True or False?

    False and True, respectively, mostly.

    That may be a confusing answer, so let’s elaborate:

    • Is it dangerous? Mostly not; it’s mostly just water. However, two possibilities for harm exist:
      • Careless preparation could result in a harmful ingredient still being present in the water—and because of the “like cures like” principle, many of the ingredients used in homeopathy are harmful, ranging from heavy metals to plant-based neurotoxins. However, the process of “ultra-dilution” usually removes these so thoroughly that they are absent or otherwise scientifically undetectable.
      • Placebo treatment has its place, but could result in “real” treatment going undelivered. This can cause harm if the “real” treatment was critically needed, especially if it was needed on a short timescale.
    • Is it a scam? Probably mostly not; to be a scam requires malintent. Most practitioners probably believe in what they are practising.
    • Is it a pseudoscience? With the exception that placebo effect has been highly studied and is a very valid complementary therapy… Yes, aside from that it is a pseudoscience. There is no scientific evidence to support homeopathy’s “like cures like” principle, and there is no scientific evidence to support homeopathy’s “water memory” idea. On the contrary, they go against the commonly understood physics of our world.

    It may help some people as a complementary therapy: True or False?

    True! Not only is placebo effect very well-studied, but best of all, it can still work as a placebo even if you know that you’re taking a placebo… Provided you also believe that!

    Science doesn’t know how it works, but it works: True or False?

    False, simply. At best, it performs as a placebo.

    Placebo is most effective when it’s a remedy against subjective symptoms, like pain.

    However, psychosomatic effect (the effect that our brain has on the rest of our body, to which it is very well-connected) can mean that placebo can also help against objective symptoms, like inflammation.

    After all, our body, directed primarily by the brain, can “decide” what immunological defenses to deploy or hold back, for example. This is why placebo can help with conditions as diverse as arthritis (an inflammatory condition) or diabetes (an autoimmune condition, and/or a metabolic condition, depending on type).

    Here’s how homeopathy measures up, for those conditions:

    (the short answer is “no better than placebo”)

    Homeopathy works on valid principles and is effective: True or False?

    False, except insofar as placebo is a valid principle and can be effective.

    The stated principles of homeopathy—”like cures like” and “water memory”—have no scientific basis.

    We’d love to show the science for this, but we cannot prove a negative.

    However, the ideas were conceived in 1796, and are tantamount to alchemy. A good scientific attitude means being open-minded to new ideas and testing them. In homeopathy’s case, this has been done, extensively, and more than 200 years of testing later, homeopathy has consistently performed equal to placebo.

    In summary…

    • If you’re enjoying homeopathic treatment and that’s working for you, great, keep at it.
    • If you’re open-minded to enjoying a placebo treatment that may benefit you, be careful, but don’t let us stop you.
    • If your condition is serious, please do not delay seeking evidence-based medical treatment.

    Share This Post

  • 7 Signs of Undiagnosed Autism in Adults

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    When it comes to adults and autism, there are two kinds of person in the popular view: those who resemble the Rain Man, and those who are making it up. But, it’s not so, as Paul Micallef explains:

    The signs

    We’ll not keep them a mystery; they are:

    1. Social interaction difficulties: such a person may struggle with understanding social cues, leading to awkwardness, isolation, or appearing eccentric.
    2. Need for structure and routine: either highly structured or disorganized, both of which stem from executive function challenges. The former, of course, is a coping mechanism, while the latter is the absence of same.
    3. Sensory sensitivities: can include sensitivities or insensitivities to light, sound, temperature, smells, tastes, and so forth.
    4. Spiky skillset: extreme strengths in certain areas, coupled with significant difficulties in others, leading to uneven abilities. May be able to dismantle and rebuild a PC, while not knowing how to arrange an Über.
    5. Emotional regulation issues: experiences of meltdowns, shutdowns, or withdrawal as coping mechanisms when overwhelmed. Not that this is “or”, not necessarily “and”. The latter goes especially unnoticed as an emotional regulation issue, because for everyone else, it’s something that’s not there to see.
    6. Unusual associations: making mental connections or associations that seem random or uncommon compared to others. The mind went to 17 places quickly and while everyone else got from idea A to idea B, this person is already at idea Q.
    7. Being “just different”: a general sense of being the odd one out, standing out in subtle or distinct ways. This is rather a catch-all, but if there’s someone who fits this, there’s a good chance, the other things apply too.

    For more on all of these, whether pertaining to yourself or a loved one (or both!), enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

    Share This Post

Related Posts

  • Long COVID is real—here’s how patients can get treatment and support
  • The Mediterranean Diet: What Is It Good For?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    More to the point: what isn’t it good for?

    What brought it to the attention of the world’s scientific community?

    Back in the 1950s, physiologist Ancel Keys wondered why poor people in Italian villages were healthier than wealthy New Yorkers. Upon undertaking studies, he narrowed it down to the Mediterranean diet—something he’d then take on as a public health cause for the rest of his career.

    Keys himself lived to the ripe old age of 100, by the way.

    When we say “Mediterranean Diet”, what image comes to mind?

    We’re willing to bet that tomatoes feature (great source of lycopene, by the way), but what else?

    • Salads, perhaps? Vegetables, olives? Olive oil, yea or nay?
    • Bread? Pasta? Prosciutto, salami? Cheese?
    • Pizza but only if it’s Romana style, not Chicago?
    • Pan-seared liver, with some fava beans and a nice Chianti?

    In reality, the diet is based on what was historically eaten specifically by Italian peasants. If the word “peasants” conjures an image of medieval paupers in smocks and cowls, and that’s not necessarily wrong, further back historically… but the relevant part here is that they were people who lived and worked in the countryside.

    They didn’t have money for meat, which was expensive, nor the industrial setting for refined grain products to be affordable. They didn’t have big monocrops either, which meant no canola oil, for example… Olives produce much more easily extractable oil per plant, so olive oil was easier to get. Nor, of course, did they have the money (or infrastructure) for much in the way of imports.

    So what foods are part of “the” Mediterranean Diet?

    • Fruits. These would be fruits grown locally, but no need to sweat that, dietwise. It’s hard to go wrong with fruit.
    • Tomatoes yes. So many tomatoes. (Knowledge is knowing tomato is a fruit. Wisdom is not putting it in a fruit salad)
    • Non-starchy vegetables (e.g. eggplant yes, potatoes no)
    • Greens (spinach, kale, lettuce, all those sorts of things)
    • Beans and other legumes (whatever was grown nearby)
    • Whole grain products in moderation (wholegrain bread, wholewheat pasta)
    • Olives and olive oil. Special category, single largest source of fat in the Mediterranean diet, but don’t overdo it.
    • Dairy products in moderation (usually hard cheeses, as these keep well)
    • Fish, in moderation. Typically grilled, baked, steamed even. Not fried.
    • Other meats as a rarer luxury in considerable moderation. There’s more than one reason prosciutto is so thinly sliced!

    Want to super-power this already super diet?

    Try: A Pesco-Mediterranean Diet With Intermittent Fasting: JACC Review Topic of the Week

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • 4 ways to cut down on meat when dining out – and still make healthy choices

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Many of us are looking for ways to eat a healthier and more sustainable diet. And one way to do this is by reducing the amount of meat we eat.

    That doesn’t mean you need to become a vegan or vegetarian. Our recent research shows even small changes to cut down on meat consumption could help improve health and wellbeing.

    But not all plant-based options are created equal and some are ultra-processed. Navigating what’s available when eating out – including options like tofu and fake meats – can be a challenge.

    So what are your best options at a cafe or restaurant? Here are some guiding principles to keep in mind when cutting down on meat.

    Mikhaylovskiy/Shutterstock

    Health benefits to cutting down

    Small amounts of lean meat can be part of a healthy, balanced diet. But the majority of Australians still eat more meat than recommended.

    Only a small percentage of Australians (10%) are vegetarian or vegan. But an increasing number opt for a flexitarian diet. Flexitarians eat a diet rich in fruits and vegetables, while still enjoying small amounts of meat, dairy, eggs and fish.

    Our recent research looked at whether the average Australian diet would improve if we swapped meat and dairy for plant-based alternatives, and the results were promising.

    The study found health benefits when people halved the amount of meat and dairy they ate and replaced them with healthy plant-based foods, like tofu or legumes. On average, their dietary fibre intake – which helps with feeling fuller for longer and digestive health – went up. Saturated fats – which increase our blood cholesterol levels, a risk factor for heart disease – went down.

    Including more fibre and less saturated fat helps reduce the risk of heart disease.

    Achieving these health benefits may be as simple as swapping ham for baked beans in a toastie for lunch, or substituting half of the mince in your bolognese for lentils at dinner.

    A hand holding a plate filled with vegetables and pita bread.
    Filling your plate with fibre-rich foods can help lower cholesterol. Wally Pruss/Shutterstock

    How it’s made matters

    For a long time we’ve known processed meats – such as ham, bacon and sausages – are bad for your health. Eating high amounts of these foods is associated with poor heart health and some forms of cancer.

    But the same can be true of many processed meat alternatives.

    Plant-based alternatives designed to mimic meat, such as sausages and burgers, have become readily available in supermarkets, cafes and restaurants. These products are ultra-processed and can be high in salt and saturated fat.

    Our study found when people replaced meat and dairy with ultra-processed meat alternatives – such as plant-based burgers or sausages – they ate more salt and less calcium, compared to eating meat or healthy plant-based options.

    So if you’re cutting down on meat for health reasons, it’s important to think about what you’re replacing it with. The Australian Dietary Guidelines recommend eggs, legumes/beans, tofu, nuts and seeds.

    Tofu can be a great option. But we recommend flavouring plain tofu with herbs and spices yourself, as pre-marinated products are often ultra-processed and can be high in salt.

    What about when dining out?

    When you’re making your own food, it’s easier to adapt recipes or reduce the amount of meat. But when faced with a menu, it can be difficult to work out what is the best option.

    Two people eat noodles from takeaway bowls.
    Eating a range of colours is one way to ensure variety. Mikhail Nilov/Pexels

    Here are our four ways to make healthy choices when you eat out:

    1. Fill half your plate with vegetables

    When cutting down on meat, aim for half your plate to be vegetables. Try to also eat a variety of colours, such as leafy green spinach, red capsicum and pumpkin.

    When you’re out, this might look like choosing a vegetable-based entree, a stir-fry or ordering a side salad to have with your meal.

    2. Avoid the deep fryer

    The Australian Dietary Guidelines recommend limiting deep fried foods to once a week or less. When dining out, choose plant-based options that are sautéed, grilled, baked, steamed, boiled or poached – instead of those that are crumbed or battered before deep frying.

    This could mean choosing vegetarian dumplings that are steamed not fried, or poached eggs at brunch instead of fried. Ordering a side of roast vegetables instead of hot chips is also a great option.

    3. Pick wholegrains

    Scan the menu for wholegrain options such as brown rice, wholemeal pizza or pasta, barley, quinoa or wholemeal burger buns. Not only are they good sources of protein, but they also provide more dietary fibre than refined grains, which help keep you fuller for longer.

    4. If you do pick meat – choose less processed kinds

    You may not always want, or be able, to make a vegetarian choice when eating out and with other people. If you do opt for meat, it’s better to steer clear of processed options like bacon or sausages.

    If sharing dishes with other people, you could try adding unprocessed plant-based options into the mix. For example, a curry with lentils or chickpeas, or a vegetable-based pizza instead of one with ham or salami. If that’s not an option, try choose meat that’s a lean cut, such as chicken breast, or options which are grilled rather than fried.

    Laura Marchese, PhD candidate at the Institute for Physical Activity and Nutrition, Deakin University and Katherine Livingstone, NHMRC Emerging Leadership Fellow and Senior Research Fellow at the Institute for Physical Activity and Nutrition, Deakin University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • Super Gut – by Dr. William Davis

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    You may be wondering: what sets this book apart from the other gut health books we’ve reviewed? For this one, mostly it’s depth.

    This is the most scientifically dense book we’ve reviewed on gut health, so if you’re put off by that, this might not be one for you. However, you don’t need prior knowledge, as he does explain things as he goes. The advice in this book is not just the usual “gut health 101” stuff, either!

    A particular strength of this book is that it looks at a wide variety of gut- and gut-related disorders, and ways certain readers may need to do different things than others, to address those problems on the path to good gut health.

    The style, for all its hard science content, is quite sensationalist, and that may take some getting used to for non-Americans. However, it doesn’t affect the content!

    Bottom line: if you just want simple basic advice, then probably best to skip this one. However, if you are sincerely serious about gut health (or just like reading this sort of thing because learning is satisfying), then this book is packed with relevant and detailed information.

    Click here to check out Super Gut, and get to know and improve yours!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: