Imagine a woman jogging in a park suddenly collapses in front of you. You’re the only one there. After calling 911 on speakerphone, you check for breathing for ten seconds; she isn’t breathing, or she’s only gasping.
Statistically, what happens next often depends on whether the victim is a man or a woman.
According to a recent survey from the American Heart Association (AHA), men who suffer out-of-hospital cardiac arrest in public receive bystander CPR 45% of the time. In contrast, women receive help in only 39% of cases. This hesitation has a real cost: men have a 23% higher survival rate than women in these scenarios.
Changing the Standard
For sixty years—since the first AHA curriculum in 1963—instructions often implied removing clothing above the waist before starting compressions. Today, the recommendation has shifted: bystanders should leave clothing on until an Automated External Defibrillator (AED) is available.
Keeping clothes on until the AED arrives is less “shocking” for bystanders, saves precious seconds, and provides a protective layer for both the rescuer and the patient.
Proper Hand Placement Through Clothing
The technique for chest compressions is identical for men and women, yet the most common mistake AHA instructors see is incorrect hand placement. If your hands are too low on the sternum, you risk breaking the Xiphoid Process (the tip of the breastbone) and compressing the liver instead of the heart.
How to find the sternum through clothing:
- Reach across to the opposite side of the person, just under their armpit.
- Bring the heel of your hand back toward the center of the chest.
- Feel for the hard bone (the sternum). You can even try this on yourself right now—you’ll find the bone is easy to locate even through layers.
Note: If a brassiere or heavy clothing makes it impossible to feel the sternum, then—and only then—should clothing be removed.
Closing the Gender Gap
This proper placement means the heel of your hand will be directly on the sternum, which, on a woman, involves contact with the breast. Understanding this reality is vital for training. To normalize this and increase rescuer confidence, all AHA Training Centers are required to incorporate at least one female manikin into their classes by June 2025.
Your Hands, Her Life
Remember to renew your AHA certification every two years. Even if your certification has lapsed, remember: any CPR is better than no CPR. When a life is on the line, any woman would prefer her life be in your hands.
Learn more about our AHA CPR certification, BLS classes, and how to save a life with high-quality CPR. All classes are held live with an instructor in San Francisco.
By Roy Gordon, AHA CPR Instructor/ EMT
At Revive CPR, we believe that high-quality, hands-on training shouldn’t be hard to find. Located at 148 Townsend St. in San Francisco’s SOMA district, we are proud to serve the SF medical community, local businesses, and families. Whether you’re a healthcare provider near UCSF needing a BLS renewal or a parent in the Bay Area looking for infant CPR, our 2025 AHA-compliant courses ensure you leave feeling confident and prepared.
