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Rating: 5.0/5 (1 vote cast)

Authors Institution
Luke West University of East Anglia - United Kingdom
Twitter - @LukeWest85
Theme
7AA eLearning: Games, resources and platforms
Are YouTube videos an accurate and reliable source of educational information about cardiopulmonary resuscitation (CPR)?
Background
  • Approximately 28,000 Cardiac arrests in UK annually1
  • Good quality bystander CPR reduces mortality and morbidity2-4
  • The internet allows dissemination of healthcare information2-7
  • Videos improve cognitive ability and knowledge4
  • Videos represent 2/3rds of downloaded data on the internet3
  • YouTube is a freely accessible, easy to use platform2-5
  • There are concerns regarding the risks of using such platforms due to the lack of regulation of the content  and the dynamic nature of the platform2-6

 

 

 

 

8

Summary of Work
  • Literature search of MEDLINE using MeSH terms
  • Search of YouTube for key words e.g. “CPR”, “Basic  Life Support”, “BLS”
  • Excluded videos included:
    • Irrelevant videos e.g. Paediatric CPR, comedy, contained adverts, duplicates
    • Lack of practical demonstration
    • Videos in languages other than English or Portuguese4
  • Analysis of :
    • Source – subdivided into 5 categories
    • Number of views/viewers per day
    • Length of video
    • Inclusion of mannequins for demonstration or scene re-enactment
    • American Heart Association (AHA) 2010 CPR guidelines, scored out of 8 including the correct sequence and the tasks outlined (see more detail)

9

Summary of Results
  • Murugiah et al. (2011)2 – based on 52 videos
    • Type = 40 CPR no Automated External Defibrillator (AED), 8 CPR + AED, 4 hands only CPR.
    • Format = Instructional demo (30), instructions followed by scene enactment (17), scene enactment only (5).
    • Demonstration = mannequin (28), real person (13), both (8), animation (2), still images (1)
    • Credentials = unspecified credentials (25), credentials specified (9), private agency (12), news (3), government organisation (3)
  • Tourinho et al. (2012)3 – based on 61 videos
    • Category – 90% education section
    • Divided based on search term BLS vs CPR
    • Credentials = unspecified credentials (26), Corporation (20), government organisation (15)
  • Yaylaci et al. (2014)4 – based on 209 videos
Conclusion
  • Lack of identification of target audience2-3
  • Lack of credentials and a lack of trusted sources of videos2-4
  • Incorrect/outdated procedures – could affect quality of treatment2-4
  • Higher viewer count did not correlate with good quality and accurate information2
  • Scoring of viewability was subjective2-4
  • No reviews of videos relating to paediatric and infant CPR4
  • Lack of reviews in languages other than English or Portuguese2-4
  • Searching of videos on YouTube.com does not allow analysis of views of videos posted on websites that are embedded in YouTube2
  • YouTube content constantly changes, therefore, these studies only represent a “snapshot”2-3
Take-home Messages
  • Good quality videos from trusted sources are lacking2-4, 6
  • There is a role for video material in education especially given the advent of smartphones which may aid people in emergency situations2
  • YouTube content is dynamic thus outdated material may be misleading, however, regulation or removal of material older than 5 years may resolve this issue2-6

10

Acknowledgement

With thanks to the academic team at the University of East Anglia, especially Dr Veena Rodrigues, Ms Margaret Bunting and Dr Sam Leinster.

References
  1. Resuscitation Council. 2014. Consensus Paper on Out-of-Hospital Cardiac Arrest in England. [pdf] Available at https://www.resus.org.uk/pages/OHCA_consensus_paper.pdf [accessed 11/01/2015]
  2. Murugiah, K., et al. 2011. YouTube as a source of information on cardiopulmonary resuscitation. Resuscitation. 82, p332-334.
  3. Tourinho, F., et al. 2012. Analysis of YouTube videos on basic life support and cardiopulmonary resuscitation. Rev. Col. Bras. Cir. 39 (4), p335-339.
  4. Yaylaci, S., et al. 2014. Are YouTube videos accurate and reliable on basic life support and cardiopulmonary resuscitation? Emergency Medicine Australasia. 26, p474-477.
  5. Topps, D., Helmer J., and Ellaway, R., 2013. YouTube as a Platform for Publishing Clinical Skills Training Videos. Academic Medicine. 88 (2) p192-197.
  6. Gabarron, E., et al. 2013. Identifying Measures Used in Assessing Quality of YouTube Videos with Patient Health Information: A Review of Current Literature. Interactive Journal of Medical Research. 2 (1) p1-9
  7. Unis, A., Khubrani, R., and Howatee, A., 2014. Impact of Emerging Web Technologies on Undergraduate Medical Education Process in the University of Tabuk. [pdf]. International Conference: New Perspectives in Science Education. Edition 4. Available at: http://conference.pixel-online.net/NPSE/acceptedabstracts_scheda.php?id_abs=265 [Accessed 20 December 2014]
  8. Youtube. 2010. Using the YouTube logo. [image online] Available at https://www.youtube.com/yt/brand/en-GB/using-logo.html [accessed 11/08/2015].
  9. Rencsi. 2009. How to Become a Group Fitness Instructor I Get CPR/AED Certified. 2009. [image online] Available at http://rencsi.com/b/tag/cardiopulmonary-resuscitation/ [accessed 11/08/2015]
  10. Samford First Responders. 2014. The “Chain of Survival”: American Heart Association. [image online} Available at  http://www.sfrg.mysamford.com.au/chainofsurvival.htm [accessed 11/08/2015]
Designed & Managed by Innovative Technology®
Background
Summary of Work
Guidelines for scoring videos4
Task Score
Provide scene safety 1
Check responsiveness and consciousness 1
Call ambulance 1
Check accurate hand positioning before initiating compressions 1
Is the depth of compressions adequate? 1
Is the rate of compressions right? 1
Is the ratio of compressions/ventilations right? 1
Summary of Results
Table of common errors in the videos2
Step of CPR Correct Incorrect Not done
Scene safety assessment 34.6%   65.4%
Assessing responsiveness 94%   6%
Calling ambulance 81.6% 8.2% 10.2%
Opening airway 81.2% 10.4% 8.3%
Assessing respiration by look-listen-feel technique 89.6%   10.4%
Providing 2 rescue breaths 91.7%   8.3%
Location of chest compressions 66% 34%  
Rate of compressions 36.7% 63.2%  
Depth of compressions 42.9% 57.1%  
Compression-ventilation ratio 68.9% 28.9% 2.2%

 

Major errors found in videos3

Major errors BLS CPR
Followed 2005 guidelines 29.41% 22.22%
Procedure "See, hear and feel for breathing" 11.76% 11.11%
Does not follow the new sequence of algorithm C-A-B-D 14.70% 22.22%
Interruption of chest compressions to fix the paddles of the AED 2.95% 11.11%
Chest compression depth of 4-5cm 5.80% 7.40%
Inappropriate recognition of CPA 2.95% 11.11%

 

Characteristics of videos included for analysis4

Characteristic Sub characteristics n %
Year Uploaded

2011

2012

2013

32

42

135

15.3

20.1

64.6

Individual or institution that uploaded the video

Private agency

Guideline bodies e.g. AHA/Red cross

Individual with specified credentials e.g. certified CPR instructor

Individual with unspecified credentials

News programme

19

61

49

65

15

9.1

29.2

23.4

31.1

7.2

Demonstration or application performed on

Manikin

Human

Both

136

58

15

65.1

27.8

7.2

AED use

Yes

No

71

138

34.0

66.0

Compatability with 2010 CPR guidelines

Yes

No

24

185

11.5

88.5

Total scores received

Below 5

5 and higher

95

114

45.5

54.5

 

Conclusion
Take-home Messages
Acknowledgement
References
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