CPR BLOWN OUT OF PROPORTION ON TV, RESEARCHERS SAY.

Byline: Suzanne Zolfo Medical Tribune News Service

Don't believe everything you see on some of television's most popular hospital and medical dramas, a new study warns.

Researchers found that people who receive cardiopulmonary resuscitation (CPR) on television fare remarkably better than people in real life.

``CPR can lead to prolonged suffering, severe neurologic damage or an undignified death,'' the researchers wrote.

The investigators raised concern over whether television audiences have an unrealistic view of their chances of survival and recovery after CPR.

The study, which focused on how CPR is portrayed on CBS' ``Chicago Hope'' and ``Rescue 911'' and NBC's ``ER,'' appears in a recent issue of the New England Journal of Medicine.

But the researchers' concerns are based on the assumption that the television-watching public does not distinguish between fact and fiction, said a Red Cross official.

``The purpose of television is entertainment,'' said Jose Salazar, an associate for Health and Safety Education and Development for the American Red Cross at the national headquarters in Falls Church, Va. The instructors of the Red Cross CPR classes are frank with students about survival rates, Salazar said.

In the episodes the researchers watched, 75 percent of the people who suffered cardiac arrests were alive immediately after they received CPR.

However, medical literature indicates that only zero to 30 percent of the people who experience cardiac arrest resulting from a trauma injury actually survive. ``The public should not be deluded and think that this is what is going to happen,'' said Dr. Gregory L. Henry, supervisor of Emergency Medicine Rotation for the Family Practice Residency Program at the University of Michigan in Ann Arbor.

The team of investigators, led by Dr. Susan J. Diem at the Durham Veterans Affairs Medical Center in Durham, N.C., found 60 occurrences of CPR in 97 episodes of the three shows combined that they watched.

The prevalence of miracle recoveries, especially on ``Rescue 911,'' could lead TV viewers to ignore advice from their doctors and to hope for miracles - both of which could be harmful to patients, the study said.

``Instead of blaming television for failing to portray CPR accurately, physicians need to make a concerted effort to discuss this difficult topic openly with all their patients,'' wrote Dr. Neal A. Baer, one of the writers for ``ER,'' in an accompanying editorial.

Diem and her collaborators found that the portrayal of CPR and death on these popular television shows was misleading in several ways that could lead viewers to believe that they are more likely to survive and recover completely if they are given CPR than is realistic.

The aftermath of CPR on television was portrayed as either full recovery or death, except for one instance in which the patient stammered moderately when speaking.

``CPR is not without its dangers,'' Henry said.

The treatment involves external chest compression and mouth-to-mouth resuscitation.

People who give mouth-to-mouth resuscitation can contract diseases such as tuberculosis through the exchange of saliva between the patient and the person trying to revive him, Henry said.

Although the chest compression can restart a person's heart, the individual may have no brain function, leaving the patient on a life-support system.

Diem and her team observed that 28 percent of the television incidents of CPR resulted from an underlying heart disease.

The other 72 percent resulted from a trauma, most commonly near-drowning or gunshot wounds.

But in reality - 75 percent to 95 percent of the time - CPR is performed because of an existing cardiac disease, Henry said.

``Traumatic injuries really have nothing to do with CPR,'' he added.

In the three shows watched, 65 percent of the CPR cases were children, teen-agers and young adults, another inaccuracy, he said.

``CPR is easily 50 times more common in the elderly than in the young,'' Henry said. Children, teens and young adults make up less than 1 percent of the people who receive this treatment.