Cardiopulmonary resuscitation in television medical dramas: Results of the TVMD2 study

Introduction: Television medical dramas (TVMDs) use cardiopulmonary resuscitation (CPR) as a mean of achieving higher viewing rates. TVMDs portrayal of CPR can be used to teach laypersons attempting to perform CPR and to form a shared professional and layperson mental model for CPR decisions. We studied the portrayal of CPR across a wide range of TVMDs to see whether newer series fulfill this promise. Materials and methods: Advanced cardiac life support (ACLS) certified healthcare providers underwent training in the use of a unique instrument based on the AHA (American Heart Association) guidelines to assess TVMD CPR scenarios. Components of the assessment included the adequacy of CPR techniques, gender distribution in CPR scenes, performance quality by different healthcare providers, and CPR outcomes. Thirty-one TVMDs created between 2010 and 2018 underwent review. Results: Among 836 TVMD episodes reviewed, we identified 216 CPR attempts. CPR techniques were mostly portrayed inaccurately. The recommended compressions depth was shown in only 32.0% of the attempts (n=62). The recommended rate was shown in only 44.3% of the attempts (n=86). Survival to hospital discharge was portrayed as twice higher in male patients (67.6%, n=71) than in female patients (32.4%, n=29) (p < 0.05). Paramedics were portrayed as having better performance than physicians or nurses; compression rates were shown to be within the recommendations in only 42% (n=73) of the CPR attempts performed by physicians, 44% (n=8) of those performed by nurses, and 64% (n=9) of those performed by paramedics. Complete chest recoil after compression was shown in only 34% (n=58) of the CPR attempts performed by physicians, 38% (n=7) of those performed by nurses, and 64% (n=9) of those performed by paramedics. Outcomes were better on the screen than in real life; among the episodes showing outcome (n=202), the overall rate of survival from CPR was 61.9% (n=125). Conclusion: Portrayal of CPR in TVMDs remains a missed opportunity for improving performance and communication on CPR. (C) 2020 Published by Elsevier Inc.