Teach CPR Correctly, Grey’s Anatomy
Not really spoilers, but just a warning before my rant, so look away!
Tonight’s episode featured several residents and attendings performing CPR on patients, and boy did they do it wrong. Normally it’s fun to get mad at the medical dramas for their medical inaccuracy, because we medical folks know better, but I honestly think the producers and medical consultants for the show really did viewers (and the public at large) a disservice, as CPR is one of the areas of medicine that the public may be called upon to perform
20 million people watch the show (and that’s just in the US), and with no change in the plot, timing, or dialog, the writers, directors, and actors could have been demonstrating proper CPR technique. They got the ratio of breaths to compressions wrong, and they got the speed and force of compressions wrong, too. According to the 2005 guidelines (click the image for a full-sizer) , you give 2 breaths per 30 compressions (they did 2 breaths per 5 compressions), and you should be pushing hard, moving the chest wall. You should be trying to mimic a heart rate of 100–that’s almost 2 compressions a second. The 2 codes that I’ve seen have not been pretty; they’ve been violent, frantic, and aggressive. People performing CPR generally can’t keep it up for more than a couple minutes: it is exhausting.
So rather that demonstrate what it should look like when a real person is actually performing CPR, they demonstrated the wrong technique in a watered-down version. I hope to God that if a viewer has to perform CPR in the future, he or she doesn’t use Grey’s as their refresher course or example.
Here are the latest CPR guidelines, and you can learn CPR at a class near you. (But remember, the most important step is early activation of 911. And also remember your ABCs: Airway, Breathing, Circulation!)
Update: Oh no! Dr. Karen Pike is the medical consultant, she’s an ER doc, she lives in the Bay Area, and she graduated from Stanford’s ER residency! Busted!
Update 2: I love you, YouTube CPR.
That is a pet peeve of mine, too. Not that I’ve seen the Greys episode, but on other shows and movies. I never really noticed it til my doctor sis commented on a scene in a movie where the doctors had given up and there was a peaceful touching scene between the patient and her family. “That would NEVER happen in real life!” It’s similar to how I feel when they try to put computer stuff into movies.
I’ve had this argument a few times with other medical students and we’ve come to the following conclusion: it’s a good thing that the compressions are weak as it would probably be very uncomfortable for the person being compressed and the potential for injury is unacceptably high.
Coming from a medical background, what you all need to understand is that it is entertainment. Duh, it wouldn’t happen in real-life! Come on, it’s TV. The CPR thing was ridiculous though, I’ll say that much. Anyway, that’s all for now.
Also, if you keep thinking that x wouldn’t happen in real-life in terms of movies in general, then I’d imagine you’d spend most of your life loathing theatres. Maybe you do, but to keep on saying “hell, that couldn’t happen” when watching a movie is just stupid, to put it lightly. Sorry, it’s just a huge pet-peeve of mine when people do running commentary on films trying to be the next cynic of the century.
Actually, the AMA has changed certain details of CPR so much in the last few years that I’m confused—and I’m not really sure that I know how to do it right myself anymore, heh!
Oops…I meant the AHA. (I told you I was confused.) (Here in podunk it’s “corn-fused”…)
In Europe the CPR protocol is slightly different, since after you evaluate the absence of breathing, you start immediately with the 30 chest compression, and only after those you do the 2 rescue breaths. (see http://www.erc.edu)
I agree with Topher. To appreciate Grey’s Anatomy, you sort of have to accept that you’re not watching reality TV. To me, the show is more about people, and science or medicine is just the setting. There’s a lot more character development in Grey’s than you normally see on TV. The show might be escapist fantasy but the characters and their emotions are complex and real. It’s really very high quality TV. TV is all about melodrama, and Grey’s has a way of performing melodrama with honesty and integrity. What I can’t stand is why people would rather watch CSI, and why more people aren’t criticizing the gratuitous violence that’s become a “normalized” expression of American culture. Did anyone see the American Heart Association commercial during the Superbowl? The one in which evil superheroes were beating up an old frail heart? Clearly, the target audience of the commercial was kids.
I am one of the physicians who helps develop the CPR guidelines and teaching materials for the American Heart Association (AHA), and I am glad that folks are concerned about how CPR is depicted in the media — so am I. I know its “just a TV show”, but a lot of folks get important impressions from TV… we are trying to collect examples of bad CPR on TV to discuss at the AHA, if any of you can point us to specific TV shows/episodes, we’d be grateful (and you’d possibly be doing the world of CPR teaching a service!)
Email any tips or clips to resuscit@resuscitationatpenn.com
thanks!
My wife (ER doc) and I (Ortho “doc”) always comment on the weak compressions we see. I was actually impressed with the first compressions in that the chest wall actually moved. It wasn’t until the “chief” started doing compressions that it went back to “TV – barely touch the patient” compressions. And you CAN make it more real… use the CPR dummy body and the actor’s head and crank away.
We learned in med school that if you don’t break a couple ribs, you’re not compressing hard enough (which is why compressions are probably the only thing an Orthopod is good for in a code).