Abstract Sun601: Barriers and strategies to address layperson CPR for women: perspectives from telecommunicators

Abstract

Introduction: Women receive bystander cardiopulmonary resuscitation (CPR) less frequently than men in public. Our prior work in North Carolina demonstrated that telecommunicator CPR may lessen this known disparity. Few studies have focused on the perspective of the telecommunicator to develop strategies to promote individuals to perform CPR on women. Objectives: We sought to understand telecommunicator reported barriers, with a perspective to develop strategies to encourage laypersons to perform CPR on a woman. Methods: Informed by the National Institute on Minority Health and Health Disparities Framework, interviews were conducted with Forsyth County, NC and Durham County, NC 9-1-1 telecommunicators by staff trained in qualitative research methods. Interviews were transcribed. We conducted rapid qualitative analysis with two coders. Data were organized by prior barriers identified through the literature and by new emergent strategies identified and suggested by the telecommunicators. We reported the top salient themes. Results: From 1/2025-5/2025, 13 interviews were completed (6 Forsyth, 7 Durham). Of the telecommunicators, 27% had < 2 yrs experience, 27% 2-5 yrs experience, and 46% had > 10 yrs experience. Mean age was 39 yrs, 92% were female; 62% were White and 31% were Black. Telecommunicators perceived several top barriers, and suggested corresponding strategies to bystander CPR on women including: 1) Fear of being sued for touching a woman’s breast; telecommunicators suggested telling the caller there is no need to undress the patient and directing them to the breastbone; 2) Fear of hurting the woman; telecommunicators described giving reassurance and direct messaging that doing something is better than doing nothing; 3) Recognition of cardiac arrest in women; telecommunicators stated carefully listening and detailed questioning of the caller; 4) Fear of performing mouth to mouth on women; telecommunicators described reassuring that one only needs to perform chest compressions; and 5) Women being perceived as more dramatic and emotional; using a neutral and consistent approach. Conclusion: Telecommunicator strategies to address barriers to why women are less likely to receive CPR include: addressing issues of the female anatomy, undressing the patient, and caller control techniques to encourage performance of CPR. This has implications for future telecommunicator education and potential protocols.