Availability and Quality of Internet-Based Cardiopulmonary Resuscitation Training Films Featuring Women Experiencing Cardiac Arrest

Abstract

Despite efforts to reduce disparities in cardiopulmonary resuscitation (CPR) provision, men are more likely than women to receive bystander CPR worldwide. 1,2 Women have worse outcomes following out-of-hospital cardiac arrest than men. [1][2][3] In the Resuscitation Outcomes Consortium registry, men had a 29% increased probability of survival to discharge compared with women. 1 Bystanders report common themes behind hesitation to perform CPR on women. Bystanders are less likely to remove clothing and place hands properly because of fears of personal violation, breasts interfering with CPR, and causing physical injury. 4,5 Methods | The study was a cross-sectional analysis performed using the most common online search engine (Google) and the most common online video site (YouTube) to identify free, online instructional CPR films. Institutional review board approval and consent procedures were not required because this was not human subjects research. Each site was queried by searching for the phrase "how to do CPR." The search was restricted to page 38 of the search results for Google (374 videos) and page 25 of the search results for YouTube (500 videos). Exclusion c riteria included humor/parody or noninstructional content, pediatric CPR, CPR on animals, non-English language content, live videos, content from an inhospital location, duplicate videos, CPR on a pregnant woman, or CPR on a man. The affected person's sex was assessed visually by the authors. Although the face of Resusci-Anne, a CPR manikin, is modeled after a young woman, the torso lacks breasts and the manikin is considered unisex. Therefore, videos with no person in cardiac arrest other than this manikin were not considered to feature a woman experiencing cardiac arrest, particularly given that breasts are a common barrier to performing CPR on a woman.Videos were scored (C.W.L.) and reviewed (L.E.B.T.) on 6 key aspects of CPR education: (1) assessing scene safety, (2) checking victim responsiveness, (3) activating emergency medical services, (4) properly positioning hands, (5) using an accurate rate of compression (100-120 per minute), and (6) using an appropriate depth (2-2.5 in [5-6 cm]). 6 Those that demonstrated 5 or more criteria were considered high quality. Videos were also coded according to whether they taught current, hands-only CPR technique and specifically addressed barriers to performing CPR on women. Videos from the American Heart Association and American Red Cross were separately evaluated. Data collection occurred in April and May 2019. Data were analyzed with Excel version 16.16.22 (Microsoft).

Evaluating Effectiveness of YouTube Videos for Teaching Medical Students CPR: Solution to Optimizing Clinician Educator Workload during the COVID-19 Pandemic

“…These YouTube videos were selected by the course instructor for this study, as they covered the same content as the screencast video by the instructor and the contents included the key aspects of CPR education that are reported in the literature, namely: (1) assessing scene safety, (2) checking victim responsiveness, (3) initiating contact with emergency medical services, (4) proper hand positioning for CPR, (5) accurate compression rate (100–120 per minute), and (6) appropriate chest compression depth (2–2.5 inches) [ 19 ]. The YouTube videos were not modified for the purpose of the course.…”

Gender inequality in hands-only cardiopulmonary resuscitation videos on YouTube

“…[18][19][20] A recent study observed that there is a scarcity of female-specific CPR instructional videos available on the internet. 21 To our knowledge, there has been no systematic analysis comparing videos about Hands-only CPR based on the gender of the recipient. Given the importance and misconceptions about it, this type of analysis would be a valuable next step in developing interventions.…”