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PAPERS: P N Gordon, S Williamson, and P G Lawler As seen on TV: observational study of cardiopulmonary resuscitation in British television medical dramas BMJ 1998; 317: 780-783 [Abstract] [Full text]

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Television Dramas

Geoff Hughes   (28 September 1998)

Crime dramas could do better

Jonathan P Wyatt   (1 October 1998)

Television Dramas 28 September 1998
Geoff Hughes, Clinical Director Emergency & Trauma Services Wellington Hospital Wellington New Zealand Wellington NZ Send response to journal: Re: Television Dramas	Sir I read the article by Gordon, Williamson and Lawler with considerable interest. From 1991-1997 (when I left Bristol)I was medical adviser to the BBC programme 'Casualty'. I am pleased that the successful outcomes from resuscitation cases were in line with the 'BRESUS' figures. This was not deliberatley planned. During my time with the programme I worked with six producers, dozens of directors and an even greater number of writers. Generally I (or the nurse adviser) would be asked for a solution to an idea in the writer's mind along the lines of: - "a fit young male suffers a catastrophic collapse but recovers rapidly within a few hours etc etc". For the majority of cases a satisfactory disease/condition was identified. Occassionally the fictional demand was so extreme that a solution could not be found or a tough compromise between fact and fiction negotiated. The latter sometimes pushed us to the limits of medical credibility. Resuscitation is a popular choice because it looks good visually, gives the actors some psychomotor activity and helps move the plot forward with minimal dialogue. The nature of the non-medical fiction demanded frequent poor outcomes. Additional advice given included ideas about NHS politics and reforms, professional issues for doctors and nurses and the limits that the writers could reach for their stories e.g. A & E departments do not routinely perform emergency caesarian sections in resus!. Although there was rarely any long term strategic planning to the indivdual medical stories we always strived to maintain medical credibility. This paper is interesting and I for one found the results of great value.
Crime dramas could do better 1 October 1998
Jonathan P Wyatt Send response to journal: Re: Crime dramas could do better	EDITOR - As unashamed regular viewers of television dramas, we agree with Gordon et al that television can play a key role in moulding the public's knowledge and attitudes regarding emergency medical matters.1 Although British television medical dramas may present scenes of cardiopulmonary resuscitation realistically, we are concerned that British television crime dramas may mislead the public as to how to respond when finding an unresponsive trauma victim. These programmes frequently depict unresponsive victims being found soon after sustaining trauma, yet the actions of the persons finding the victim (usually police officers) often appear to be highly deficient. Initial assessment rarely follows standard guidelines, usually merely consisting of a cursory pulse check.2 An ambulance is rarely called and resuscitation rarely started. These deficiencies are not often easily explained away simply in terms of a concomitant "risk to the rescuer". A recent typical example was the ITV screening of "A touch of Frost" during Sunday evening on 23rd August 1998. In this episode, Inspector Frost found a young woman within a few minutes of her being "strangled", but he did not perform an airway or breathing check, did not summon help and did not commence resuscitation. Instead, he simply performed a cursory (and inadequate) pulse check. Makers of television crime dramas have a responsibility to educate the public about the need to make an adequate assessment, summon help and commence basic life support when a victim is found after recent trauma. This is particularly true with certain mechanisms of injury (eg drowning, strangulation, hanging), where resuscitation after cardiac arrest may result in neurologically intact long-term survival.3 Television producers could improve the educational component of their programmes by increasing involvement of medical advisors. Jonathan Wyatt Consultant in Accident and Emergency, Treliske Hospital, Truro, TR1 3LJ Polly Wyatt Paediatric nurse, Treliske Hospital, Truro, Cornwall TR1 3LJ 1 Gordon PN, Williamson S, Lawler PG. As seen on TV: observational study of cardiopulmonary resuscitation in British television medical dramas. BMJ 1998; 317: 780-3. 2 Resuscitation Council (UK). Advanced Life Support Course Provider Manual (3rd edition). Resuscitation Council (UK), London, 1998. 3 Golden F St C, Tipton MJ, Scott RC. Immersion, near-drowning and drowning. Br J Anaesthesia 1997; 79: 214-25.