How You Can Save Women’s Lives During Out-of-Hospital Cardiac Arrest

Early first aid intervention is a key condition in improving the survival rate of individuals experiencing cardiac arrest. French statistics show that about 70% of cardiac arrests happen in front of someone else, but that only 47% of those people provide first aid. In comparison, in the early 2000s, only 20% of witnesses provided first aid and the survival rate was below 2%. Currently, when a witness takes action and performs chest compressions, the survival rate is 10.4%.2 It increases to 35.9% if they also use a nearby defibrillator.1

While this is an improvement, the survival rate is still too low! To continue improving, we must communicate the benefits of a strong chain of survival, raise awareness, train populations on a large scale, and properly install automatic defibrillators in public access areas. When the first links in the chain of survival are stronger, these elements allow for effective coordination with the pre-hospital EMS resuscitation teams, as well as in-hospital cardiology and resuscitation teams.

There are a number of elements that decrease women’s survival rates. The first is a lack of knowledge about the signs indicating the severity of a cardiac event or about the atypical signs of a heart attack. For example, nearly half of women under 60 years of age have no chest pain during their heart attacks. In many cases, cardiovascular emergencies present as intense asthenia (weakness) or digestive problems. All of these elements can slow down the response, especially when cardiac arrest complicates the symptoms. Fewer people provide first aid when they see a woman experiencing these symptoms (69%) than for men (74%).3

This delay in helping a woman who collapses can be caused by a desire to avoid baring a woman’s chest to do compressions, the supposed fragility of women, and the fear that the person who helps out will be suspected of sexual assault. As a result, the survival rate is lower in women (12.5%) than in men (20.1%) as shown in a recent Dutch study.3 We must do a number of things to change this situation. Women need to be informed about the warning signs of cardiovascular events. Education for the general public about CPR with an automatic defibrillator should include information about passive behaviors when caring for women. We also need to erase the factors that could reduce the chances of women’s survival so that the prognosis for cardiac arrest is at least comparable to that of men. Women’s Cardiovascular Healthcare Foundation is launching an appeal: Provide first aid to a woman in cardiac arrest to improve her chances of survival!

N BENAMEUR*,**; J HENNACHE*,**; S NAVE*,**; J COULIER *,**; D KLUG **,***; P GOLDSTEIN*.
*SAMU du Nord, CESU du Nord, Emergency Department at University Hospital of Lille **Sudden Death Center of Expertise, Heart and Lung Institute at University Hospital of Lille ***Cardiology and cardiovascular disease clinic, Heart and Lung Disease Institute at University Hospital of Lille 1. PY Gueugnaud, J Beaune, H Hubert, RéAC, Congrès de la Mort Subite [Sudden Death Congress], Mulhouse, 2017. 2. Gerald L et al “Epidemiology of out-of-hospital cardiac arrest: A French national incidence and mid-term survival rate study” Anaesth Crit Care Pain Med, 2019 Apr;38(2):131-135 3. Marieke T. Blom “Women have lower chances than men to be resuscitated and survive out-of-hospital cardiac arrest” European Heart Journal (2019) 40, 3824–3834