Cardiopulmonary resuscitation (CPR) is one of the most important first aid skills in acute and critical care medicine (1) and is widely used in the emergency resuscitation of patients with cardiac arrest, which is decisive for saving lives. Cardiac arrest is a sudden, life-threatening emergency that manifests itself as a sudden cessation of heartbeat and respiration. The main goal of CPR is to restore blood circulation to the brain and other vital organs by means of chest compressions and artificial ventilation until autonomic circulation can be restored or further specialized medical support can be obtained (2). Studies have shown that the use of CPR is considered a potentially life-saving measure, and that effective early intervention is essential to improve the survival of cardiac arrest patients (3–5). Prompt administration of high-quality chest compressions and respiratory support within the first few minutes after the onset of cardiac arrest significantly improves the patient’s chances of survival (6). Although cardiac arrest can occur in all age groups, the older adults those with underlying cardiovascular disease, and those with cardiac arrest due to accidents such as drowning and electrocution are among the high-risk groups. In addition, Ashish et al. suggested (7) that whether or not to initiate bystander CPR (B-CPR) is also influenced by a variety of factors, including demographic characteristics, subjective willingness, knowledge base, skill level, and scene environment. Although many bystanders possess the willingness to rush, they are often unable to perform effectively due to a lack of basic knowledge or operational skills (8).

Although CPR is a highly technical first aid measure, its basic operation is relatively simple and can be mastered by the general public through standardized training. However, due to the practical application, there are often problems such as insufficient compression, substandard frequency, or poor ventilation, which affect the resuscitation effect (9). In addition, CPRCPR operation may also bring certain risks, such as chest injury or rib fracture, especially in older adults patients. Therefore, standardized training and hands-on practice are essential to improve the quality of CPR, optimize the resuscitation outcome, and reduce the risk of related complications.

In recent years, with the rapid development of digital technology, online video platforms are becoming an important way for the public to obtain health information (10). Compared with traditional health education, the Internet provides patients with greater initiative, enabling them to take the initiative to search and learn health knowledge through online search, thus improving their health management ability (11). However, health information disseminated on short-form video platforms is uneven, and some of the content contains medical errors that may lead to public and trigger inappropriate decision-making (12, 13). Therefore, it is of great practical significance to improve the scientificity and credibility of online health information.

Currently, all major video platforms feature a large number of short videos related to CPR, with YouTube, Bilibili, and TikTok being the most common (14–16). Previous studies have analyzed the quality of videos on topics such as Cardiac Rehabilitation (17), dermatology (18), Coronavirus Disease 2019 (COVID-19) (19), and diabetes (20), but there is still a lack of systematic evaluation of the quality of CPR-related videos on these platforms. Therefore, this study aims to investigate and analyze the quality of CPR-related video content on YouTube, Bilibili, and TikTok, with the goal of providing scientific guidance for the public to learn CPR online, as well as offering constructive suggestions to content creators and platform regulators.

With the rapid development of social media platforms, short videos have become an important vehicle for health education, enabling the public to access medical information more conveniently (25). However, studies across different fields have shown that the overall quality of health-related videos is highly variable, and there is a broad academic consensus on the need to improve their scientific accuracy and standardization. In cardiovascular health education—covering topics from CPR to secondary prevention and rehabilitation—content quality issues remain common (17). Among them, CPR, as a cornerstone of emergency care and a vital life-saving skill for the general public, warrants particular attention. However, systematic quality assessment of short videos in critical care—especially those focusing on CPR—are scarce, and comparative analyses across the three major platforms, YouTube, Bilibili, and TikTok, are lacking. This gap is important, as low-quality or inaccurate CPR content could mislead viewers, delay timely intervention, and even jeopardize lives. This study systematically evaluates CPR-related videos across these platforms, aiming to provide actionable evidence to improve the scientific rigor and reliability of emergency education videos on social media, with potential benefits for public health.

As the influence of short videos continues to expand in the field of health communication, how to balance the professionalism and accessibility of the content to promote effective learning for the public has become an important topic for future health communication research. This study is the first comprehensive evaluation of CPR videos on YouTube, Bilibili, and TikTok. With the development of the Bilibili and TikTok platforms, the number of related videos has increased year by year, especially TikTok has grown significantly. Our detailed statistical analysis shows that YouTube and Bilibili videos lengths are significantly longer than TikTok (57.0 (21.0, 416.0) seconds for TikTok), which correlates with platform-specific time limits and previous literature (26). Longer videos tend to better convey complex medical information, whereas shorter videos may more effectively capture attention and facilitate rapid dissemination (27, 28). On platforms like TikTok, characterized by fast content turnover, concise videos can quickly convey key messages, reduce cognitive load, and enhance viewer engagement. This may explain TikTok’s higher VIQI-1 scores and larger follower counts, consistent with the findings of Liu et al. (29). There were significant differences in the identity of uploaders across platforms: TikTok had the highest proportion of professionals, especially more medical professionals in acute and critical care. Videos uploaded by professional individuals and institutions are generally of higher quality and more recognized by viewer, which may also explain one of the reasons for the high interaction of TikTok viewer. Overall, both certified uploader and platform characteristics influence video content and viewer interaction. Therefore, we suggest that all professionals actively seek platform certification, and the platform providers implement a more flexible and user-friendly verification process. Such changes would help eliminate barriers—such as restrictions based on professional titles or institutional affiliations—that currently hinder qualified experts from disseminating high-quality content.

Statistical analysis shows that YouTube displays a large number of professional videos on CPR knowledge and the use of AEDs, while TikTok mainly covers news report content. YouTube videos focus more on the principles and critical steps of CPR, which may enhance public understanding of first aid procedures, improve implementation accuracy, and ultimately reduce patient mortality. In contrast, Bilibili and TikTok—both Chinese short-video platforms—feature a substantial amount of “CPR Skills Challenge” footage, primarily recorded during competitions. While these videos demonstrate professional techniques, they often lack explanations of basic concepts and supplementary information, which likely contributes to their relatively low audience engagement. Although these videos may be engaging, they contribute little to enhancing the public’s fundamental first aid skills. Furthermore, a notable gap exists in pediatric and infant CPR content across all three platforms, particularly on TikTok. Given the critical importance and real-world applicability of pediatric and infant CPR, professional organizations should increase the production and dissemination of related educational videos to ensure that parents are better prepared in emergencies and to help prevent avoidable tragedies. To further address the scarcity of pediatric CPR content, we recommend three actionable steps. First, collaborate with organizations such as regional pediatric associations to develop high-quality, social media-tailored pediatric CPR content. Second, partner pediatric medical institutions with social media creators, leveraging their audience insights to turn professional guidelines into accessible, shareable material. Third, integrate pediatric CPR into school curricula and community programs, encouraging participants to share their learning online to amplify reach. These steps would strengthen pediatric CPR education across platforms.

We employed three validated assessment tools—PEMAT, VIQI, and GQS—to comprehensively evaluate video quality. The findings indicate that demonstrated significantly higher overall quality and reliability compared with those on Bilibili and TikTok. In contrast, TikTok videos are limited by their short video lengths and low information content, while Bilibili have a higher proportion of non-professional individuals. Furthermore, both platforms lack rigorous video review mechanisms, which likely contributed to their overall lower quality scores. The findings indicate that non-professional uploaders and the absence of robust review mechanisms are key contributors to the low quality of videos. Platforms should strengthen the qualification of uploaders and improve the content monitoring mechanism to improve the quality of healthy videos.

This study also found a weak correlation between video quality and viewer interaction (e.g., likes and comments), consistent with previous research (30). Viewer and platform algorithms preferred high-heat, short-lengths videos over professional and educational content, resulting in high quality health videos struggling to gain appropriate attention. In the future, platform recommendation algorithm should be optimized to prioritize, evidence-based health education videos while balancing content quality with viewer experience. In addition, there is a significant positive correlation among the three scoring tools, especially the strong correlation between VIQI-sum and GQS, indicating that these measures may partially reflect video popularity (31). The combined use of multiple assessment tools is recommended in future research to enhance the accuracy and objectivity of quality evaluations. To improve the quality of CPR short videos, platforms should implement stricter content quality controls and strengthen both the support for and certification of qualified professionals. Platforms should enhance the auditing and supervision of health education videos to limit the dissemination of misleading information. In parallel, governmental and relevant regulatory bodies should conduct regular monitoring and removal of low-quality or misleading content to safeguard the credibility and accuracy of public health information.

Several limitations of this study should be acknowledged. First, although anonymous device access was employed and no user accounts were logged in, the influence of personalized recommendation algorithms could not be entirely eliminated. Second, the exclusion of videos without subtitles may have resulted in the omission of some high-quality content. Third, although three evaluators were used to independently score and standardize the disagreement, the scoring tool itself is still subjective and cannot avoid potential systematic bias. Future research could develop a more comprehensive and objective content quality assessment tool, combining with AI technology to improve assessment efficiency and accuracy. Finally, the sample size was limited, and some videos were uploaded earlier. With the evolution of technology and platforms, the quality of CPR videos may be further improved in the future, which deserves continuous attention and evaluation.

CPR-related videos on social media platforms have contributed to the popularization of first aid knowledge and skills among the public. TikTok’s short-form, highly interactive videos attract substantial viewer attention, while YouTube and Bilibili offer longer, more professional content with higher quality ratings. Nonetheless, video quality across all platforms remains suboptimal, particularly regarding content completeness and professionalism. Therefore, there is an urgent need to encourage more professionals to participate in the production of CPR videos, while platforms should strengthen their content review and recommendation mechanisms to ensure that high-quality videos are fully exposed. By optimizing the algorithms, the platforms are able to push more scientific and accurate first aid knowledge to users, further enhancing the public’s first aid awareness and practical operation ability. In conclusion, improving the overall quality of CPR-related content and minimizing public exposure to misleading information is essential for advancing social first-aid capacity and safeguarding public health—an objective that requires coordinated efforts from multiple stakeholders.