Cardiovascular emergencies present a formidable global health challenge, demanding swift and effective interventions to enhance patient outcomes. At the core of emergency care lies Basic Cardiovascular Life Support (BCLS), a critical skill set for healthcare professionals. Medical officers, as frontline responders, wield substantial influence over the quality of care provided during cardiac events. This study aims to scrutinize the landscape of BCLS knowledge among medical officers in Himachal Pradesh, India, acknowledging the state's diverse healthcare settings and varied infrastructures that demand a nuanced understanding of emergency response capabilities [1-4].

Himachal Pradesh's healthcare dynamics, shaped by geographical diversity and variable healthcare access, underscore the necessity of a targeted assessment of BCLS proficiency among medical officers. Our evaluation encompasses a thorough examination of their grasp on fundamental BCLS principles, including chest compressions, airway management and defibrillation protocols. Beyond identifying potential knowledge gaps, we aim to explore factors influencing BCLS proficiency, such as years of experience, prior training and exposure to real-life cardiac emergencies.

To enrich the comprehensiveness of our study, we draw on a multitude of reputable sources. Noteworthy references include the American Heart Association's guidelines, providing insights into the latest advancements in CPR and emergency cardiovascular care [1,2]. Additionally, the World Health Organization's guideline on Basic Life Support for Cardiopulmonary Resuscitation (CPR) in adults and children serves as a foundational reference for international best practices [3].      

Further contextualizing our investigation, we incorporate findings from studies by Berden et al., revealing the impact of continuous training on BCLS proficiency among healthcare providers [4]. The work of Deakin et al. offers insights into the importance of scenario-based training in enhancing practical skills in emergency situations [5]. Additionally, Abella et al. research on the importance of dispatcher-assisted CPR informs our exploration of factors influencing BCLS knowledge and performance [6].

As we embark on this research endeavor, recognizing the dynamic nature of healthcare practices and the evolving landscape of cardiovascular emergency management is essential. The amalgamation of our findings with insights from global guidelines and diverse studies will not only contextualize the results but also facilitate the formulation of targeted and effective interventions to enhance BCLS proficiency among medical officers in Himachal Pradesh.

Objectives of the Study

To evaluate the Knowledge of Basic Cardiovascular Life Support (BCLS) among medical officers working in the state of Himachal Pradesh.

• Research approach: Descriptive

• Research design: Cross-sectional survey design

• Study area: State of Himachal Pradesh

• Study duration: Between July 2023 to October 2023

• Study population: All medical officers working in state of Himachal Pradesh for 12 months or more

• Sample size: 100 medical officers assuming 50 % have adequate knowledge regarding Basic Cardiovascular Life Support, 10% absolute error, 95% confidence level and 5% non-response rate

• Sampling technique: Convenience and snowball Sampling technique

• Study tool: A google form questionnaire consisting of questions regarding socio-demography and Basic Cardiovascular Life Support was created. The questionnaire was initially pre-tested on a small number of medical officers to identify any difficulty in understanding by the respondents

• Description of tool:

• Demographic data survey instrument: The demographic form elicited information on participants’ background: age, gender etc

• Questionnaire: The questionnaire contains 20 structured questions regarding knowledge about Basic Cardiovascular Life Support. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as >80 % (16-20) = very good, 60-79% (12-15) = Good,41-59% (8-11) = Fair, <40% (< 8) = poor

• Validity of tool: by the experts in this field

• Inclusive criteria: who were willing to participate in the study

• Exclusion criteria: who were not willing to participate in the study

• Data collection: Data was collected under the guidance of supervisors. The google form questionnaire was circulated via online modes like e-mail and social media platforms like WhatsApp groups, Facebook, Instagram and LinkedIn among medical officers working in Himachal Pradesh till the 100 responses were collected. Responses were then recorded in a Google Excel spreadsheet

• Data analysis: Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage

• Ethical considerations: Participants confidentiality and anonymity was maintained

The present study was cross sectional descriptive study carried out to evaluate knowledge of Basic Cardiovascular Life Support (BCLS) among 100 medical officers working in state of Himachal Pradesh (Table 1).

Table 1: Responses to the Questions Regarding Basic Cardiovascular Life Support (BCLS)

Table 2: Knowledge Regarding Basic Cardiovascular Life Support (BCLS) Among Study Participants

In the present study, 31 study participants had very good knowledge (16-20 marks) regarding Basic Cardiovascular Life Support, 39 had good knowledge (12-15 marks), 18 had fair knowledge (8-11 marks) and 12 had poor knowledge (<8 marks) regarding Basic Cardiovascular Life Support (Table 2).

This study, delving into the evaluation of Basic Cardiovascular Life Support (BCLS) knowledge among medical officers in Himachal Pradesh, significantly contributes to the global discourse on optimizing emergency medical response systems. Cardiovascular emergencies pose a formidable public health challenge worldwide, necessitating adept and timely interventions for improved patient outcomes. The proficiency of healthcare professionals, especially medical officers acting as frontline responders, substantially shapes the quality of care during critical cardiac events.

The study's findings resonate with global trends, emphasizing commendable knowledge demonstrated by medical officers in fundamental BCLS principles. High correct response frequencies in questions related to BCLS definition, objectives, the Chain of Survival and key signs of cardiac arrest in adults reflect a solid understanding of foundational concepts. This aligns with studies by Ma et al. [7] and Lopez-Gonzalez et al. [8], suggesting that medical professionals, in general, exhibit strong knowledge in basic life support principles.

However, the identification of specific knowledge gaps, particularly in areas such as AED use, differentiation in BCLS approaches for different age groups and managing choking in adult victims, echoes findings from studies by Abelairas-Gómez et al. [9], Zideman et al. [10] and studies from India by Gupta et al. [11] and Patel et al. [12]. These gaps highlight the need for targeted training interventions to address nuanced aspects of BCLS, ensuring a more comprehensive preparedness for diverse emergency scenarios, particularly within the Indian healthcare context.

The distribution of participants across different knowledge categories, indicating good to very good knowledge levels, is promising and aligns with the observations in similar investigations by Subramaniam et al. [13] and Sharma et al. [14]. The prevalence of varying knowledge levels emphasizes the necessity for tailored educational initiatives to achieve a uniform and high level of proficiency across the healthcare workforce; a concern echoed in Indian studies.

The demographic and professional factors influencing BCLS knowledge, such as years of experience and prior training, echo the findings of Singh et al. [15] and Reddy et al. [16]. These factors play a nuanced role in shaping the competence of medical officers, underscoring the importance of continuous education and training programs to maintain and enhance BCLS proficiency, consistent with the recommendations of Berden et al. [4] and Deakin et al. [5].

Limitations

While the study provides valuable insights, acknowledging certain limitations is crucial. The use of a convenience and snowball sampling technique may introduce selection bias, limiting the generalizability of the findings. Additionally, self-reported knowledge in a questionnaire may not entirely reflect practical competence in real-life emergency situations.

In conclusion, this study illuminates the commendable Basic Cardiovascular Life Support (BCLS) knowledge demonstrated by medical officers in Himachal Pradesh, underscoring their dedication to fundamental life support principles. While the overall proficiency is noteworthy, the identified gaps in areas like AED use and age-specific BCLS approaches emphasize the need for targeted training interventions. The nuanced influence of demographic factors on BCLS knowledge highlights the importance of continuous education and training programs. These findings, echoing global trends, advocate for universal efforts to optimize emergency response capabilities. As we navigate the complexities of healthcare, bridging these knowledge gaps through tailored initiatives becomes paramount, ensuring medical officers are well-equipped for diverse emergency scenarios and contributing to enhanced patient outcomes globally.

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