Cardiopulmonary Resuscitation (CPR) stands as a critical and universally acknowledged intervention for managing sudden cardiac arrest, significantly impacting patient outcomes. The proficiency of healthcare professionals in delivering effective CPR is central to its success; however, variations in training methodologies, resource accessibility and regional healthcare structures may contribute to differences in competency among medical officers [1-3].

Himachal Pradesh, nestled in the breathtaking Himalayan landscape, presents a unique healthcare milieu marked by geographical challenges and diverse healthcare infrastructure. The effectiveness of emergency medical response, particularly in the context of CPR, warrants a comprehensive evaluation of the knowledge and skills possessed by medical officers in this region.

This study aims to assess CPR proficiency among medical officers in Himachal Pradesh, encompassing both theoretical understanding and practical application in simulated emergency scenarios. By identifying potential gaps in training and practice, our goal is to contribute to the enhancement of emergency response capabilities in this distinct healthcare landscape.

While existing studies have explored CPR proficiency among healthcare providers, this research specifically addresses the unique challenges faced by medical officers in regions characterized by diverse topography. Building on the current body of knowledge, our study seeks to provide nuanced insights tailored to the healthcare context of Himachal Pradesh [4-8].

Understanding the current state of CPR proficiency is crucial for refining the quality of emergency medical care and subsequently improving patient outcomes. By undertaking this assessment, we hope to contribute valuable data that can inform targeted training programs and interventions, thereby strengthening the emergency response capabilities of medical officers in Himachal Pradesh.

Objectives of the Study

To evaluate the Knowledge of Cardiopulmonary Resuscitation (CPR) 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 Himachal Pradesh for 12 months or more

• Sample Size: 100 medical officers assuming 50% have adequate knowledge regarding Cardiopulmonary Resuscitation (CPR), 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 Cardiopulmonary Resuscitation (CPR) 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 Cardiopulmonary Resuscitation (CPR). 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 the state of 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 Cardiopulmonary Resuscitation (CPR) among 100 medical officers working in the state of Himachal Pradesh (Table 1).

In the present study, 27 study participants had very good knowledge (16-20 marks) regarding Cardiopulmonary Resuscitation (CPR), 31 had good knowledge (12-15 marks), 26 had fair knowledge (8-11 marks) and 16 had poor knowledge (<8 marks) (Table 2). 

Table 1: Responses to the Questions Regarding Cardiopulmonary Resuscitation (CPR)

Table 2: Knowledge Regarding Cardiopulmonary Resuscitation (CPR) among Study Participants

The findings of this study offer a comprehensive understanding of Cardiopulmonary Resuscitation (CPR) knowledge among medical officers in the distinct healthcare landscape of Himachal Pradesh. Through a cross-sectional survey encompassing both theoretical understanding and practical application in simulated emergency scenarios, the study highlights the strengths and areas requiring targeted interventions.

The majority of respondents exhibited a commendable understanding of the primary goal of CPR in a cardiac arrest situation (94% correct responses). This aligns with international guidelines and is consistent with the findings of studies conducted in India, such as the work by Rajashekar et al. [9] and Gupta et al. [10], where high awareness of CPR objectives was observed among healthcare professionals.

Despite this, variations were noted in responses related to components of the "Chain of Survival" (71% correct responses) and the importance of early defibrillation in CPR (32% correct responses). This echoes the observations of studies conducted in Indian healthcare settings by Aggarwal et al. [7] and Kapoor et al. [11], indicating a need for focused interventions to enhance awareness, especially regarding the critical role of early defibrillation.

The study participants demonstrated robust knowledge regarding compression-related aspects, such as the recommended compression rate for high-quality CPR in adults (58% correct responses) and the depth of chest compressions during adult CPR (58% correct responses). Comparable findings were reported by Chaudhary et al. [8] and Singh et al. [12], affirming the foundational knowledge among medical professionals in India regarding these essential CPR components.

However, gaps in knowledge were identified in areas such as the recommended compression-ventilation ratio for one-person adult CPR (56% correct responses). This echoes the findings of the study by Rastogi et al. [13], emphasizing the need for targeted training programs to reinforce these specific aspects of CPR among healthcare providers in India.

Responses related to the use of Automated External Defibrillators (AEDs), steps for operating an AED and the role of rescue breaths in CPR indicated varying levels of understanding among participants. These findings are consistent with the observations of the study conducted by Joshi et al. [14], in India, emphasizing the importance of enhancing knowledge and practical skills related to AED utilization.

Comparing our outcomes with Indian studies reinforces the notion that while CPR knowledge among medical officers in Himachal Pradesh is promising, targeted interventions are essential, aligning with the recommendations of global and regional studies. Simulation-based training, as suggested by Kapoor et al. [11] and Aggarwal et al. [7], proves valuable in bridging the gap between theoretical knowledge and practical application.

Categorizing participants based on knowledge levels revealed that a substantial proportion had good to very good knowledge (58%), highlighting a solid foundation. However, the identification of individuals with fair (26%) and poor (16%) knowledge underlines the necessity of implementing focused educational initiatives, resonating with the findings of studies conducted in India by Natarajan et al. [15] and Shukla et al. [16].

In conclusion, the assessment of Cardiopulmonary Resuscitation (CPR) proficiency among medical officers in Himachal Pradesh reveals a commendable overall knowledge base, with strengths observed in the understanding of the primary goal of CPR and certain compression-related aspects. However, identified gaps in knowledge related to the "Chain of Survival," early defibrillation and specific compression-ventilation ratios underscore the need for targeted training interventions. The study findings, when compared with relevant Indian studies, emphasize the consistency of challenges faced by healthcare providers in various regions. To enhance emergency response capabilities, it is imperative to focus on reinforcing specific aspects of CPR through tailored educational programs, drawing from successful global and Indian strategies, ultimately ensuring a more uniformly robust CPR proficiency among medical officers in the diverse healthcare landscape of Himachal Pradesh.

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