(1392) Placing Equity in Cardiopulmonary Resuscitation Performance With Simulated Patients

Introduction: Early cardiopulmonary resuscitation (CPR) is a key indicator of survival after sudden cardiac arrest (SCA). While male and female patients are equally at risk of SCA, females are less likely to be resuscitated. During traditional CPR training, students are educated in simulation with a “male” manikin, failing to provide the opportunity to recognize physical landmarks and perform compressions on a patient who is not flat-chested. We hypothesize that physical attributes of a patient’s sex may influence CPR performance on a female versus male victim during simulated cardiac arrest.

Methods: Internal medicine residents at a Southern California academic institution were recruited for the IRB-approved study. Participants performed CPR in two in-hospital cardiac arrest scenarios: ventricular fibrillation arrest of a male and female manikin, with a four-hour washout between scenarios. Participants were randomly assigned to one of two manikin orders (male first or female first) Participants received a pre-brief and were then asked to perform CPR. A trained observer recorded participant recognition of ventricular fibrillation arrest, correct placement of defibrillator training pads, time to defibrillation, and CPR quality metrics.

Results: 36 residents participated (15 females; 21 males). When CPR performance was evaluated by manikin, compression depth (in range of 12% female; 23 % male, p=0.01) and compression rate (56% female, 59% male) were better on the male. Time to pad placement (79s female; 74s male), compressions (51s female; 43s male), and shock (29s female; 28s male) was faster on the male manikin. When CPR performance on female manikins is evaluated by participant sex, female participants were more likely to correctly place pads (54% vs. 46%), be within the target range for compression depth (18% vs. 8%), and complete tasks more rapidly (avg 5.21 seconds faster).

Conclusions: This is the first study of differences between male and female manikin CPR performance in in-hospital cardiac arrest. We may compromise CPR quality because women manikins aren’t standard in training tools. By promoting the inclusion of frequent female manikin use in healthcare educational institutes, medical personnel will exude higher equitable care toward victims of sudden cardiac arrest.