Study: CPR manikins used in instructive social media posts lack diversity

By Leila Merrill
EMS1

A study released this month shows a lack of diversity in the manikins depicted by public social media accounts of organizations that provide CPR education and suggests that greater diversity in training materials could help improve the survival rates of patients who experience heart attacks outside of hospitals.

Fewer than 10% of the images represented Black or Asian people, none of them represented pregnant women, and fewer than 2% represented overweight people.

Most of the manikins are lean, white and masculine, but lean white men make up a small proportion of the people who experience heart attacks outside of hospitals.

The researchers analyzed Twitter and Instagram posts by organizations in North and South America from Sept. 1, 2019 to Sept. 19, 2021. They collected 211 manikin images.

“Diversity training is an important target for CPR education as it would theoretically change the perception of sudden cardiac death in a broad population,” explained lead investigator Adrian Baranchuk, MD, in a news release. He works at the Kingston Health Sciences Center’s Department of Medicine at Queen’s University in Canada. “Social media platforms are becoming cornerstones of medical education for students, physicians, and the public. It is crucial that these educational tools are representative of the populations receiving CPR, so we decided to investigate these platforms further.”

The study is published as a Research Letter in the Canadian Journal of Cardiology, an official journal of the Canadian Cardiovascular Society, which is published by Elsevier.

Recent North American estimates showed that only 41% of OHCA patients receive bystander-initiated CPR, and fewer than 6% have an automated external defibrillator applied by a bystander before EMS providers arrive, according to lead author Nicholas Grubic and coauthors in an accompanying editorial.

“The provision of care and survival after OHCA has been shown to differ by sociodemographic factors, most notably sex/gender and race,” they said. “This study highlights a ‘real-world’ gap in sociodemographic diversity among health promotion media for OHCA. The paucity of mannikins representing non-lean, female or pregnant individuals identified by this analysis is concerning. This study provides important data to suggest that implicit biases in OHCA exist, and that these biases may influence disparities in OHCA training, care, and outcomes. Novel strategies that aim to alter historical perceptions of resuscitation and OHCA, which are rooted in cultural appropriation and lack of diversity, should be a public health priority.”