Knowledge and Skills Regarding Cardiopulmonary Resuscitation among Staff of the 108 Ambulance Service in Sagar District, Madhya Pradesh, India: A Cross-Sectional Study

Abstract

Background: Cardiopulmonary resuscitation (CPR) is a time-critical intervention that significantly improves survival after cardiac arrest. Ambulance personnel are often the first healthcare providers to initiate CPR in out-of-hospital cardiac arrest (OHCA); however, deficiencies in CPR knowledge and practical skills may compromise patient outcomes.

Objectives: To assess CPR knowledge and practical skills among personnel of the 108 ambulance service in Sagar district, Madhya Pradesh; to evaluate the availability and functionality of emergency equipment; and to identify training gaps.

Methods: A cross-sectional observational study was conducted among 161 ambulance personnel working in Basic Life Support (BLS) and Advanced Life Support (ALS) ambulances. Data were collected using a structured questionnaire based on American Heart Association recommendations, direct observation of CPR skills using standardized checklists, and assessment of ambulance equipment.

Results: The study revealed considerable deficiencies in both CPR knowledge and practical skills despite prior training among many participants: 57.1% had average knowledge and 54.7% had average skills, while only 19.9% and 18.0%, respectively, achieved a good level. Knowledge and skill levels were significantly associated (χ² = 26.71, df = 4, p = 0.00002). Equipment assessment showed high overall availability (ALS: 95.6%; BLS: 93.6%) and functionality (ALS: 95.0%; BLS: 95.9%), with selected deficiencies in AEDs, infant/child AMBU bags, and select airway devices.

Conclusion: Regular simulation-based refresher training, competency assessment, and improved ambulance preparedness are essential to strengthen prehospital emergency care under the 108 ambulance system.