The Unacceptable state of medical reporting

A recent study found that when compression-only CPR was conducted by bystanders with the assistance of a dispatcher the survival rate of victims suffering from cardiac arrest improved. The NHS Behind the headlines team point out that the researchers ‘do not advocate from their findings that people should make a deliberate decision to avoid mouth-to-mouth resuscitation without guidance from the emergency services’. Furthermore:

Importantly, all the incidents included in this study were of out-of-hospital cardiac arrest due to heart-related problems; the researchers say that other studies have found that standard CPR is better for cardiac arrest with non-cardiac causes (e.g. drowning, trauma and asphyxia, which would be the case in most arrests in babies and children). [emphasis is mine]

The NHS try to make clear that this is important, ‘well-conducted research’ but that the ‘findings only apply to this population in these specific circumstances, and do not apply to the general public in all circumstances’. They even point out that ‘many emergency medical dispatchers in the UK make recommendations to bystanders of an adult cardiac arrest that are broadly consistent with these findings anyway’.

So, how did our responsible media report these findings?

First up the BBC goes with: ‘Study backs chest compressions in resuscitation‘. They start with:

Concentrating on chest compressions rather than mouth-to-mouth when giving emergency resuscitation can produce better results, says research published in The Lancet.

Although they give plenty of information they fail to really gets to grips with the specificity of what the researchers found and the reader is probably left with the impression that avoiding mouth-to-mouth when performing CPR is always likely to produce ‘better results’. Therefore the article is, to a certain extent, misleading.

Next up the Telegraph chooses to go with: ‘Skip the ‘kiss’ when giving the kiss of life doctors recommend‘. The article starts with:

Skip the ‘kiss’ when giving the kiss of life, doctors advise, as study reveals performing only chest compressions is more effective at saving lives.

Again, the article fails to mention the specificity of the results and is accompanied by a photo of two female lifeguards, one performing CPR on the other on a wet beach. Clearly the photo is illustrating the resuscitation of someone who has drowned, a situation in which traditional CPR (with the ‘kiss’) is better according to the NHS (see above). The article is broadly the same as the BBC in that it is misleading because it generalises very specific findings – in particular the Telegraph’s assertion that ‘doctors advise’ people ‘skip the “kiss” when giving the kiss of life’ is a complete invention given the very limited set of recommendations given in respect to a very specific set of circumstances.

Finally, the Daily Mail went with: ‘Kiss of death: Does mouth to mouth put lives at risk?‘. As usual the Daily Mail feels the need to sensationalise the headline to a frankly ludicrous degree and the start of the article continues the trend:

It may be called the kiss of life, but mouth-to-mouth resuscitation could actually be anything but.

According to experts, the treatment can in fact hinder heart attack patients’ chances of survival.

As with the other two articles the Mail fails to gets to grips with the specificity of the researcher’s findings, preferring to concentrate on implying that this ‘kiss of death’ technique is being taught to a legion of potential killers:

Doctors are so concerned they are calling for the technique to be left out of CPR guidelines for the condition.

This technique is widely taught in schools, offices and to those who help at big sporting events.

Clearly the Daily Mail is attempting to make people panic, implying that if they have a cardiac arrest in school, at work or at a sporting event someone may attempt to kiss them to death. Not surprisingly the Daily Mail coverage of this story has by far the most panic-inducing tone and imagery, a tone which as usual is contradicted later in the article by some details that make the headline look distinctly wrong. These two sentences towards the end of the article for example:

However, mouth-to-mouth shouldn’t be removed from the first-aid repertoire altogether, as it can still be effective if a patient stops breathing, but their heart is still beating.

This could include those who are choking, are near to drowning, victims of carbon-monoxide poisoning or those who have taken a drug overdose.

These two lines seem to contradict the initial claims the article makes that it is the ‘kiss of death’ and acknowledge that mouth-to-mouth can still be ‘effective’ – although they fail to mention that traditional CPR with mouth-to-mouth is actually more effective in these cases. I think the primary reason for this is that mentioning this fact would catch them in a nightmarish loop – they would have to write a second headline declaring ‘can CPR without the kiss of life kill?’ simply because CPR with mouth-to-mouth is more effective in certain circumstances.

This quandary just demonstrates the utterly irresponsible, simplistic and fear-inducing headline that the Mail has gone with. The truth is never simple, but the Daily Mail insists that its articles must be, hence the huge discord between the original findings of the researchers and the black-and-white reporting of the Daily Mail. The result – headline declaring that mouth-to-mouth is a potential killer, end of the article declaring that it is still effective and important in some cases – can only lead to confusion. People walk away from the article unsure about whether mouth-to-mouth is or is not safe to use – and cynical about the researchers involved (just read some of the comments posted) because they blame then for the contradictions rather than the reporter.

There is no excuse for this kind of journalism, given that the NHS Behind the headlines team can explain it so effectively and rationally.