The gender SCA gap: why survival rates are lower for women


Did you know that after a sudden cardiac arrest, women have a lower survival rate than men?

There are several reasons for this. Some are medical, such as women being more likely to have an un-shockable heart rhythm. Some are social – for instance, the average woman waits around 37 minutes longer than men to contact medical services.

But surprisingly, some aren’t to do with the patient at all – but the response of the people around them. Because the faster you spot the signs of sudden cardiac arrest, start performing CPR, and use a defibrillator, the more likely the patient is to survive.

Spotting the signs

According to a study by Duke University, women suffering from SCA in public were 27% less likely to receive life-saving CPR than men. A Dutch study reported similar findings, revealing that bystanders attempted resuscitation on 72.7% of male patients, but only 67.9% of female patients.

However, this might not be because bystanders are simply reluctant to perform CPR on women. It might be because they don’t realise the woman needs CPR in the first place.

Typically, those learning rescue skills will be well-versed on what sudden cardiac arrest looks like in men – but not realise that the signs and symptoms can be different for women.

For instance, signs of a heart attack in women include fatigue, nausea, clamminess, and/or pain in the neck, jaw, back, shoulder, or stomach – symptoms which are much less obvious than the chest pains reported by some men.

Sudden cardiac arrest also presents differently to a heart attack. With an SCA, the patient will suddenly pass out, and either stop breathing or breathe in abnormal gasps. Without immediate CPR and defibrillation as soon as possible, the patient will die.

However, this deadly condition is much less well-known than the ‘clutch your chest and collapse’ heart attack that we see in TV and films. It’s therefore essential to continue raising awareness of the signs of SCA – and what to do if you witness it – to help save victims’ lives.

The training problem

Another reason why bystanders might be reluctant to perform CPR on a woman is lack of training. Standard CPR training dummies are male (or at least, they don’t have breasts). So even if you’ve practised chest compressions before, doing them on a female patient might be an unfamiliar and perhaps even an intimidating prospect.

In response to this issue, US advertising agency JOAN has created a specially adapted ‘WoManikin,’ allowing trainees to practise chest compressions on a dummy with breasts.

“The absence of women’s bodies in CPR training results in hesitation from bystanders,” said JOAN’s co-founder and Chief Creative Officer Jaime Robinson.

“[This] in turn results in women being more likely to die in cardiac arrest. Our hope is that the WoManikin will bridge this gap in education and, ultimately, save many lives.”

The societal problem

In 2018, the University of Colorado conducted an interesting online survey about why women might be less likely to receive CPR than men.

Four themes emerged in the responses: not knowing the signs of cardiac arrest in women, fear of causing physical injury, the misconception that breasts make CPR more challenging, and finally, the ‘fear of being accused of sexual assault’ or ‘inappropriate touching’.

While the last fear is understandable in the post #MeToo climate, we don’t think anyone should pay it much heed in a real emergency. Because ultimately, social awkwardness is infinitely less important than saving a life.

So how do you perform CPR on a woman?

Once you’ve identified the signs of sudden cardiac arrest: exactly the same way as you perform CPR on a man.

You can view our illustrated guide to CPR here – or take our ‘Are you rescue ready?’ quiz to test your knowledge of resuscitation.

And don’t forget – performing CPR on someone who’s just suffered a sudden cardiac arrest can double or even triple their chance of survival.

So keep sharpening your skills, and one day we may be able to close the gender SCA gap.