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UK experts criticise suggestion women less good at CPR

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UK emergency care and first aid experts have poured scorn on a controversial new study that seems to suggest women are not as good at cardiopulmonary resuscitation as men.

The study, by Swiss researchers, concluded that the performance of female-only resuscitation teams was “inferior” to male-only teams in a cardiac arrest training exercise.

“More targeted measures need to be introduced to prepare and train women for emergency situations”

Sabina Hunziker

Published in the journal Critical Care Medicine, it suggested that there may be a need for “gender-specific” training to prepare male and female clinicians for emergency situations.

UK organisations representing first responders, such as St John Ambulance, said they strongly disagreed with the findings from the study by the University of Basel and University Hospital Basel.

But the researchers stressed that every second counted when somebody’s heart stopped, making the knowledge, skills and interaction between members of a resuscitation team key.

They noted that previous studies had shown efficient and strong leadership could improve survival chances and that communication skills were taught to medical students and others.

However, they said there had been little research to date on the impact of gender on performance in resuscitation situations and it was something they had set out to explore.

“We should not shy away from issues of variance in performances wherever they exist”

Tony Kemp

Their study involved 216 medical students – 108 male and 108 female – from two universities who were randomly split into groups of three. The groups consisted either of women only, men only or both.

The researchers then observed how well the groups performed in a simulated scenario overseen by a trained critical care nurse and involving an older female patient who had lost consciousness and showed signs of cardiac arrest.

The team analysed video recordings of the training including looking at how quickly participants embarked on hands-on CPR such as chest compressions, defibrillation and ventilation.

They also assessed how often they made firm “leadership statements” during the exercises, such as assigning tasks and making decisions on what to do or how to do it, and took “unsolicited CPR measures” – whether people did something useful without being asked.

“In comparison with male-only teams, the female groups showed less hands-on time and took longer overall to start the CPR,” said study lead Professor Sabina Hunziker.

“Poorer female leadership” was in part to blame for weaker overall performance, the study paper suggested.

“We found important shortcomings in leadership behaviour of female rescuers, such as fewer secure leadership statements and less planning of pending tasks,” it said. “Also, female rescuers executed fewer unsolicited CPR measures.”

The research team argued that their findings showed there were differences between men and women in such situations.

“This suggests that more targeted measures need to be introduced to prepare and train women for emergency situations,” said Professor Hunziker.

However, UK emergency care experts have questioned the validity of the Swiss conclusions.

Tony Kemp

Tony Kemp

Tony Kemp

Tony Kemp, nurse and chair of the British Association for Immediate Care, said: “We should not shy away from issues of variance in performances wherever they exist, but the work to support their exposure must be robust.”

Mr Kemp, who is also a senior lecturer in advanced healthcare practice at Bedfordshire University, described the study as “troublesome”, because it was based on the performance of inexperienced students.

He said it did not set out clearly what training or experience, if any, participants had received before taking part.

He also argued that the study did not support the hypothesis that women were less good at CPR and should be trained separately to men.

“The study has too many variables and, most particularly, is looking at leadership as determining the quality of CPR in inexperienced students who were in a learning situation,” he told Nursing Times.

He added that the study test was based on “unstructured” teams responding to a sudden collapse, which was not normally the case, given the advent of highly specialised crash teams.

“We can all be the difference between a life lost and a life saved”

St John Ambulance

He said: “Thankfully, in the UK and elsewhere, resuscitation has very significantly improved due to highly focused advanced life support training that specifically seeks to address the issues of leadership, as well as the different component skills that together support the efficient implementation of resuscitation algorithms.

“A very significant part of this is the evolution of the crash team,” he said. “The medical students in the study had not benefitted from this level of training and were unsupported by the experienced nurse facilitator until three minutes had passed.”

Meanwhile, a spokeswoman for St John Ambulance said: “The many thousands of women who have saved lives through learning first aid through one of our training courses or as a volunteer, would strongly disagree with the findings in this study.

“We believe that everyone can learn first aid and we can all be the difference between a life lost and a life saved,” she added. 

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