Outdated CPR on TV could delay lifesaving interventions

Scripted television often shows outdated CPR techniques for lay people, potentially fueling misconceptions that could delay bystanders' lifesaving interventions in the crucial moments after a real-life cardiac arrest. That's according to University of Pittsburgh School of Public Health and School of Medicine researchers in the first analysis of TV depictions of bystander CPR, published today in Circulation: Population Health and Outcomes.

In 2008, the American Heart Association (AHA) endorsed hands-only CPR, a simpler and faster intervention that was shown to be equally as effective in rushing oxygen to vital organs, compared to the approach used by healthcare providers that also incorporates rescue breaths.

In my volunteer work training Pittsburgh youth in CPR, there's a lot of confusion. We ask students, 'What's the first thing you do?' and they say, 'Check for a pulse.' But we don't do that in bystander CPR anymore. And in our pre-course surveys, a lot of students say that they've seen CPR on social media and television. Those two observations inspired the study."

Beth L. Hoffman, Ph.D., MPH, assistant professor of behavioral and community health sciences at Pitt Public Health

Hands-only CPR is just two steps: call 911 and start chest compressions. But when the researchers analyzed 169 U.S. television show episodes that portrayed hands-only CPR since 2008, they found that fewer than 30% of episodes depicted the steps correctly. Nearly half of the episodes showed outdated practices, including mouth-to-mouth resuscitation (48%) and pulse checks (43%).

The team's analysis found more disconnects between TV and real life, in both who receives bystander CPR and where they receive it. On-screen, 44% of recipients were between the ages of 21 and 40, whereas in reality, the average age of people receiving CPR is 62. And in the shows studied, 80% of CPR recipients were in public and 20% were at home, but in actuality, 80% of out-of-hospital cardiac arrests happen at home.

"This can potentially skew public perceptions," said Ore Fawole, B.S., B.A., a recent Pitt graduate who spearheaded the coding and analysis for the study as lead author. "If viewers think cardiac arrest only happens in public or to young people, they may not see CPR training as relevant to their own lives. But most cardiac arrests happen at home, and the person you save is likely someone you love."

The study also showed disparities in who receives CPR-and in this case, fiction and reality were aligned. Most cardiac-arrest victims receiving hands-only CPR on-screen were white men. Today, women and Black and Latino people are less likely than white men to receive the lifesaving intervention from a bystander.

"Whether this is reflecting reality or whether it's shaping reality, we don't know, but that would be a good question to explore in future studies," said Hoffman. She added that collaborations between public health experts and content creators could help ensure that depictions of CPR empower viewers to act-and act correctly-when seconds count.

Other authors on the study were Sylvia Owusu-Ansah, M.D., MPH; and Ankur A. Doshi, M.D., both of Pitt's School of Medicine.

This research was supported by the National Institutes of Health (UL1TR001857).