Cardiovascular diseases (CVDs) continue to be a leading global health concern, contributing significantly to morbidity and mortality rates. Within the realm of critical cardiac care, Advanced Cardiovascular Life Support (ACLS) stands as a critical lifeline. ACLS represents a comprehensive and advanced set of clinical interventions designed to save lives in emergency situations, particularly those involving cardiac arrest and severe cardiovascular events. In the picturesque district of Shimla, nestled amidst the Himalayan splendor, healthcare providers play a pivotal role in addressing the healthcare needs of the local population. The ability of medical officers in Shimla to effectively administer ACLS can mean the difference between life and death, given the geographical challenges that may hinder rapid access to specialized medical facilities [1-4]. Cardiovascular diseases do not discriminate by region, and Himachal Pradesh, with its serene landscapes and rugged terrains, is no exception to the global CVD burden. It is crucial that medical officers in the region possess a strong command of ACLS to offer timely, expert interventions when faced with cardiac emergencies. Their proficiency in ACLS is not only an essential component of providing quality healthcare but also aligns with international guidelines and recommendations for enhancing survival rates in critical cardiac events [5-7].

This study aims to comprehensively assess the knowledge of ACLS among medical officers serving in District Shimla, Himachal Pradesh. By evaluating their understanding and proficiency in ACLS, we endeavor to identify areas that may require additional training and awareness initiatives. The insights gleaned from this study can serve as a valuable resource for healthcare authorities and institutions, enabling them to tailor training programs and interventions that equip medical officers with the vital skills needed to respond effectively to cardiovascular emergencies. Ultimately, this study seeks to improve patient outcomes, enhance the quality of cardiac care, and contribute to the overall health and well-being of individuals residing in District Shimla.

Objectives of the Study

To evaluate the Knowledge of Advanced Cardiovascular Life Support (ACLS) among medical officers working in the District Shimla, Himachal Pradesh

Research Approach 

Descriptive

Research Design

Cross-sectional survey design

Study Area

Hilly state of Himachal Pradesh

Study Duration 

Between April 2023 to July 2023

Study Population

All medical officers working in District Shimla, Himachal Pradesh for 12 months or more. 

Sample Size

100 medical officers assuming 50% have adequate knowledge regarding Advanced 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 Advanced 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, educational level, socioeconomic status etc.

Questionnaire

The questionnaire contains 20 structured questions regarding knowledge about Advanced Cardiovascular Life Support having multiple options. The participants have to choose right one. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero in each category. Scoring was done on the basis of marks as >80% (16-20) = very good, 61-79% (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 close guidance and supervision of the assigned supervisors to ensure accuracy and methodological rigor throughout the process. A structured Google Form questionnaire was designed and circulated among residents of District Bilaspur, Himachal Pradesh, to obtain relevant responses. The questionnaire was disseminated using various online modes such as e-mail and widely used social media platforms, including WhatsApp groups, Facebook, Instagram, and LinkedIn. Data collection was continued over a defined period until a total of 400 valid responses were successfully obtained for analysis.

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 Advanced Cardiovascular Life Support (BCLS) among 100 medical officers working in District Shimla, Himachal Pradesh. Table 1 shows the Responses to the questions regarding Advanced Cardiovascular Life Support (ACLS). 

In the present study, 19 study participants had very good knowledge (9–10 marks) regarding Advanced Cardiovascular Life Support, 28 had good knowledge (7–8 marks), 27 had fair knowledge (4–6 marks), and 26 had poor knowledge (<4 marks) regarding Advanced Cardiovascular Life Support. Overall, the findings indicate varying levels of ACLS knowledge among the study participants. Table 2 shows the knowledge regarding Advanced Cardiovascular Life Support (ACLS) among study participants.

Table 1: Responses to the Questions Regarding Advanced Cardiovascular Life Support (ACLS)

Table 2: Knowledge regarding Advanced Cardiovascular Life Support (ACLS) Among Study Participants

The objective of this study was to assess the knowledge of Advanced Cardiovascular Life Support (ACLS) among medical officers in District Shimla, Himachal Pradesh. The findings provide valuable insights into the current state of ACLS proficiency among these healthcare professionals.

The study results revealed varying levels of knowledge among the participating medical officers in different aspects of ACLS.A substantial majority (76) of medical officers correctly identified the primary goal of ACLS. This understanding is crucial as it forms the foundation for effective cardiac emergency response. Approximately 66 of participants could explain the components of the "Chain of Survival" in ACLS. Understanding this concept is essential as it outlines the critical steps required to maximize survival rates in cardiac arrest situations. About 64 of respondents correctly described the key initial steps when approaching a patient in cardiac arrest. These steps are fundamental in initiating timely and effective resuscitation efforts. Approximately 56 of medical officers knew the recommended compression rate and depth for high-quality CPR in adults. This knowledge is essential for maintaining circulation during cardiac arrest [2-5].

Around 56 of participants understood how to assess the rhythm of a cardiac arrest victim using an ECG monitor. Proper rhythm assessment guides appropriate interventions. A significant number (47) recognized the differences in managing asystole and ventricular fibrillation during ACLS. Distinguishing between these rhythms is crucial for providing the right treatment. Approximately 41 knew when to administer epinephrine in ACLS and the recommended dosage. Medication administration is a critical component of ACLS [3-5].

About 42 recognized the role of advanced airway management, such as endotracheal intubation, in ACLS. Proper airway management is vital for oxygenation and ventilation. Only 30 of respondents knew how to calculate and administer appropriate defibrillation energy levels. This aspect of ACLS requires further attention and training. A modest percentage (28) could describe the purpose and indications for synchronized cardioversion in ACLS. Knowledge in this area needs improvement [5-7].

These findings are in line with similar studies conducted in various regions, which have consistently shown variability in ACLS knowledge among healthcare providers. This highlights the need for ongoing training and education in ACLS to ensure consistent and up-to-date proficiency.

Practical Implications

The study underscores the importance of continuous ACLS training and education for medical officers in District Shimla. While a significant proportion demonstrated good knowledge in some aspects of ACLS, there are areas where proficiency could be enhanced.

In conclusion, this study assessed the knowledge of ACLS among medical officers in District Shimla, Himachal Pradesh. While several medical officers exhibited good knowledge in various ACLS components, there is room for improvement in specific areas. These findings emphasize the need for regular ACLS training and education programs to enhance the proficiency of medical officers in managing cardiovascular emergencies effectively.

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