Abstract Body: Introduction: Female sex is associated with lower rates of bystander cardiopulmonary resuscitation (B-CPR) in public. Telecommunicator CPR (T-CPR), or provision of CPR instructions when individuals call 9-1-1, is essential to improving B-CPR. Few investigations have examined how T-CPR impacts this known sex difference in receipt of B-CPR.

Objectives: We sought to examine sex disparities in receipt of B-CPR and time measures with provision of T-CPR. We hypothesized that with provision of T-CPR instruction, there would be no sex disparity in the receipt of B-CPR.

Methods: We conducted a retrospective cohort study of adult, non-traumatic out-of-hospital cardiac arrests (OHCA) from the North Carolina (NC) RACE-CARS trial (NCT04660526) dispatch module. We examined differences between males and females in receipt of B-CPR (primary outcome) and time measures (secondary outcomes), including time to recognition and time to first compression (secs). Between-group comparisons were assessed using the Pearson’s Chi-square or Fisher’s exact test for categorical variables and the Wilcoxon rank-sum test for continuous variables.

Results: From 7/2022-12/2023, RACE-CARS collected data on 8,839 OHCAs covering 52 counties in NC. After excluding pediatric, traumatic, EMS-witnessed, and healthcare facility arrests there were 2,398 OHCAs. Median (25^th, 75^th percentiles) age was 63 (49-74), 67% were White, and 37% were female. B-CPR was administered in 52% of the OHCAs (81% with telecommunicator assistance vs. 19% without). When the telecommunicator provided assistance vs when they did not, B-CPR was 44% vs. 9% for female patients and 40% vs. 11% for male patients; these sex differences were not statistically significant (p=ns). Median time to CPR recognition from call received (secs) was 87 (50-149) for females vs. 87 (53-160) for males. Median time to first compression from telecommunicator call to call received (secs) was 204 (147-275) for females vs. 207 (145-281) for males (p=ns).

Conclusion: Telecommunicator CPR may potentially attenuate the known sex disparity in receipt of B-CPR. Understanding this may help inform future health policy and advocacy for prehospital systems of care. Future work may examine how T-CPR decreases sex variation and increases B-CPR especially in women.