BOSTON — On the tube, there's nothing like a good cardiac arrest.
All that chest pounding. Those scary defibrillator paddles. And best of all, the near-dead are brought back to life with amazing regularity.
But in the real emergency room, doctors say, cardiopulmonary resuscitation--or CPR, as it's usually called--is no miracle. Indeed, a recent report in the New England Journal of Medicine contends that TV medical dramas misrepresent just about everything about CPR.
Dr. James A. Tulsky and colleagues from the Veterans Administration, Duke University and the University of Chicago watched 97 episodes of "ER," "Chicago Hope" and "Rescue 911." They counted 60 cases of CPR. Among their conclusions about the shows:
* Only 17% of people getting CPR were elderly. In reality, cardiac arrest is much more common with that age group.
* Three-quarters of the cases of cardiac arrest resulted from accidents, stabbings, lightning strikes and other non-cardiac disasters. In reality, 75% to 95% are triggered by underlying heart disease.
* Two-thirds of the CPR patients survived. In reality, survival is between 7% and 15%--and that's when patients' hearts stop beating in the hospital. With accident victims in cardiac arrest, the ER survival is close to zero.
* As dramatic as CPR looks on television, the shows don't convey how gruesome this procedure can be. "Resuscitation is an ugly thing," Tulsky said. "It's violent. It's not dignified. It may break bones in the chest."
Dr. Neal A. Baer, an "ER" co-producer, countered in an editorial in the journal that there is no evidence that watching these shows directly affects viewers' personal choices about CPR.
However, Dr. Gregory L. Henry, president of the American College of Emergency Physicians, said many people's unrealistic beliefs about CPR are a "tragic consequence" of television. "By and large," said Henry, "your death is pretty much predictable if you have cardiac arrest."