Only a few of the instructional videos about cardiopulmonary resuscitation (CPR) on YouTube provide accurate advice on how to perform basic life support, according to a team of Turkish emergency medicine specialists.

Once a video is up on YouTube, it stays up unless it contravenes site policy or the owner takes it down, so it’s not surprising that many lower quality videos are available to watch, said Carol Haigh, a professor of nursing at Manchester Metropolitan University in the UK, who wasn’t part of the study.

It could be dangerous to have misleading videos online, but they are difficult to police, she said.

“Site owners do not have the subject-specific education to make that call,” Haigh said.

Researchers from university and state hospitals across Turkey reviewed 209 videos on cardiopulmonary resuscitation or basic life support that were recorded in English, without advertisements, and uploaded to YouTube between 2011 and 2013. They excluded thousands of others that were irrelevant, not in English or accompanied by ads.

Only 24 of the videos, 11.5 percent, were completely compatible with 2010 CPR guidelines from the American Heart Association (AHA), according to the results published in Emergency Medicine Australasia.

The researchers gave a video a high score if it included all seven required steps for action, and in the correct order: make sure the scene is safe, check victim for consciousness, if he is not conscious then call an ambulance, position hands over ribcage, begin compressions, check airway and provide air.

AHA guidelines specify a ratio of 30 compressions to two breaths for adults and children over age one.

The number of times a video had been downloaded did not necessarily correlate with its quality, although those downloaded more than 10,000 times did have a higher average score than others, the researchers found.

The source of the video, including guideline-making bodies and private agencies, did not affect compatibility scores.

“The American Heart Association CPR videos on YouTube were watched more than 2 million times alone this year, so people are definitely using YouTube as a way to learn about CPR,” said Dr. Comilla Sasson, an emergency medicine expert at the University of Colorado, Denver.

People are more likely to use YouTube for course learning than in an actual emergency, she said.

“It is so important that people know the latest science in this area,” Sasson said. “The CPR guidelines have changed tremendously since 2005, however inaccurate information is still readily available.”

There are a number of reputable courses available that teach CPR and first response techniques, and charities like the British Heart Foundation and the American Heart Association provide up to date information, Haigh said.

People looking for online information on CPR should look for reputable resources, Sasson said. The American Heart Association has its own YouTube channel where only the most up-to-date information on CPR will be available, she said.

To regulate online videos, the onus may be on healthcare educators, Haigh said.

“If I were looking for an open access video to support my teaching and identified one that was misleading I would, at the very least, make a comment to that effect on the host site and would also contact the author to highlight my concerns,” she said.