Author: Liu Man
No matter which medical drama is turned on, the scene without CPR is like a Japanese drama without running under the sunset, losing its soul.
The naked eye scanned 836 episodes of medical dramas, identified 216 observable CPR scenarios, and screened 194 scenes with recognizable compression depth and compression frequency, and the researchers demonstrated its outrageousness.
Image source: SooGif
Lilac Garden surveyed 2012 doctors, 94% of whom said they had seen medical dramas, and the vast majority of them (85%) had found medical errors while watching the drama, and its central pulmonary resuscitation (CPR) was considered to be the most erroneous first aid knowledge in medical TV dramas.
Reference 2 screenshot
Research published in the American Journal of Emergency Medicine reveals the characteristics of CPR in medical dramas: most CPR is inaccurate, but the therapeutic effect is much better than in reality.
Reference 1 screenshot
Research background
In order to find out the accuracy of CPR in medical dramas, whether there is a gender difference in rescued patients, the quality difference between doctors and nurses who perform CPR, and the difference between patient outcomes and reality, researchers can be described as the chase of Phi Xing Dai Yue.
After searching for eligible medical dramas on Google and Netflix, they watched 31 and 836 episodes with statistical destinations, and because the medical titles were not listed in the paper, it is not known whether the more than ten seasons of "Grey's Anatomy" and "House" accounted for the majority of them.
All the researchers watching the play are professional, high-level, not like we are slumped on the bed and nibbling on the neck of the duck, but to record the information of the patients in the play independently, the rescuer information, the frequency of CPR compressions, the depth, the level of thoracic rebound, the patient outcome, etc., and then review and discuss together until all the data are agreed upon and begin to analyze. They finalized 216 CPR scenarios with cardiac arrest patient characteristics, and 194 scenarios that identified the depth and frequency of compressions.
Characteristics of cardiac arrest patients in medical dramas (Lilac Garden Mapping)
In medical dramas, CPR is mostly not standardized
Of the 194 identifiable scenarios, 91% of cardiac arrest patients were able to receive CPR immediately, which is very different from the real situation. But behind this excellent data, only 32% meet the pressure depth required by the American Heart Association/European Resuscitation Association, and 44% meet its compression frequency.
Considering that patients in medical dramas are also actors, and that CPR cannot be done on people with heartbeats, researchers also say that they can understand why most of the compressions are not deep enough.
CPR Specification Ratio in Medical Drama (Lilac Garden Mapping)
The operational specifications of CPR in medical dramas are very important, as they serve as the main window and medium for the general public to understand medical knowledge, and if accurate first aid knowledge can be transmitted, it can help more patients with cardiac arrest.
However, some studies have found that the average person who regularly watches medical dramas does worse than those who occasionally watch it. It can be seen that the induction of errors may indeed silently affect people's cognition and consume people's learning of accurate operation.
Paramedics in the show are better at CPR
In addition, the researchers also found that in most scenarios, the implementation of CPR is done by doctors, and a very small number of nurses or paramedics are used. Paramedics are healthcare workers who work in emergency situations and can be defined as people who provide advanced life support services before a patient is taken to the hospital.
Although the patients' spontaneous respiratory circulation recovery (ROSC) after CPR surgery was not much different in terms of patient outcomes, if the CPR operation was compared, the paramedics could be said to be better than doctors and nurses. Both the depth of compression, the frequency of compression, and the exact proportion of full rebound of the chest are far ahead.
Therefore, in medical dramas, doctors are in the limelight because of the diagnosis of incurable diseases, and auxiliary medical staff perform better in cardiopulmonary resuscitation.
Differences in CPR Between Three Types of Medical Staff in Medical Dramas (Lilac Garden Mapping)
Differences in CPR between men and women
Among the patients who received CPR in medical dramas, 145 were males and 67 were females, and the patients in several scenarios were registered as others, and the amount of information was too large to be included in this article.
In scenarios where compression depth and frequency are recognized, CPR differs between men and women. In terms of compression frequency, there is little difference between men and women, and in terms of compression depth, men enjoy CPR that is more in line with international requirements. In addition, there is little difference between men and women in the use of defibrillators.
Differences in CPR received by male and female patients in medical dramas (Lilac Garden Mapping)
A university of Pennsylvania study showed that this difference is also reflected in reality: When patients develop cardiac arrest in public, 45% of men can receive CPR, compared with only 39% of women. At the same time, male patients survive CPR 23% more than women.
According to the researchers, part of the reason for this phenomenon is the concept of "gender distinction". We usually practice CPR on the unified Resuscitation Anne, and Anne's chest has no breasts and does not have any female physiological characteristics. Over time, it becomes a fixed-trend thinking.
Rescuers may be hesitant to touch or damage a woman's breast when CPR is touched, making the compression depth insufficient, which in turn leads to a lower survival rate for women undergoing CPR in both the play and in reality than men.
In order to improve this problem, joan Creative in New York also created "Miss Annie" (Womanikin) together with the United Nations Women's Organization, that is, a knitted fake breast on the ordinary cardiopulmonary resuscitation dummy model to simulate the woman's breasts, hoping to alleviate the "embarrassment" and "unaccustomedness" of the rescuers suddenly facing female patients during the practice.
Image source: Screenshot of the Womanikin website
The effect of CPR in medical dramas is far beyond reality
To evaluate the effect of CPR, it is necessary to judge the spontaneous circulatory respiration recovery (ROSC), but in the play, the tactile pulse and measurable blood pressure are rarely depicted, and a small number of people will tell the audience by showing the rhythm on the monitor: The patient has been rescued.
But if you only consider admission to cardiac arrest and discharge, there is a total effective rate of 62%. Among them, the survival rate of male patients is 69.6%, and the survival rate of female patients is less than one-third.
However, according to the latest data from BMJ, the survival rate of CPR performed outside the hospital after cardiac arrest is about 12%, and the survival rate of CPR performed in the hospital is only 24% to 40%. Such a high survival rate in medical dramas may affect people's cognition, and giving CPR too high expectations may further lead to the waste of medical resources and the tension of the doctor-patient relationship.
Limitations of the study
Because the limitations of the CPR scene in the medical drama, the depth of compression, etc. can not be accurately measured, so the unified evaluation from only a few researchers is not very reliable; and the entire recovery process is not fully displayed, and as soon as the camera is turned, several rounds of CPR have passed.
In addition, the patients were not followed up after discharge, and the symptoms of their complications were unclear. There is also a limitation that is not said in the text: only watched English medical dramas. If you add medical dramas from other countries, what is the result?
A good medical drama not only requires a complete plot, online actor acting skills, and superb shooting skills, but also the most valuable thing is to restore the norms of medical diagnosis and treatment and the real medical world to the greatest extent.
Curated: z7
Executive Producer: Gyouza
Source: Screenshot of "Dr. House"
bibliography
1.https://www.ncbi.nlm.nih.gov/pubmed/?term=TVMD2%20study
3.Colwill M , Somerville C , Lindberg E , et al. Cardiopulmonary resuscitation on television: are we miseducating the public? [J]. Postgraduate Medical Journal, 2017:postgradmedj-2017-135122.
4.https://www.bmj.com/company/newsroom/patients-overestimate-the-success-of-cpr/