CPR and the Female Casualty: What Every First Aider Needs to Know

In this film, we are going to look at CPR and defibrillation for a female casualty. This is an extremely important topic, as women are statistically less likely to receive life-saving CPR or early defibrillation. Understanding why this happens helps us improve care and save more lives.

Why Female Casualties Receive Less CPR

Research shows that a female casualty is around 25% less likely to have an AED used compared with a male casualty.

The most common reason is hesitation. People often feel uncomfortable about:

• Exposing the chest
• Touching the chest area
• Placing AED pads around breast tissue

However, the guidelines are very clear: saving a life always comes first. CPR and defibrillation must never be delayed because of modesty, embarrassment, or fear of doing something wrong.

Exposing the Chest Is Essential

To perform effective CPR and use an AED correctly, the chest must be exposed.

This may involve:

• Moving clothing out of the way
• Adjusting or lifting a bra
• Removing a bra entirely if necessary

The latest guidance confirms that this is appropriate, lawful, and essential during resuscitation.

Never allow clothing or underwear to interfere with AED pad placement. Your priority is restoring a normal heart rhythm, not preserving modesty.

Updated AED Pad Placement for Female Casualties

AED pad placement has been refined in the latest guidelines to improve the electrical pathway through the ventricles of the heart. Correct positioning is especially important when working around breast tissue.

Key Principles for Pad Placement

• Avoid placing pads directly over breast tissue
• Ensure full contact between the pad and the skin
• Follow the latest recommended positions, even if the diagrams on the AED pads show older placements

Correct Pad Positions

• Right-side pad: Place on the upper right chest as usual, adjusting slightly if needed to avoid breast tissue
• Left-side pad: Place higher and further to the side, under the left armpit along the mid-axillary line

This positioning improves shock effectiveness and helps avoid breast tissue completely.

Chest Compressions Are the Same for Everyone

Chest compressions for a female casualty are performed exactly the same as for any adult.

• Place your hands in the centre of the chest
• Compress to a depth of 5–6 cm
• Maintain a rate of 100–120 compressions per minute

Do not alter your technique because the casualty is female. Effective compressions are critical and must always take priority.

Recognising Heart Problems in Women

It is also important to understand that women may present differently when experiencing heart problems.

Many women do not have the classic crushing chest pain associated with heart attacks. In fact, around 25% experience more subtle symptoms, such as:

• Jaw pain
• Nausea or vomiting
• Shortness of breath
• Unusual fatigue or discomfort

These symptoms can lead to delays in calling for help, increasing the risk of cardiac arrest.

The Key Message

When a woman suffers a cardiac arrest, immediate CPR and early defibrillation are critical.

Do not delay because of:

• Concerns about exposing the chest
• Uncertainty about AED pad placement
• Fear of embarrassment or doing something wrong

Act quickly. Act confidently. Your decisive action could save a life and significantly improve the chance of recovery.