Diem S J, Lantos J D, Tulsky J A
Center for Health Services, Research in Primary Care, Durham Veterans Affairs Medical Center, NC 27705, USA.
N Engl J Med. 1996 Jun 13;334(24):1578-82. doi: 10.1056/NEJM199606133342406.
Responsible, shared decision making on the part of physicians and patients about the potential use of cardiopulmonary resuscitation (CPR) requires patients who are educated about the procedure's risks and benefits. Television is an important source of information about CPR for patients. We analyzed how three popular television programs depict CPR.
We watched all the episodes of the television programs ER and Chicago Hope during the 1994-1995 viewing season and 50 consecutive episodes of Rescue 911 broadcast over a three-month period in 1995. We identified all occurrences of CPR in each episode and recorded the causes of cardiac arrest, the identifiable demographic characteristics of the patients, the underlying illnesses, and the outcomes.
There were 60 occurrences of CPR in the 97 television episodes--31 on ER, 11 on Chicago Hope, and 18 on Rescue 911. In the majority of cases, cardiac arrest was caused by trauma; only 28 percent were due to primary cardiac causes. Sixty-five percent of the cardiac arrests occurred in children, teenagers, or young adults. Seventy-five percent of the patients survived the immediate arrest, and 67 percent appeared to have survived to hospital discharge.
The survival rates in our study are significantly higher than the most optimistic survival rates in the medical literature, and the portrayal of CPR on television may lead the viewing public to have an unrealistic impression of CPR and its chances for success. Physicians discussing the use of CPR with patients and families should be aware of the images of CPR depicted on television and the misperceptions these images may foster.
医生和患者就心肺复苏术(CPR)的潜在使用做出负责任的、共同的决策,需要患者了解该操作的风险和益处。电视是患者获取心肺复苏术信息的重要来源。我们分析了三个热门电视节目对心肺复苏术的描绘方式。
我们观看了1994 - 1995收视季电视剧《急诊室的故事》(ER)和《杏林先锋》(Chicago Hope)的所有剧集,以及1995年三个月期间连续播出的50集《急救911》(Rescue 911)。我们确定了每集中所有心肺复苏术的出现情况,并记录了心脏骤停的原因、患者可识别的人口统计学特征、基础疾病以及结局。
在97集电视剧中出现了60次心肺复苏术——《急诊室的故事》中有31次,《杏林先锋》中有11次,《急救911》中有18次。在大多数情况下,心脏骤停是由外伤引起的;只有28%是由原发性心脏原因导致的。65%的心脏骤停发生在儿童、青少年或年轻人身上。75%的患者在心脏骤停后立即存活,67%的患者似乎存活至出院。
我们研究中的存活率显著高于医学文献中最乐观的存活率,电视上对心肺复苏术的描绘可能会使观众对心肺复苏术及其成功几率产生不切实际的印象。与患者及其家属讨论心肺复苏术使用情况的医生应意识到电视上描绘的心肺复苏术画面以及这些画面可能引发的误解。