Jul 28, 2014
Common misconceptions thanks to inaccurate procedures portrayed by medical TV shows.
When it comes to performing CPR on a victim in dire need of help, hearing the words “Don’t worry, I saw this on TV,” isn’t exactly reassuring. Aside from the fact that watching paid actors simulate a scripted CPR scene on camera does virtually nothing in terms of replicating the magnitude of a real life emergency, also take this into consideration: they usually don’t even do it right.
Don’t get me wrong; I happen to find some medical drama’s highly entertaining. I will not look down on any healthcare professional that chooses to spend their nights plucked in front of the TV with the cast of Grey’s Anatomy, nor am I above joining in on an eight-hour House marathon. That having been said, these are the last places I’d turn to for medical advice. From fictional diseases to fallacious depictions of the roles played, medical dramas are often flawed by a host of medical inaccuracies.
We see it all the time, just slightly different variations of the same story. You know, the one where the patient flatlines and all seems lost, until the dreamy doctor gives the defibrillators a quick “good luck” rub and miraculously brings the patient back to life. Strictly from a cinematic standpoint, the dramatic effect these scenes are able to accomplish earns two thumbs up from me. Medically speaking, however, their authenticity is far from superb.
I know that the purpose of these shows is to entertain their audience, not to educate them. I understand that criticizing the medical procedures used on TV shows is probably being a bit too over-analytical. I recognize all of that, but I’m going to do it anyways. Here are the three most common CPR myths that derive from inaccurate medical TV shows.
This is the granddaddy of CPR myths – the misconstrued belief that more often than not, performing life support on a dying patient ends with a successful resuscitation. A New England Journal of Medicine study concluded that 75% of on-screen resuscitations result in the patient surviving cardiac arrest immediately once CPR is performed. More up-to-date studies have shown that survival rates on recent TV shows are closer to 55%, a slight improvement, but still far from realistic. Anyone who has ever worked in a hospital or has adequate CPR training knows that number is far from the truth.
Take a look at the CPR survival rates from three popular medical dramas:
- ER – 68%
- Chicago Hope – 64%
- Grey’s Anatomy – 46%
Compare those numbers to the actual survival rates from these medical studies:
- Journal of the American Medical Association study – 2% of adults who collapse on the street and receive CPR fully recover.
- American Heart Association study – 8% of people who suffer from cardiac arrest outside of a hospital survive.
- National Center for Biotechnology Information (NCBI) study – 15% of patients who receive in-hospital CPR are successfully resuscitated.
As you can see, there is a significant discrepancy between on-screen survival rates and actual survival rates. What’s even more disturbing, however, is how most people’s opinion towards CPR survival rates tends to navigate closer to the percentages portrayed on TV. Here are the findings of a recent NCBI survey: “Most respondents (81%) believed that their chance of surviving inpatient CPR and leaving the hospital was 50% or better, and 23% of those respondents believed that their chance was 90% or better.
It is tough to come up with an exact survival rate, but most research estimates the actual survival rate is between 5-10%.
CPR is not some magical formula that instantly brings people back to life. It’s not even a preferred option – it’s a last resort. If a patient needs CPR, it means that their heart has literally stopped working. These days, when most things malfunction, all you need to do is hit the reset button and wait for it to start up again. We’re talking about a human heart though – there is no universal reset button. Sadly, it’s not as easy as pressing a button that instantly restarts a heart and brings a patient back to life 75% of the time.
This one drives healthcare professionals crazy. Perhaps the most stereotypical drama-filled CPR TV scenes always reach their climax once the heart rate monitor “flat-lines,” and the patient is all but dead – until the defibrillator gets charged, the nurse yells, “CLEAR,” and the doctor zaps the patient back to life.
Here’s the thing: shocking a patient who has flat-lined will do absolutely nothing in terms of helping bring a patient back to life. In medical terms, a flat-line is a condition known as asystole, which means the heart is not contracting. Seems logical to shock the patient to create a contraction, right? Wrong.
In simple terms: sending a massive shock of electrical energy to the heart is meant to take an irregular heartbeat and revert it into a normal rhythm – not to restart a heart. Shocking a patient who has no rhythm is the last thing a patient needs. To treat a patient for asystole, the proper method is to continue performing CPR, (epinephrine is commonly advised for treating asystole patients).
For a more scientific, in-depth explanation of why you should never shock a flat-lined patient, check out this Gizmodo article.
There are several defibrillator techniques often deployed in medical TV shows that are rather puzzling. I’ll start with the classic “defibrillator rub,” where the doctor gives the paddles a little good-luck-rub together before shocking the victim. Even though it has practically become customary for TV shows, you will never see this happen in reality. It might look cool and add to the drama, but it is completely unnecessary. In fact, rubbing the paddles together will do nothing but damage the device.
Another common mistake you see with the use of defibrillators is their placement when shocking a patient. As this National Institutes of Health article shows, the proper way to set up an Automated External Defibrillator (AED) is by placing one pad on the right center of the person’s chest above the nipple, and the other pad slightly below the other nipple and to the left of the rib cage (as pictured below). However, on TV you’ll typically see the paddles placed parallel to one another on a victim’s chest.
Some healthcare professionals couldn’t care less about medical TV shows and shrug off the inaccuracies they display. Some become genuinely angered and refuse to watch such shows. Others find them comical and simply laugh – and they’ll probably laugh even harder at this article purely for the fact that I even gave this topic the time of day.
But the fact is, for people who are not healthcare professionals, what they see on TV is responsible for a large portion of their medical knowledge. Specifically, those individuals without any prior CPR education or training, these shows are essentially their form of Basic Life Support training.
I am not going to tell you to stop watching medical dramas. In fact, all this writing about them got me in the mood, and I’m about to start catching up on Chicago Fire as we speak. All I’m saying it to proceed with caution. Enjoy the show, but don’t take notes.