Cardiac arrest is characterized by abrupt loss of consciousness caused by lack of adequate cerebral blood flow. It is an event that uniformly leads to death in the absence of an active intervention, although spontaneous reversions occur rarely. The most important factor in an emergency is the amount of time lost before a patient reaches the hospital. Cardiopulmonary resuscitation is designed to support and maintain breathing and circulation until emergency medical personnel arrive and take over.
To evaluate the effectiveness of hands on practice schooling and allied factors regarding Basic Life Support among civil patrols.
One group quasi experimental design was used among fifty civil patrols by selected by cluster random sampling technique. The collected data were collected by structured skill questionnaire and performance checklist. Collected data were analyzed using descriptive and inferential statistics.
The mean pre-test skill score was 5.10 with SD ±0.73 and the mean of post- test skill score was 16.58 with SD ±1.60. The paired’ test showed the difference in overall skill (47.604, p< 0.05) respectively. Age (2 =8.320, p=0.05), educational status (2 =33.040, p=0.05) and previous awareness on CPR (2 =18.000, p=0.05) were statistically significant associated with pre-test knowledge level of civil patrols. Thus suggests the effectiveness of skill training in terms of gain in skill score among civil patrols.
The present study concluded that the civil patrols lack in hands on techniques regarding Basic Life Support (BLS) and recommended that further study can be conducted with large similar groups, first responders like fire fighters, life guards, teachers, high school students, and other lay person as well.
Keywords: Hands on Practice Schooling. Allied Factors, Basic Life Support, Patrol
Heart disease is the world’s largest killer, claiming 17.5 million lives every year. About every 29 seconds, an Indian dies of heart problem. As many as 20,000 new heart patients develop every day in India 9 crore suffer from heart disease and 30% more are at high risk. Sudden cardiac arrest is a major public health problem. Basic Life Support (BLS) is the provision of treatment designed to maintain adequate circulation and ventilation to the patient in cardiac arrest, without the use of drugs or specialist equipment. Basic Life Support (BLS) includes recognition of signs of suddencardiac arrest (SCA), heart attack, stroke, and foreign-bodyairway obstruction (FBAO); and cardiopulmonary resuscitation (CPR) [1].
Cardiac arrest is characterized by abrupt loss of consciousness caused by lack of adequate cerebral blood flow. It is an event that uniformly leads to death in the absence of an active intervention, although spontaneous reversions occur rarely. Nationally over 80% of emergency victims in India do not receive proper medical attention during the golden hour and statistics indicate that 62% of those getting involved in emergencies are those belonging to the productive age group of 25 to 50 years, and for the country this is a major drain on the nation’s most important resource, trained manpower [2].
Sudden Cardiac Arrest (SCA) is one of the most common causes of death in many countries [3]. While for many of the victims a Cardio Pulmonary Resuscitation (CPR) was performed, the survival to discharge after CPR was about 6.9% [4]. CPR is a technique used in cardiac arrest to re-establish heart and lung function until more advanced life support is available [5].
CPR is unlikely to restart the heart; its main purpose is to maintain a flow of oxygenated blood to the brain and the heart, thereby delaying tissue death and extending the brief window of opportunity for a successful resuscitation without permanent brain damage [6]. The concept of educating the lay public in the techniques of resuscitation was advocated by Dr. Beck in the late 1950s, when he created a short teaching film in which he introduced were successfully resuscitated and in which he stated that “a massive teaching program is needed” [7].
Thus this life saving strategy is considered to be one of the important practical skills. The training of which is not just confined to the medical professionals, but almost anyone can perform provided with adequate skill which therefore needs to be regularly practiced to ensure full competency. Towards saving the precious lives [8].
To find out the pre-existing skill of Basic Life Supportamong civil patrol in selected police station at Dakshina Kannada.
To assess the effectiveness of Hands on Practice Schooling regarding Basic Life Supportamong civil patrol in selected police station at Dakshina Kannada.
To find out the association between pre-test skill level and selected demographic pro-forma of civil patrol on Basic Life Support
One group pre-test post-test, quasi experiment design
The study was conducted in police hall at Dakshina Kannada. There were a total of 28 police stations under superintendent of police, DK. Five police stations were selected using cluster sampling method and then 50 patrols were selected randomly.
The tool is divided into mainly two parts,
Part-I: Demographic pro-forma of the civil patrol.
Part-II: Structured skill questionnaire on BLS, which is divided into three sections.
Section A: Consists 6 items regarding general concept of BLS.
Section B: Consists 16 items regarding resuscitation and after procedure care according to the standards of American Heart Association (AHA)
Section C: Performance checklist for evaluation of BLS skill (modified AHA guidelines)
Validity of the tool was ascertained in consultation with nine experts in the field of medical-surgical nursing, one intensivist from Intensive Care Unit and a Professor in the field of medicine. The experts were requested to judge the items for accuracy, relevance, appropriateness and degree of agreement. The suggestions of the experts were incorporated into the tool and the tool was modified accordingly.
The pilot study was conducted in Ullal police station at Dakshina Kannada. The patrols who were participated in the pilot study were excluded from the sample. To find the feasibility of the study, five civil patrols were selected by using random sampling technique. After conducting the pilot study, found that the study was feasible, the questionnaire was relevant and the time and cost for the study was within the limit.
Prior permission was obtained from the concerned authority. Informed consent obtained from the subjects. The respondents were assured the anonymity and confidentiality of the information provided by them. The pre-test data were collected from the sample 2010. Lecture cum discussion, demonstration and re-demonstration were the methods of instruction. LCD projector and video footage were used as an AV aid. The duration of the practical was one day. After 7 days a post-test was conducted using the performance checklist and structured questionnaire to assess the effectiveness of Hands on Schooling.
The collected data were analyzed by using SPSS, descriptive (frequency, distribution, percentage, mean and standard deviation) and inferential statistics (Chi square test, paired t test).
N = 50
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| 1 | Age | ||
| Less than 25 | 29 | 58 | |
| 26 – 35 | 16 | 32 | |
| 36 – 45 | 5 | 10 | |
| 2 | Gender | ||
| Male | 34 | 68 | |
| Female | 16 | 32 | |
| 3 | Education | ||
| SSLC | 4 | 8 | |
| PUC | 17 | 34 | |
| Graduation | 27 | 54 | |
| Post graduate | 2 | 4 | |
| 4 | Duration of working Experience | ||
| 1 – 5 year | 30 | 60 | |
| 6 – 10 year | 17 | 34 | |
| 11 years and above | 3 | 6 | |
| 5 | Previous awareness on CPR | ||
| Yes | 10 | 20 | |
| No | 40 | 80 | |
The above table 1 depicts that more than half 29 (58%) of the civil patrols were in the age group of less than 25 years. Majority 34 (68%) of the civil patrols belongs to male. In relation to their educational status, highest 27(54%) of them had graduation. In addition, most of 30 (60%) civil patrols had 1-5 years experience. Regarding previous awareness on CPR reveals that, majority 40 (80%) of the sample did not have previous exposure.
N= 50
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| Below 40 | Poor(<8) | 50 | 100 |
| 41-60 | Average(9 – 13) | - | - |
| 61-80 | Good(14-17) | - | - |
| 81-100 | Very good(>18) | - | - |
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The finding of the present study reveals that all the patrol had poor skill on BLS.
N= 50
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| Initial assessment | 3 | 1.04 | 1 | 0.66 | 34.66 |
| Airway | 2 | 0.84 | 1 | 0.76 | 42 |
| Breathing | 6 | 1.70 | 2 | 0.73 | 28.33 |
| Circulation | 10 | 1.52 | 1 | 0.64 | 15.2 |
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The data presented in the above table shows that the mean percentage of total skill scores of civil patrols in the pre-test was 24.28 % with mean ± SD of 5.1± 2.79. Area-wise mean percentage of skill scores was highest (42%) in the area airway and initial assessment with a mean ±SD of 1.04±.0.66. In the area related to breathing the mean percentage was (28.33%) with an area-wise mean ±SD of 1.70±0.73. In the area of Circulation the mean percentage was 15.2% with an area-wise mean ±SD of 1.52± 0.64. The findings reveal that the skill of the patrol regarding BLS is poor in all the areas.
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| Pre-test | 5.10 | 5 | 0.73 |
| Post-test | 16.58 | 17 | 1.60 |
The data presented in the above table shows that the pre-test mean was 5.10 with that of SD ±0.73and post- test mean was 16.58 with that of SD of ±1.60.
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| Poor | 50 | 100 | - | - |
| Average | - | - | 2 | 4 |
| Good | - | - | 37 | 74 |
| Very good | - | - | 11 | 22 |
The data presented in the above table shows that the pre-test skill level of all the patrol was poor and post test skill level good 74%, very good11% and average 4%.
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5.10 | 11.48 | 47.604* |
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16.58 |
The findings revealed that the mean post test score was significantly higher than their mean pre test score. The calculated’ value (47.604, P<0.05) in skill aspect was greater than the table value (2.02) at 0.05. Hence it is concluded that there is very highly significant gain in skill of patrol on BLS.
N = 50
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| Age | 8.320 | 2 | S |
| Gender | 2.880 | 1 | NS |
| Educational status | 33.040 | 3 | S |
| Duration of work experience | 3.040 | 2 | NS |
| Have you come across doing CPR | 18.000 | 1 | S |
Data presented in Table 8 reveals that the calculated chi-Square value of age (8.320), educational status (33.040) and previous knowledge on CPR (18.000) were greater than that of table value at 0.05 level of significance, hence the research hypothesis was accepted and concluded that there was a significant association between the pre-existing skill with these demographic variables on BLS.
The study was undertaken to assess the effectiveness of hands on practice schooling on BLS among patrols in a selected police station at Dakshina Kannada. The data were collected from 50 respondents before and after the administration of the skill training. Percentage distribution of patrol according to their age shows that the highest percentage (58%) of the respondents were in the age group ofless than 25 years, 32% were in the age between 26-35 years and only (10% ) were in the age group of 36-45 years. With regard to gender distribution of samples most (68%) of the respondents were males and 32% were female.
The present study shows that the mean pre-test skill score was 5.10 with SD ±0.73 and the mean of post- test skill score was 16.58 with SD ±1.60, which is compared to similar study [9] to evaluate the effectiveness of skill training revealed that mean score for pretest was found to be 7.07 ±2.12 with a mean percentage of 35.3% which was significantly improved to 14.9 ±3.25 with a mean percentage of 74.5 % at p <0.001 for posttest score. There was a significant association of age (2 =8.320, p=0.05), educational status (2 =33.040, p=0.05) and previous awareness on CPR (2 =18.000, p=0.05) with pre-test knowledge level of civil patrols in present study which was not similar to the study (Tarika Sharma and Urvashi Sharma, 2016) [9], where there was no association found between levels of knowledge of study participants with selected demographic variables.
Hence the study concluded that prevalence of BLS was more effective among patrols and increased significantly with age. Moreover, the level of skill about the CPR was very low. So there an essential to conduct similar training programme for patrols on updated BLS.
A similar study can undertake with a larger sample to generalize the findings.
A similar study may be conducted by using a control group. A similar study could be used to test the effectiveness of hands on training regarding BLS among parents, drivers, teachers, lifeguards and all first responders including lay persons.
I thank Divinity for His abundant grace and blessings showered upon me throughout the study. I would like to extend a word of thanks to the Dept. of Karnataka police. My sincere thanks to all participants who formed the core and basis for this study for their whole hearted co-operation. I would render my sincere gratitude to YGT one who helped me in preparing manuscript and other needs and deeds. My heartfelt thanks extended to respect Guide, dear parents and friends for their Unceasing support in the successful completion of this research.
Anil Kumar Parashar. Effective planned teaching program on knowledge and practice of Basic Life Support among students in Mangalore. The Nursing Journal of India. 2010 Available from: http://www.tnaionline.org/
McNally B, Robb R, Mehta M, Vellano K, Valderrama AL, Yoon PW, Sasson C, Crouch A, Perez AB, Merritt R, Kellermann A; Centers for Disease Control and Prevention. Out-of-hospital cardiac arrest surveillance Cardiac Arrest Registry to Enhance Survival (CARES), United States, 2010
Committee E. Subcommittees and Task Forces of the American Heart Association. American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 112(24), 2005, 1-203.
Suraseranivongse S, Chawaruechai T, Saengsung P, Komoltri C. Outcome of cardiopulmonary resuscitation in a 2300-bed hospital in a developing country. Resuscitation. 71(2), 2006, 188-93.
Sandra M. Nettina; The Lippincott manual of nursing practice; Philadelphia; Lippincott Williams and Wilkins-7, 2001
Wikipedia, the free encyclopedia. The Wikibook First Aid Primary Assessment & Basic Life Support. Available from: http://en.wikipedia.org/wiki/ Cardiopulmonary_ resuscitation;
Cooper JA., Cooper J D, Cooper JM. Cardiopulmonary Resuscitation: History, Current Practice, and Future Direction. American Heart Association Circulation. 114, 2006, 2839-2849.
Towards saving the precious lives Available on URL: http://www.medvarsity. com/vmu1.2/dmr/dmrdata/hb/april2002/heartbeat1-17.pdf