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The depiction of major disasters in emergency department-associated medical television shows

Journal logoUnlabelled imageAmerican Journal of Emergency Medicine 40 (2021) 210-212

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American Journal of Emergency Medicine

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The depiction of major disasters in emergency department-associated medical television shows

terrorism, events surrounding the disaster), victim/patient demo- graphics [stated total number of victims, stated total number of deaths,

total number of patients (defined as victims who were depicted in-

depth as patients in the ED during the episode), patient demographics

Keywords: Disasters Terrorism

Emergency department Medical television shows

(estimated age/sex/race), total number of patient deaths)]. Victim mor- tality rates (Total # of deaths from disaster/Total # of victims from the disaster) and patient mortality rates (Total # of patient deaths/Total # of patients depicted) were calculated. The Institutional Review Board

at the Penn State Hershey Medical Center deemed the study exempt.

A total of 26 major disasters depicted in 111 episodes were included

Medical television shows are known to over-exaggerate medical and traumatic scenarios in order to capture the interest of its audience. Pre- vious research has shown that the most frequently depicted conditions in their sample of medical television shows included injuries secondary to natural disasters and car accidents. [1] There have been no published studies analyzing the depiction of major disasters in medical television shows, focusing on types of disasters and mortality rates. The objective of this study was to describe major disasters depicted in a select number of emergency department (ED)-associated medical television shows and compare these depictions with ten major U.S. disasters occurring 2014-2018 (Table 1).

Six ED-associated medical television shows (Grey’s Anatomy, The Resident, Chicago Med, Night Shift, Code Black, and 911) were selected for analysis (Table 2). The first and last three episodes of every season between 2014 and 2018 were coded independently by three reviewers. Abstracted data for each depicted disaster included: description of the disaster (external/internal, man-made/natural, associated with

in analysis: 24 (92.3%) were considered external and 2 (7.7%) considered internal; 20 (76.9%) were considered man-made and 6 (23.1%) consid-

ered natural; 6 (23.1%) were considered terrorist-related. (Table 3).

Based on the 26 major disasters depicted in our sample of ED- associated medical television shows, there was a total of 119 reported deaths in 878 total victims, for a victim mortality rate of 13.6%. Based on the 26 major disasters depicted in our sample of ED-associated med- ical television shows, there was a total of 36 reported deaths in 234 total patients, for a patient mortality rate of 15.4%. The majority of patients (n = 234) depicted were between 18 and 65 years of age (73.5%), male (61.1%) and Caucasian (65.0%). (Table 4).

In conclusion, based on our sample of ED-associated medical televi- sion shows, we demonstrated an average mortality rate of 13.6% for all victims and 15.4% for depicted patients, which is higher than the weighted mortality rate (0.14%) of our selection of 10 major U.S. disas- ters occurring 2014-2018. This difference in mortality rates exists de- spite the similarities in the description of major disasters in our

Table 1

Description of selected major U.S. disasters, 2014-2018.

Disaster

Disaster type

Description

Total # of victims

Total # of deaths

Mortality rate

Hurricane Harvey [2]

External/natural

Category 4 hurricane that made landfall on Texas and Louisiana in August 2017, causing catastrophic

43,000

103

0.24%

The Camp Fire [3]

External/natural

flooding

Deadliest and most destructive wildfire in California history and the most expensive natural disaster

53,385

85

0.16%

Hurricane Maria [4]

External/natural

in the world in 2018

Category 5 hurricane that devastated Dominica, St Croix, and Puerto Rico in September 2017

3.4 million

4600

0.14%

Pulse Nightclub shooting [5]

Las Vegas shooting

External/man-made (Terrorist-related)

External/man-made

On June 12, 2016, Omar Mateen, a 29-year-old security guard, killed 49 people and wounded 53 others in a mass shooting inside Pulse, a nightclub in Orlando, Florida.

On the night of October 1, 2017, a lone gunman opened fire on a crowd of concertgoers at the Route

320

22,000

49

59

15.3%

0.27%

[6]

Dallas police officer

(Terrorist-related)

External/man-made

91 Harvest music festival on the Las Vegas Strip in Nevada.

On July 7, 2016, Micah Xavier Johnson ambushed and fired upon a group of police officers in Dallas,

100

5

5%

shooting [7]

Stoneman Douglas

(Terrorist-related)

External/man-made

Texas.

On February 14, 2018, a gunman opened fire with a semi-automatic rifle at Marjory Stoneman

3206

17

0.53%

school shooting [8]

U.S. Marine Corps

(Terrorist-related)

External/man-made

Douglas High School in Parkland, Florida.

On July 10, 2017, a Lockheed KC-130 T Hercules aircraft of the United States Marine Corps crashed

16

16

100%

KC-130 crash [9]

Philadelphia train

External/man-made

in Leflore County, Mississippi, killing all 16 people on board.

On May 12, 2015, an Amtrak Northeast Regional train from Washington, D.C. bound for New York

242

8

3.3%

derailment [10]

City derailed and wrecked on the Northeast Corridor in the Port Richmond neighborhood of

Bronx Lebanon Hos-

Internal/man-made

Philadelphia, Pennsylvania.

On June 30, 2017, a doctor opened fire at the Bronx-Lebanon Hospital Center in the Bronx, New York

7

1

14.3%

pital shooting [11]

Total

City, killing a doctor on the 17th floor and wounding six people on the 16th floor with an AR-15

-type Semi-automatic Rifle.

3,522,276

4943

0.14%

https://doi.org/10.1016/j.ajem.2020.05.064

0735-6757/(C) 2020

The depiction of major disasters in emergency department-associated medical television shows 211

Table 2

Description of ED-associated medical television shows

Television show name

Network

Date premiered

Description

Total # episodes included in the analysis

Grey’s

ABC

March 2005

Focuses on the lives of surgical interns, residents, and attending doctors as they develop into seasoned doctors

33

Anatomy

while balancing personal and professional relationships

Night Shift

NBC

May 2014

Followed the crazy cases and lives of doctors and nurses who work the night shift at fictional San Antonio

24

Memorial Hospital

Code Black

CBS

September 2015

Follows the understaffed and under-resourced ED of Angels Memorial Hospital.

18

Chicago Med

NBC

November 2015

An ED-based television drama focusing on the doctors of fictional Gaffney Chicago Medical Center.

21

911

FOX

January 2018

Delves into lives of emergency First responders as they deal with high pressure medical situations in Los Angeles

6

The Resident

FOX

January 2018

Follows the lives of doctors in a fictional hospital in Atlanta, Georgia in which explores the roles of its characters

9

in the ED and hospital

sample of medical television shows [external disasters (92.3%), man- made disasters (76.9%), terrorist-related (23.1%)] and in our sample of real-life disasters [external disasters (90%), man-made disasters (70%), terrorist-related (40%)].

With the overdramatization of major disasters in medical televi- sion shows, audience members may feel the need to develop and/ or refine their family emergency response plan, or have a better un- derstanding of the rescue efforts that prehospital health care workers and frontline hospital staff perform in times of crisis. A pub- lished study examining the compliance of a select number of families with national recommendations for Disaster preparedness con- cluded that families, for the most part, are not compliance with na- tional recommendations for preparedness. [12] Lastly, by viewing the depiction of major disasters on medical television shows, audi- ence members may be inspired to collaborate with community groups (health care workers, local EMS/fire/police departments, emergency departments/hospitals, schools/child care centers, public

health officials, regional/state/national government officials, etc.) to ensure an effective and efficient community preparedness plan.

There are a few limitations to our study. First, the data gathered from our sample of six ED-associated medical television shows may not be generalizable to all medical television shows aired over the past few de- cades. Furthermore, we chose the first three and last three episodes of each season to analyze, since most television series overdramatize the beginning and end of the season in order to initially capture the interest of the audience and then provide a “cliffhanger” to ensure viewership for the following season. Secondly, data abstracted, in particular patient demographics, and numbers of victims/patients, were often extrapo- lated (age or race of patients) or estimated (numbers of victims/pa- tients, number of first responders). For example, if the newscaster said “over 100 people were involved in a deadly shooting,” we decided to un- derestimate and have the total number of victims be 101, where it may have been any number higher than 100. Although the estimation of victims/patients may affect total mortality rates, the actual number

Table 3

Description of disasters (n = 26) depicted in our sample of ED-associated medical television shows.

Type of Disaster

Subcategory

Total # of victims from the disaster

Total # of patients depicted

Total # of deaths from disaster

Mortality rate from the disaster

Total # of patient deaths

Mortality rate of patients

External/man-made

explosion

9

9

2

22.2%

2

22.2%

(Terrorist-related)

External/man-made

transportation accident (train)

70

8

1

1.4%

1

12.5%

External/man-made

mass shooting

101

23

3

2.9%

3

13.0%

(Terrorist-related)

External/natural

virus outbreak

7

7

1

14.3%

1

14.3%

External/man-made

building fire

70

7

7

10.0%

1

14.2%

External/man-made

transportation accident (bus)

24

10

1

4.1%

1

10%

Internal/man-made

(Terrorist-related)

hospital shooter

5

5

1

20%

1

20%

External/man-made

explosion (factory)

44

6

8

18.1%

1

16.7%

External/man-made

transportation accident (MVC)

10

6

3

30%

3

50%

External/man-made

transportation accident (MVCs)

11

8

1

9%

1

12.5%

External/man-made

mass shooting

17

7

10

58.8%

2

28.6%

(Terrorist-related)

External/natural

wildfire

20

6

1

5%

1

16.7%

External/natural

virus outbreak

30

10

9

30%

2

20%

External/man-made

bombing

15

8

1

6.7%

1

12.5%

External/man-made

amusement ride malfunction

24

9

10

41.7%

0

0%

External/natural

virus outbreak

47

9

0

0%

0

0%

Internal/man-made

hospital shooter

15

3

1

6.7%

1

33.3%

(Terrorist-related)

External/man-made

school shooter

60

16

30

50%

5

31.2%

(Terrorist-related)

External/natural

mudslide

14

12

4

28.6%

2

16.7%

External/man-made

explosion at mall

30

13

0

0%

0

0%

External/man-made

tunnel collapse

60

8

14

23.3%

3

37.5%

External/man-made

transportation accident (MVCs)

16

7

0

0%

0

0%

External/man-made

amusement ride malfunction

6

6

2

33.3%

2

33.3%

External/man-made

transportation accident (MVCs)

15

7

3

20%

2

28.6%

External/man-made

hazardous gas exposure

8

8

0

0%

0

0%

External/natural

virus outbreak

150

16

6

4%

0

0%

Totals

878

234

119

13.6%

36

15.4%

212 The depiction of major disasters in emergency department-associated medical television shows

Table 4

Demographics of patients (n = 234) depicted in our sample of ED-associated medical tele- vision shows.

Age (years) Under 18 17.5% (n = 41)

18-65 73.5% (n = 172)

Over 65 9.0% (n = 21)

Sex (%) Male 61.1% (n = 143)

Female 38.9% (n = 91)

Race (%) Caucasian 65.0% (n = 152) African-American 8.1% (n = 19)

Hispanic 11.1% (n = 26)

Asian 3.4% (n = 8)

Other 12.4% (n = 29)

was not as important as the comparison between the depiction in med- ical television shows and real life events.

Funding sources

This research did not receive any specific grant from funding agen- cies in the public, commercial, or not-for-profit sectors.

Declaration of competing interest

None.

Liza Gergenti, MD Emergency Medicine Resident, Department of Emergency Medicine, Reading Hospital Medical Center, 420 S 5th Ave, West Reading,

PA 19611, USA

Adrienne Caiado, MD Emergency Medicine Resident, Department of Emergency Medicine, Med Star Washington Hospital Center, 110 Irving Street NW, East Building,

Room 3124, Washington, DC 20010, USA

Lynnette Lacek, MD Emergency Medicine Resident, Department of Emergency Medicine, University of Washington, 325 9th Avenue, Box 359702, Seattle,

WA 98102, USA

Robert P. Olympia, MD Departments of Emergency Medicine and Pediatrics, Penn State Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA

?Corresponding author at: Department of Emergency Medicine, Penn State Hershey Medical Center, 500 University Drive, PO Box 850,

Hershey, PA 17033-0850, USA.

E-mail address: [email protected].

13 May 2020

https://doi.org/10.1016/j.ajem.2020.05.064

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