Singapore Heart Foundation launches 'first of its kind' female CPR manikin vest for training use

SINGAPORE: Those taking cardiopulmonary resuscitation (CPR) courses will soon be able to practise the emergency procedure on female physiques, with the launch of a female CPR manikin vest by the Singapore Heart Foundation (SHF).

The vest, launched in conjunction with National Life Saving Day 2021, has been described as the "first of its kind" and can be fitted on most CPR manikins in the market, said SHF in a press release.

It will be used in the Foundation's CPR+AED (automated external defibrillator) training programmes from Sunday. The Foundation will also distribute the vests to around 60 accredited CPR+AED training centres.

SHF received many queries from course participants on touching and exposing the chest of female casualties while performing CPR+AED, said the foundation's CPR+AED chief instructor Denise Ng.

"With this female CPR manikin vest, participants can be accustomed to doing chest compressions around the female breasts and learn how to paste the AED pads without exposing the women's chest.

"To be frank, in such a life-and-death moment, no amount of embarrassment is worth refraining from saving a life," she said.

According to a 2020 survey on CPR+AED commissioned by the SHF and the Singapore Civil Defence Force (SCDF), 6 per cent of 1,003 respondents cited the fear of being accused of molest as a deterrent to performing CPR on a stranger.

"As CPR+AED training is taught traditionally with CPR manikins of a male physique, trained lifesavers are primed to be familiar with performing CPR on males compared to females," said the press release.

"Coupled with the fear of committing an outrage of modesty on a woman's chest or inflicting injury on female cardiac arrest casualties, the gender gap in life-saving widens."

As such, there is an "urgent need" to train resuscitators to perform CPR on women and "lower the mental barriers" to save a life.

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IMPROVEMENT IN SURVIVAL RATES

Data for out-of-hospital cardiac arrest, released by the Unit for Pre-hospital Emergency Care (UPEC) on Sunday, suggests that more people are suffering from cardiac arrest outside of hospitals.

This is even after adjusting for Singapore's ageing population, said Prof Marcus Ong, who is the medical director at UPEC and senior consultant at the department of emergency medicine at Singapore General Hospital. 

"This is due to the rapidly ageing population and a rising prevalence of chronic diseases in Singapore, such as diabetes, hypertension and other underlying heart conditions," said the press release.

Survival rates for such casualties have improved over the past decade, with 13.1 per cent of the 2,972 people who suffered from an out-of-hospital cardiac arrest having their hearts restarted at the scene or en route to the hospital. This was the highest from 2011 to 2018.

This led to a "record high" of 175 survivors of out-of-hospital cardiac arrest in 2018. More than two-thirds of these survivors had "good neurological function" after being discharged.

Part of this was a result of the "tremendous" improvement in bystander CPR rates over the years, said SHF. In 2011, the bystander CPR rate was 22 per cent, increasing to 61.8 per cent in 2018. Meanwhile, the bystander AED usage rate went up from 1.8 per cent in 2011 to 7.2 per cent in 2018.

"The dramatic improvement in bystander CPR rates over the past years is mainly attributed to the success of the Dispatcher-Assisted CPR programme," said SHF. In 2018, 1,222 patients received dispatcher-assisted CPR. There were just 54 such patients in 2012.

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But there is "much room for progress", said SHF, comparing Singapore to other countries with "top-notch emergency medical services (EMS) systems".

In 2018, Singapore's Utstein survival rate was 25.9 per cent, compared to 56 per cent in Seattle, US, which has one of the highest sudden cardiac arrest survival rates in the world.

The Utstein survival rate measures the percentage of patients who suffer an out-of-hospital cardiac arrest that were witnessed and had shockable heart rhythms who survived to discharge. 

"The survival rates for out-of-hospital cardiac arrest victims has shown to increase with bystander CPR. Many a time, there is a fear about doing harm - like breaking ribs while doing CPR or being afraid to use the AED. 

"The breaking of ribs will not cause greater harm to the individual than the benefits of maintaining circulation with CPR. The AED is also a simple machine to operate," said SCDF's chief medical officer Colonel Shalini Arulanandam.