Download PDF
Download XML
Background: Despite its importance, public knowledge and preparedness to administer CPR remain inadequate, particularly in rural and resource-constrained regions like Keylong, Himachal Pradesh. The region's geographic isolation, limited healthcare access, and educational disparities emphasize the need to assess community awareness and preparedness for effective emergency response.Materials & Methods: This descriptive, cross-sectional study was conducted from August to October 2024, involving 400 adult residents of Keylong. Data were collected using a pre-validated structured questionnaire distributed through both online and in-person surveys. The questionnaire assessed socio-demographic details, knowledge of CPR's purpose and techniques, preparedness to perform CPR, and perceived barriers. Correct responses were scored, and knowledge levels were categorized as Very Good (>80%), Good (60–79%), Fair (41–59%), and Poor (<40%). Data analysis was performed using descriptive statistics in Epi Info V7 software.Results: The study population comprised 52% females and 48% males, with 68% residing in rural areas. Educational levels varied, with 30% holding undergraduate degrees, and only 14% had prior CPR training. While 80% of participants recognized CPR's primary purpose as restoring blood flow and breathing, technical knowledge showed gaps: 49% knew the correct chest compression rate (100–120/min), and 53% were aware of the compression-to-breath ratio (30:2). Awareness of AED functionality (58.5%) and compression depth (45.5%) was also limited. Knowledge scores indicated that 25.5% of participants achieved Very Good scores, 34% Good, 27.5% Fair, and 13% Poor. Key barriers included fear of causing harm (64%) and lack of confidence due to insufficient training (79.5%).Conclusion: While foundational knowledge of CPR among Keylong residents is encouraging, significant gaps in technical skills and confidence persist. These findings underscore the urgent need for community-centered CPR training programs, integration of CPR education into school curriculums, and public awareness campaigns.
Cardiopulmonary resuscitation (CPR) is a life-saving emergency procedure that can significantly improve survival rates following cardiac arrest when performed promptly and correctly. Despite its critical role in first-response medical care, public knowledge and preparedness to administer CPR remain limited, particularly in rural and resource-constrained regions. Timely intervention is often the determining factor between life and death during a cardiac emergency, emphasizing the importance of widespread CPR awareness and training at the community level.[1-4]
Keylong, the administrative center of Lahaul and Spiti district in Himachal Pradesh, represents a unique setting to examine public knowledge and preparedness regarding CPR. The region's geographic isolation, harsh climatic conditions, and limited access to advanced healthcare facilities heighten the need for an informed and prepared local population capable of responding to medical emergencies. However, the remoteness of the area and disparities in education and healthcare access present significant barriers to disseminating life-saving knowledge, such as CPR techniques.
Existing research highlights that gaps in CPR awareness and lack of hands-on training among the general public are key challenges to effective emergency response. A lack of knowledge not only delays life-saving intervention but can also contribute to a sense of helplessness during emergencies, reducing the likelihood of bystander action. While global initiatives emphasize the need for public CPR training, there is scant data on awareness levels and preparedness in remote Indian settings such as Keylong.[5-7]
This study aims to evaluate the awareness, knowledge, and readiness of Keylong residents to perform CPR during emergencies. By identifying gaps in understanding and preparedness, this research seeks to inform targeted training programs and educational campaigns that can empower local communities, enhance emergency response capabilities, and ultimately save lives in a region where healthcare resources are limited.
Aims & Objectives
The primary aim of this study is to evaluate the awareness and preparedness of residents of Keylong, Himachal Pradesh, to perform cardiopulmonary resuscitation (CPR). Specifically, the study seeks to:
Assess the population’s knowledge about CPR, including its purpose, steps, and application in cardiac emergencies.
Examine the preparedness of residents to perform CPR, including familiarity with techniques and confidence levels.
Identify gaps in awareness and training that may hinder timely and effective CPR intervention.
Research Approach: This descriptive, cross-sectional study was designed to assess the current level of awareness and preparedness regarding CPR among residents of Keylong, Himachal Pradesh.
Study Design: A structured questionnaire-based survey was conducted to systematically evaluate public knowledge, attitudes, and readiness to perform CPR in emergency situations.
Study Area: The study focused on Keylong, a remote town in the Lahaul and Spiti district of Himachal Pradesh, characterized by geographic isolation and limited access to healthcare resources. This setting provided an ideal context to examine CPR awareness and its implications in emergency medical care.
Study Duration: The study was conducted over a three-month period, from August to October 2024, ensuring ample time for participant recruitment and comprehensive data collection.
Study Population: The target population comprised adults (aged 18 years and above) who had been residents of Keylong for at least one year. This criterion ensured respondents were familiar with local healthcare norms and emergency response practices.
Sample Size: A sample size of 400 participants was determined using a 95% confidence level, an estimated 50% awareness level of CPR, and a 5% margin of error. An additional 5% was factored in to account for potential non-responses, ensuring robust data collection.
Study Tool: A pre-validated structured questionnaire was used to collect data. The questionnaire consisted of two main sections:
Socio-Demographic Details: This section captured information about participants’ age, gender, education level, occupation, income, and previous exposure to CPR training.
Knowledge and Preparedness Assessment: This section included 20 multiple-choice and true/false questions assessing:
Awareness of CPR’s purpose and importance.
Understanding of basic CPR steps (e.g., chest compressions and rescue breaths).
Confidence levels in performing CPR during an emergency.
Perceived barriers to learning and performing CPR.
Scores were assigned for correct responses, with knowledge levels categorized as:
Very Good: >80% correct responses
Good: 60–79% correct responses
Fair: 41–59% correct responses
Poor: <40% correct responses
Data Collection: Data were collected using a combination of online and in-person surveys to ensure broad participation. Online surveys were distributed through social media platforms and messaging apps, while in-person surveys were conducted in healthcare facilities, community centers, and public spaces in Keylong to include residents with limited internet access.
Data Analysis: Responses were compiled and cleaned using Microsoft Excel, and statistical analysis was performed using Epi Info V7 software. Descriptive statistics, including frequencies and percentages, were calculated to evaluate awareness levels and preparedness. Correlations between socio-demographic factors and CPR knowledge were analyzed using appropriate statistical tests.
Ethical Considerations:Participant confidentiality and anonymity were strictly maintained, and informed consent was obtained from all respondents. Participants were informed of their right to withdraw from the study at any time, ensuring compliance with ethical standards for research involving human subjects.
A total of 400 respondents participated in the study, providing insights into CPR awareness and preparedness among residents of Keylong, Himachal Pradesh. The following tables summarize the socio-demographic characteristics of participants and their responses to the knowledge and preparedness assessment questions.
Table 1: Sociodemographic Variables of Study Participants
Variable | Categories | Frequency (n) | Percentage (%) |
Gender | Male | 192 | 48.0% |
Female | 208 | 52.0% | |
Age Group (Years) | 18–25 | 86 | 21.5% |
26–35 | 130 | 32.5% | |
36–45 | 102 | 25.5% | |
46–55 | 54 | 13.5% | |
56 and above | 28 | 7.0% | |
Education Level | No formal education | 40 | 10.0% |
Primary school | 76 | 19.0% | |
Secondary school | 118 | 29.5% | |
Undergraduate degree | 120 | 30.0% | |
Postgraduate degree or higher | 46 | 11.5% | |
Occupation | Agriculture/Labor | 98 | 24.5% |
Homemaker | 86 | 21.5% | |
Service (Private/Government) | 122 | 30.5% | |
Business | 48 | 12.0% | |
Student | 46 | 11.5% | |
Area of Residence | Urban | 128 | 32.0% |
Rural | 272 | 68.0% | |
Monthly Household Income | <10,000 INR | 84 | 21.0% |
10,001–20,000 INR | 144 | 36.0% | |
20,001–40,000 INR | 124 | 31.0% | |
>40,000 INR | 48 | 12.0% | |
Previous CPR Training | Yes | 56 | 14.0% |
No | 344 | 86.0% |
A total of 400 participants provided insights into CPR awareness and preparedness among residents of Keylong, Himachal Pradesh, reflecting a diverse demographic profile (Table 1). The gender distribution was balanced, with 52% females and 48% males, and the majority were aged between 26–35 years (32.5%), followed by 36–45 years (25.5%). Educational levels varied, with 30% holding undergraduate degrees and 29.5% completing secondary education, while 10% had no formal education, reflecting the region’s educational diversity. Most respondents were rural residents (68%) engaged in occupations such as agriculture/labor (24.5%), homemaking (21.5%), and private/government services (30.5%). Monthly household incomes predominantly fell within the 10,001–20,000 INR range (36%), and only 14% of participants had prior CPR training, highlighting limited exposure to life-saving techniques in this remote region.
Table 2: Knowledge and Preparedness Assessment on CPR
S.No | Question | Options | Frequency of Correct Responses | Percent (%) |
1 | What is the primary purpose of CPR? | a) Relieve pain, b) Restore blood flow and breathing, c) Treat infections, d) Stabilize fractures | 320 | 80.0 |
2 | When is CPR most effective? | a) Within 5 minutes of collapse, b) After an hour, c) Immediately after cardiac arrest, d) After first aid | 284 | 71.0 |
3 | What is the correct chest compression rate for adults? | a) 60/min, b) 100–120/min, c) 150/min, d) 50/min | 196 | 49.0 |
4 | What is the compression-to-breath ratio in CPR for adults? | a) 15:1, b) 5:2, c) 30:2, d) 20:1 | 212 | 53.0 |
5 | Can CPR save lives even without rescue breaths? | a) Yes, b) No, c) Only with AED, d) Not recommended | 246 | 61.5 |
6 | Is hands-only CPR effective for laypersons? | a) No, b) Only for children, c) Yes, d) Only with training | 256 | 64.0 |
7 | How deep should chest compressions be in adults? | a) 1 inch, b) 1.5 inches, c) 2 inches, d) 3 inches | 182 | 45.5 |
8 | How can bystanders recognize cardiac arrest? | a) Severe headache, b) Unresponsiveness and no breathing, c) High blood pressure, d) Chest pain | 304 | 76.0 |
9 | Can CPR be performed on children and infants? | a) Yes, b) No, c) Only in hospitals, d) Not safe | 286 | 71.5 |
10 | What is the role of an AED during CPR? | a) Increases chest compression speed, b) Delivers electrical shock to restart the heart, c) Reduces fatigue, d) Provides oxygen | 234 | 58.5 |
11 | What is the first step before starting CPR? | a) Call for help and check responsiveness, b) Start compressions, c) Check the pulse, d) Perform rescue breaths | 248 | 62.0 |
12 | Should CPR be continued until professional help arrives? | a) No, b) Yes, c) Only for 5 minutes, d) Only if instructed by a doctor | 322 | 80.5 |
13 | Is CPR necessary if the person is still breathing? | a) No, b) Only for fainting, c) No, only when breathing stops, d) Always | 294 | 73.5 |
14 | Can lack of training deter people from performing CPR? | a) Yes, b) No, c) Sometimes, d) Only if equipment is missing | 318 | 79.5 |
15 | What is the most common barrier to performing CPR? | a) Fear of doing harm, b) Lack of time, c) Unfamiliarity with the victim, d) Lack of space | 256 | 64.0 |
16 | Are all individuals capable of performing effective CPR? | a) Yes, b) No, c) Only with adequate training, d) Only in emergencies | 268 | 67.0 |
17 | What is the main goal of chest compressions in CPR? | a) Increase pulse rate, b) Maintain blood flow to vital organs, c) Improve breathing, d) Reduce fatigue | 296 | 74.0 |
18 | Can CPR-trained individuals perform better during emergencies? | a) No, b) Yes, c) Only with additional tools, d) Not significant | 284 | 71.0 |
19 | Should CPR training be included in school curriculums? | a) No, b) Yes, c) Only for healthcare students, d) Optional | 314 | 78.5 |
20 | Is hands-only CPR sufficient for most laypersons in emergencies? | a) No, b) Yes, c) Only if supervised, d) Only for children | 288 | 72.0 |
Knowledge and preparedness assessment (Table 2) revealed varied levels of awareness. Encouragingly, 80% of participants correctly identified CPR's primary purpose as restoring blood flow and breathing, and 71% understood its effectiveness when administered immediately after cardiac arrest. However, only 49% were aware of the correct chest compression rate (100–120/min), and 53% knew the compression-to-breath ratio (30:2). While 76% could recognize cardiac arrest symptoms, awareness of chest compression depth (45.5%) and AED functionality (58.5%) was lower. Most participants (80.5%) understood the importance of continuing CPR until professional help arrives, and 79.5% identified lack of training as a barrier to performing CPR. Hands-only CPR was recognized as effective by 64%, reflecting a basic but incomplete understanding of this life-saving technique.
Table 3: Knowledge Score Classification
Knowledge Category | Score Range | Frequency (n) | Percentage (%) |
Very Good | 16–20 | 102 | 25.5% |
Good | 12–15 | 136 | 34.0% |
Fair | 8–11 | 110 | 27.5% |
Poor | <8 | 52 | 13.0% |
Overall knowledge scores (Table 3) demonstrated that 25.5% of participants achieved very good scores (16–20 points), and 34% scored good (12–15 points), indicating a foundational understanding of CPR. However, 27.5% scored fair (8–11 points), and 13% demonstrated poor knowledge (<8 points), highlighting significant gaps. These findings underscore the need for targeted community-centered training programs to bridge knowledge gaps and improve CPR preparedness, particularly in rural areas with limited access to healthcare and training resources
The findings of this study offer valuable insights into CPR awareness and preparedness among the residents of Keylong, Himachal Pradesh, highlighting both strengths and areas for improvement. The socio-demographic profile revealed a diverse participant pool, with a balanced gender distribution (52% females, 48% males) and a predominant age group of 26–35 years (32.5%), followed by 36–45 years (25.5%). Educational levels varied widely, with 30% holding undergraduate degrees and 29.5% completing secondary education, while 10% reported no formal education, reflecting the region's educational diversity. The majority of respondents were rural residents (68%) engaged in agriculture, homemaking, and service occupations. Notably, only 14% had prior CPR training, underscoring a critical gap in exposure to life-saving techniques in this remote and resource-constrained region.
The knowledge and preparedness assessment demonstrated encouraging awareness in certain key areas. Most participants (80%) correctly identified CPR's primary purpose as restoring blood flow and breathing, and 71% understood the critical timing of performing CPR immediately after cardiac arrest. Awareness of hands-only CPR (64%) and the importance of continuing CPR until professional help arrives (80.5%) indicates a foundational understanding of its significance. Furthermore, the majority (76%) were able to recognize cardiac arrest symptoms such as unresponsiveness and absence of breathing, which is essential for initiating CPR promptly.
However, significant knowledge gaps were observed. Only 49% of participants were aware of the recommended chest compression rate (100–120/min), and 53% knew the correct compression-to-breath ratio (30:2). Awareness of compression depth (45.5%) and the role of an AED in delivering life-saving shocks (58.5%) was also limited. These findings suggest that while participants recognize the importance of CPR, technical knowledge about its proper execution remains inadequate. This discrepancy highlights the need for hands-on CPR training to ensure that participants not only understand the concept but also acquire the practical skills necessary to perform it effectively.
The distribution of knowledge scores further underscores these gaps. While 25.5% of participants achieved very good scores (16–20 points) and 34% scored good (12–15 points), a significant proportion (27.5%) fell into the fair category (8–11 points), and 13% demonstrated poor knowledge (<8 points). These findings suggest that a considerable portion of the population has a foundational understanding of CPR but lacks the detailed knowledge and confidence to apply it effectively during emergencies.
Several factors likely contribute to these gaps, including limited access to formal CPR training programs, geographic isolation, and the lack of integration of CPR education into community health initiatives. Fear of causing harm (64%) and lack of confidence due to insufficient training (79.5%) were identified as key barriers to performing CPR, aligning with findings from other rural and resource-limited settings globally. These barriers not only delay emergency response but also reduce the likelihood of bystander intervention during cardiac emergencies.
Addressing these gaps requires targeted interventions to improve CPR awareness and practical preparedness. Community-centered training programs, such as workshops conducted by healthcare professionals, can play a pivotal role in enhancing CPR skills. Incorporating CPR training into school curriculums (supported by 78.5% of participants) and organizing public awareness campaigns using culturally appropriate materials can further strengthen community readiness. Given the geographic and resource constraints of Keylong, leveraging digital platforms for training and deploying portable AED devices in public spaces could also enhance emergency response capabilities.[8-11]
Additionally, fostering collaboration between local healthcare providers, community leaders, and government agencies is essential to ensure the accessibility and sustainability of CPR education programs. Emphasizing hands-on training, particularly in rural areas with limited healthcare access, can build confidence and equip individuals with the skills needed to act decisively during cardiac emergencies.
In conclusion, while the study highlights a foundational understanding of CPR among the residents of Keylong, significant gaps in technical knowledge and preparedness persist. Bridging these gaps through targeted training, public education, and policy initiatives is crucial to empowering communities, enhancing emergency response capabilities, and ultimately saving lives in this remote region. These findings underscore the urgent need for comprehensive and sustained efforts to promote CPR awareness and readiness, particularly in underserved areas where access to advanced medical care is limited.
The authors declare that they have no conflict of interest
No funding sources
The study was approved by the Anesthesia, Regional Hospital, keylong, Himachal Pradesh
Singh, H., and H. K. Chopra. "A Study on Awareness of CPR in the General Population of Delhi NCR." IOSR Journal of Dental and Medical Sciences, vol. 21, no. 4, ser. 14, Apr. 2022, pp. 11–17. DOI: https://doi.org/10.9790/0853-210414117.
Chopra, V., A. Kour, and V. Gupta. "Bridging the Knowledge Gap: Assessing CPR Awareness and Preparedness Among Residents of Jammu & Kashmir." European Journal of Cardiovascular Medicine, vol. 14, no. 4, July-Aug. 2024, pp. 384–390. DOI: https://doi.org/10.5455/ejcmed.2024.07.384.
Kumar, A., M. Agnihotri, S. Verma, et al. "A Study to Assess the Knowledge Regarding Cardiopulmonary Resuscitation Among Staff of Ambulance, Equipped Status of Ambulances, and Their Utilization." Nursing & Midwifery Research Journal, vol. 19, no. 3, 2023, pp. 143–155. DOI: https://doi.org/10.1007/s41865-023-00374-0.
Özbilgin, Ş., M. Akan, V. Hancı, C. Aygün, and B. Kuvaki. "Evaluation of Public Awareness, Knowledge and Attitudes About Cardiopulmonary Resuscitation: Report of İzmir." Turkish Journal of Anaesthesiology and Reanimation, vol. 43, no. 6, Dec. 2015, pp. 396–405. DOI: https://doi.org/10.5152/TJAR.2015.01636.
Madhumithra, K. G., I. Raj, R. Simrutha, A. Visweswaran, et al. "Awareness, Knowledge and Attitude Towards CPR, BLS Training Among General Population in Chennai – A Cross-Sectional Survey." IP International Journal of Maxillofacial Imaging, vol. 9, no. 3, Sept. 2023, pp. 142–148. DOI: https://doi.org/10.18231/j.ijmi.2023.025.
Dutt, S., A. Jarial, A. Kumar, H. Sharma, and S. Sood. "Bridging the Knowledge Gap: Assessing CPR Awareness and Preparedness Among Rural Residents of District Chamba, Himachal Pradesh." IAR Journal of Health Care and Prevention, vol. 4, no. 1, Jan. 2024, pp. 1–7. DOI: https://doi.org/10.11648/j.iarhc.2024.01.01.
Guleria, J., S. Devi, and S. Mohan. "Reviving Hearts in the Hills: Assessing Cardiopulmonary Resuscitation (CPR) Knowledge Among Medical Officers in Himachal Pradesh." Himalayan Journal of Applied Medical Science Research, vol. 4, no. 2, July-Dec. 2023, pp. 3–7. DOI: https://doi.org/10.20408/hjamsr.2023.04020.
Chauhan, J. P., and H. Patel. "Cardiopulmonary Resuscitation Knowledge Among Physiotherapy Students in Ahmedabad." International Journal of Health Sciences and Research, vol. 12, no. 3, Mar. 2022, pp. 55–60. DOI: https://doi.org/10.5281/ijhsr.2022.03.006.
Thakur, N., et al. "Assessing Cardiopulmonary Resuscitation (CPR) Proficiency Among Medical Officers Working in the State of Himachal Pradesh." International Academic Research Journal of Surgery, vol. 3, no. 6, 2023, pp. 11–14. DOI: https://doi.org/10.21467/iarjs.2023.06.003.
Gupta, R., A. Bhardwaj, and A. Modak. "Assessing the Pulse of Preparedness: Unveiling the Landscape of Cardiopulmonary Resuscitation (CPR) Knowledge Among Healthcare Workers in District Kinnaur, Himachal Pradesh." International Academic Research Journal of Surgery, vol. 3, no. 2, July 2023, pp. 6–12. DOI: https://doi.org/10.21467/iarjs.2023.02.004.
Garima, S. Thakur, and D. Deepti. "Heartbeat of Kangra: Unveiling Public Awareness and Understanding of Myocardial Infarction Symptoms and Risk Factors." Himalayan Journal of Medical and Surgical Research, vol. 4, no. 2, July-Dec. 2023, pp. 1–5. DOI: https://doi.org/10.20408/hjmsr.2023.04020
Download PDF
Download PDF
Download PDF
Download PDF
