The CPR Gap Nobody Talks About

Here's an uncomfortable statistic worth sitting with: research has repeatedly shown that women who collapse in public are less likely to receive bystander CPR than men in the same situation. The 2025 resuscitation guidelines tackle this head-on, and it's a topic every first aid instructor should be actively teaching, not just mentioning in passing.

Why the gap exists

The reasons aren't really medical — they're social. Studies and campaigns in this area have consistently pointed to two things: a reluctance to touch a woman's chest for fear of it being seen as inappropriate, and a mistaken belief that female anatomy somehow makes CPR more complicated or requires different technique. Neither is true, but both are powerful enough to make bystanders hesitate at exactly the moment hesitation is most dangerous.

What the guidelines say

The updated guidance is refreshingly practical. On chest compressions, the technique is identical regardless of the casualty's sex — hands in the centre of the chest, pushing hard and fast. There is no anatomical reason to change hand placement or technique for a woman.

On defibrillation, the guidance is equally clear and sensibly pragmatic: rescuers should prioritise correct pad placement and bare-skin contact. If that can be achieved quickly without removing a bra, it's fine to leave it in place. If the bra is genuinely in the way of getting the pads correctly positioned, it should be removed. The guidelines are explicit that rescuers shouldn't hold back from exposing a casualty's chest when it's necessary — a life-threatening emergency takes priority over embarrassment, for the rescuer and the casualty alike.

Why this belongs in every first aid course

This isn't a footnote. Awareness campaigns have highlighted findings suggesting that around a third of people feel afraid to perform CPR on a woman in public — a hesitation gap that has almost certainly cost lives. Addressing it isn't just about updating a slide in a course deck; it's about actively naming the hesitation in the room and giving learners permission, and clear guidance, to act without that moment of doubt.

How to teach it well

A few things that make this land properly in a classroom:

• Name the myth directly. Don't just state the correct technique — explain why the myth exists and why it's wrong. People retain "this is a common misconception, and here's why" far better than a bare fact.

• Practise on manikins that reflect real anatomy. If your training equipment only ever represents a male torso, you're missing an opportunity to build genuine confidence and normalise the scenario.

• Talk about the AED pad decision explicitly. Walk learners through the actual decision-making process — try first without removing clothing, remove it if needed, don't delay for modesty — rather than leaving it as an abstract rule.

Bystander CPR saves lives, and every hesitation costs precious seconds. Closing this gap isn't a side issue in first aid training — it's core to making sure everyone, regardless of who's in front of you, gets the same chance of survival.

Train with confidence, for everyone

At Basecamp First Aid, we build this kind of awareness directly into our courses, so every learner leaves confident enough to act — for anyone, in any situation.

Find out more or book a course at basecampfirstaid.com, or email info@basecampfirstaid.com with any questions.

Disclaimer: This article is for general information and educational purposes only and does not constitute medical advice. It reflects a summary of the Resuscitation Council UK 2025 Guidelines as understood at the time of writing; guidance may be updated, and implementation timelines can vary between awarding bodies and training providers. Always follow the specific instructions of your first aid course provider and the current guidance of the Resuscitation Council UK (resus.org.uk). In a real emergency, always call 999 (or your local emergency number) immediately.

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