Background: Cardiopulmonary Resuscitation (CPR) is a crucial life-saving intervention, particularly significant in regions with diverse healthcare landscapes like the District Kinnaur, Himachal Pradesh, India. Disparities in CPR knowledge among health care workers may impact emergency medical responses and patient outcomes. This study addresses the need for region-specific assessments to understand the baseline proficiency in CPR. Materials and Methods: A cross-sectional survey, conducted from August 2023 to November 2023, assessed CPR knowledge among 100 Health Care workers in District Kinnaur, Himachal Pradesh. A Google Form questionnaire, encompassing socio-demographic details and 20 CPR-related questions, was used. The scoring system categorized participants as very good (>80%), good (60-79%), fair (41-59%) and poor (<40%) based on their responses. Convenience and snowball sampling techniques were employed. Data were analyzed using Epi Info V7 Software. Results: The study revealed commendable overall CPR knowledge among participants. Notably, 29 demonstrated very good knowledge, 33 good knowledge, 27 fair knowledge and 11 poor knowledge. While participants excelled in understanding the primary goal of CPR and the "Chain of Survival," gaps were identified in areas like early defibrillation, AED operation and rhythm assessment. Importantly, 68% acknowledged the necessity of regular CPR retraining. Conclusion: Despite positive findings, targeted interventions are essential to address specific knowledge gaps. Continuous CPR retraining programs and policy enhancements can further improve the preparedness of Health Care workers in District Kinnaur, ultimately contributing to enhanced emergency response capabilities.
Cardiopulmonary Resuscitation (CPR) stands as a critical life-saving intervention crucial for reducing mortality rates associated with sudden cardiac arrests and other cardiopulmonary emergencies. The proficiency of health care workers, acting as frontline responders, is pivotal in delivering timely and effective CPR. However, the varying levels of CPR knowledge and skills among health care workers in specific regions, such as the District Kinnaur in Himachal Pradesh, India, may impact the overall quality of emergency medical responses.
This study aims to comprehensively assess CPR knowledge among health care workers in the District Kinnaur, Himachal Pradesh, to gauge their preparedness in handling cardiac emergencies. Understanding the baseline proficiency in CPR is essential for implementing targeted training programs, thus enhancing the readiness of health care professionals and improving outcomes in the region.
Cardiac diseases represent a significant global health concern, with sudden cardiac arrests contributing substantially to mortality. Both the American Heart Association (AHA) and the International Liaison Committee on Resuscitation (ILCOR) stress the importance of high-quality CPR in improving survival rates and minimizing neurological damage following cardiac events [1,2].
Studies in India emphasize the need for improved CPR awareness and training. Kapoor et al. [3], highlighted suboptimal CPR knowledge among medical professionals in Northern India, underscoring the urgency for targeted interventions [3]. Singh et al. [4], identified gaps in CPR knowledge and skills among health care providers in rural settings, emphasizing the need for region-specific assessments [4]. A study by Bhanu et al. [5], further highlighted variations in CPR knowledge among healthcare professionals in different Indian states, reinforcing the importance of regional assessments [5].
The diverse healthcare landscape in India often leads to regional variations in the quality of training and preparedness of health care workers. In this context, assessing CPR knowledge among health care workers in the District Kinnaur, Himachal Pradesh, becomes imperative for tailoring interventions according to the specific needs of the region.
The primary objective of this study is to evaluate the knowledge of CPR among health care workers in the District Kinnaur, Himachal Pradesh. By identifying gaps in CPR proficiency, this research aims to inform targeted training programs, policy development and resource allocation to enhance the overall emergency response capacity in the region.
The findings of this study are expected to contribute valuable insights into the current state of CPR knowledge among health care workers in Himachal Pradesh. The results will not only guide the development of tailored CPR training programs but also serve as a benchmark for future assessments and interventions aimed at improving emergency response capabilities in similar regional contexts.
Objectives of the Study
To evaluate the Knowledge of Cardiopulmonary Resuscitation (CPR) among Health Care workers employed in the District Kinnaur, Himachal Pradesh.
Research Approach: Descriptive
Research Design: Cross-sectional survey design
Study Area: District Kinnaur, Himachal Pradesh
Study Duration: Between August 2023 to November 2023
Study Population: All Health Care workers employed in District Kinnaur, Himachal Pradesh for 12 months or more
Sample Size: 100 Health Care workers 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 Health Care workers 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 Health Care workers working in the District Kinnaur, 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 Health Care workers employed in the District Kinnaur, Himachal Pradesh (Table 1).
Table 1: Responses to the Questions Regarding Cardiopulmonary Resuscitation (CPR)
| S.No. | Statements | Frequency of Correct Responses |
| What is the primary goal of CPR in a cardiac arrest situation? | 98 | |
| Can you describe the basic components of the "Chain of Survival" in CPR? | 74 | |
| What are the key initial steps when approaching a patient in cardiac arrest? | 58 | |
| Explain the importance of early defibrillation in CPR. | 33 | |
| What is the recommended compression rate for high-quality CPR in adults? | 60 | |
| How deep should chest compressions be performed during adult CPR? | 60 | |
| What is the recommended compression-ventilation ratio for one-person adult CPR? | 58 | |
| When should you use an automated external defibrillator (AED) during CPR? | 53 | |
| Describe the steps for operating an AED and delivering a shock to a victim. | 47 | |
| What is the role of rescue breaths in CPR and when are they performed? | 58 | |
| Can you outline the steps for assessing responsiveness and activating the emergency response system? | 45 | |
| How should you manage a choking victim who becomes unresponsive during CPR? | 47 | |
| When is the use of bag-mask ventilation indicated in CPR and how is it performed? | 33 | |
| Explain the differences in CPR techniques for infants and children compared to adults. | 34 | |
| What are the key considerations for providing CPR to a pregnant woman? | 27 | |
| Describe the technique for checking for a pulse during CPR. | 50 | |
| How do you assess the rhythm of a cardiac arrest victim using an ECG monitor? | 42 | |
| What is the role of advanced airway management, such as endotracheal intubation, in CPR? | 40 | |
| What are the potential complications or challenges that can arise during CPR and how do you address them? | 50 | |
| How often should healthcare providers undergo CPR retraining and certification? | 68 |
Table 2: Knowledge Regarding Cardiopulmonary Resuscitation (CPR) among Study Participants
| Category (Marks) | Frequency (n = 100) |
| V. Good (16-20) | 29 |
| Good (12-15) | 33 |
| Fair (8-11) | 27 |
| Poor (<8) | 11 |
In the present study, 29 study participants had very good knowledge (16-20 marks) regarding Cardiopulmonary Resuscitation (CPR), 33 had good knowledge (12-15 marks), 27 had fair knowledge (8-11 marks) and 11 had poor knowledge (<8 marks) (Table 2).
The extensive evaluation of Cardiopulmonary Resuscitation (CPR) knowledge among Health Care workers in the District Kinnaur, Himachal Pradesh, provides valuable insights into the preparedness of frontline responders in managing cardiac emergencies. The cross-sectional survey design employed in this study revealed both commendable strengths and identified areas that require attention and improvement.
The majority of participants demonstrated commendable knowledge regarding the primary goal of CPR, the basic components of the "Chain of Survival," and recommended compression rates for high-quality CPR. These findings align with studies conducted in other parts of India, emphasizing the importance of foundational CPR knowledge among health care professionals [3-8].
Despite the overall positive findings, the study identified variations in specific aspects of CPR. Notably, areas such as the importance of early defibrillation, steps for operating an Automated External Defibrillator (AED) and techniques for assessing rhythm using an ECG monitor showed lower levels of proficiency. This observation emphasizes the need for targeted training programs addressing these specific components [9-12].
The study revealed that 68% of participants recognized the need for regular CPR retraining and certification. This awareness is crucial, as guidelines and techniques in CPR are periodically updated. Regular retraining ensures that health care workers are equipped with the latest evidence-based practices, contributing to improved patient outcomes [1,13,14].
Despite the overall positive findings, a notable proportion of participants demonstrated fair to poor knowledge levels in certain aspects of CPR. For instance, considerations for providing CPR to pregnant women, the use of bag-mask ventilation and the role of advanced airway management presented opportunities for improvement. Tailored educational interventions focusing on these specific areas could enhance overall CPR proficiency [15-18].
The study's results have implications for both clinical practice and policy development. Strengthening CPR training programs, with an emphasis on the identified knowledge gaps, is essential. Additionally, healthcare institutions and policymakers should consider implementing regular, mandatory CPR retraining sessions to ensure sustained proficiency among health care workers [19-22].
Study Limitations
While the study provides valuable insights, certain limitations must be acknowledged. The use of convenience and snowball sampling may introduce selection bias and the findings may not be entirely generalizable to the broader population of health care workers in the district. Additionally, self-reported knowledge in a questionnaire may not fully reflect practical skills in a real-world scenario.
In conclusion, this study serves as a foundation for understanding CPR knowledge among Health Care workers in the District Kinnaur, Himachal Pradesh. The identified strengths and areas for improvement can inform targeted interventions, ultimately contributing to enhanced emergency response capabilities in the region.
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