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Cardiac arrest reported in newspapers: A new, yet missed, opportunity to increase cardiopulmonary resuscitation awareness

      To the Editor,
      Newspapers have the potential to influence the individual actions of the general population. Specifically, in the context of resuscitation, newspapers may influence readers’ expectations by giving an over-optimistic idea of survival after out-of-hospital cardiac arrest (OHCA).
      • Field R.A.
      • Soar J.
      • Nolan J.P.
      • Perkins G.D.
      Epidemiology and outcome of cardiac arrests reported in the lay-press: an observational study.
      Newspapers may also convey to readers wrong messages about resuscitation manoeuvres, possibly altering how laypeople react in the case of OHCA. In this work, we describe how cases of OHCA are reported in the Italian general press.
      We systematically identified and analysed 369 online newspaper articles reporting 255 single cases of OHCA that occurred in Italy between January 1, 2019, and December 31, 2019 (Table 1). Only 41 (11%) included at least one content that may educate the readers or encourage them to learn cardiopulmonary resuscitation (CPR) manoeuvres. In details, the importance of basic life support (BLS) initiated by bystanders, public access defibrillation (PAD), and BLS courses attendance was stressed in thirty-four (9.2%) articles. Nine articles (2.4%) explained cardiac arrest pathophysiology and described how automated external defibrillators (AEDs) work and seven articles (2.0%) illustrated projects aiming to increase community awareness and PAD programs. Three articles included a video describing an AED and simulating BLS manoeuvres. Extraordinarily, one article published the map of AEDs available nearby the reported OHCA. Furthermore, only 54% of online newspaper articles correctly and clearly identified the unfortunate event as “cardiac arrest” in the title. Titles incorrectly described the event as “collapse or loss of consciousness” (18%) and “myocardial infarction or heart attack” (17%) in the other cases. Nevertheless, the event was correctly identified as cardiac arrest in the text’s body of the majority of articles (70%).
      Table 1Details of online newspaper articles reporting a case of out-of-hospital cardiac arrest.
      All online newspaper articles
      n = 369
      Individual cases of out-of-hospital cardiac arrest, n255
       Number of articles per case, mean (SD)1.5 (1.1)
      Paywall, n (%)12 (3.3%)
      Definition of the event in the title
       Cardiac arrest, n (%)198 (54%)
       Collapse or loss of consciousness, n (%)68 (18%)
       Myocardial infarction or heart attack, n (%)62 (17%)
       Reported CPR or AED use, n (%)57 (15%)
       Heart stopped beating, n (%)5 (1.4%)
      Definition of the event in the text
       Cardiac arrest, n (%)257 (70%)
       Collapse or loss of consciousness, n (%)51 (14%)
       Myocardial infarction or heart attack, n (%)31 (12%)
       Reported CPR or AED use, n (%)76 (21%)
       Heart stopped beating, n (%)1 (0.3%)
      Contained at least one educational content, n (%)41 (11%)
       Importance of BLS and AED, n (%)34 (9.2%)
       Explained BLS or AED, n (%)9 (2.4%)
       Promoted a project, n (%)7 (2.0%)
       Included a video, n (%)3 (0.8%)
       Included a map of AEDs in the area, n (%)1 (0.3%)
      Abbreviations: SD = standard deviation, CPR = cardiopulmonary resuscitation, AED = automated external defibrillation, BLS = basic life support.
      Based on these findings, we developed a press and media kit for journalists interested in reporting accurate information when writing about cardiac arrests. This press kit includes four paragraphs explaining cardiac arrest, the difference between cardiac arrest and myocardial infarction or heart attack, CPR, and AED importance. We also provide two videos illustrating BLS and AED manoeuvres (standard and COVID-19 adapted) and two images summarising the correct steps to perform BLS of high quality and defibrillation. Journalists and reporters can freely use this material in their future practice, hopefully increasing the accuracy of cardiac arrest reporting. Images and videos can be downloaded or embedded directly in the article website. We further provide a link to search BLS courses and the availability of smartphone apps to alert citizens as first responders or to locate the nearest AED.
      • Scquizzato T.
      • Pallanch O.
      • Belletti A.
      • et al.
      Enhancing citizens response to out-of-hospital cardiac arrest: a systematic review of mobile-phone systems to alert citizens as first responders.
      • Scquizzato T.
      • Burkart R.
      • Greif R.
      • et al.
      Mobile phone systems to alert citizens as first responders and to locate automated external defibrillators: a European survey.
      • Semeraro F.
      • Zace D.
      • Bigham B.L.
      • et al.
      First responder engaged by technology consensus on science with treatment recommendations.
      This press kit is available on the official website of the Italian Resuscitation Council (https://www.ircouncil.it/per-il-pubblico/press-kit-arresto-cardiaco/).
      Our findings recognise the crucial role of newspapers, journalists, and mass media in disseminating accurate information about cardiac arrest. Only one in ten articles provided some education bullets to the reader or encouraged them to learn CPR, while at least half of the events were not correctly reported as cardiac arrest in the title. We would like to emphasise the strategic use of the general press. Healthcare institutions and local emergency medical services could team with media and news agencies to provide correct information about cardiac arrest. This could lead to increased awareness and motivation for laypeople, making journalists an integrated part of “Systems Saving Lives” strategies in the next future.

      Authors’ contributions

      Design of the study: Scquizzato T, Gazzato A, Semeraro F, Landoni G, Ristagno G, Scapigliati A.
      Data collection: Scquizzato T, Gazzato A, Semeraro F, Landoni G, Ristagno G, Scapigliati A.
      Statistical analysis: Scquizzato T, Gazzato A, Ristagno G.
      Manuscript draft and critical review: Scquizzato T, Gazzato A, Semeraro F, Landoni G, Ristagno G, Scapigliati A.
      Administrative support: Ristagno G, Scapigliati A.

      Conflict of interest

      FS is Vice-Chair and Science and Education Committee BLS co-Chair of the European Resuscitation Council, ILCOR BLS Working Group members, Scientific Committee member of Italian Resuscitation Council. GR is the President of the Italian Resuscitation Council, ILCOR BLS Working Group member, Science and Education Committee BLS member of the European Resuscitation Council. AS is the Past President of the Italian Resuscitation Council and Science and Education Committee BLS member of the European Resuscitation Council. TS, AG, and GL have no conflicts of interest.

      References

        • Field R.A.
        • Soar J.
        • Nolan J.P.
        • Perkins G.D.
        Epidemiology and outcome of cardiac arrests reported in the lay-press: an observational study.
        J R Soc Med. 2011; 104: 525-531https://doi.org/10.1258/jrsm.2011.110228
        • Scquizzato T.
        • Pallanch O.
        • Belletti A.
        • et al.
        Enhancing citizens response to out-of-hospital cardiac arrest: a systematic review of mobile-phone systems to alert citizens as first responders.
        Resuscitation. 2020; 152: 16-25https://doi.org/10.1016/j.resuscitation.2020.05.006
        • Scquizzato T.
        • Burkart R.
        • Greif R.
        • et al.
        Mobile phone systems to alert citizens as first responders and to locate automated external defibrillators: a European survey.
        Resuscitation. 2020; 151: 39-42https://doi.org/10.1016/j.resuscitation.2020.03.009
        • Semeraro F.
        • Zace D.
        • Bigham B.L.
        • et al.
        First responder engaged by technology consensus on science with treatment recommendations.
        (Available from:) International Liaison Committee on Resuscitation (ILCOR) EIT Task Force, Brussels, Belgium2019