title: Is current training in basic and advanced cardiac life support (BLS & ACLS) effective? A study of BLS & ACLS knowledge amongst healthcare professionals of North-Kerala.
abstract: BACKGROUND
  Healthcare professionals are expected to have knowledge of current basic and advanced cardiac life support (BLS/ACLS) guidelines to revive unresponsive patients.
  
  
  METHODS
  A cross-sectional study was conducted to evaluate the current practices and knowledge of BLS/ACLS principles among healthcare professionals of North-Kerala using pretested self-administered structured questionnaire. Answers were validated in accordance with American Heart Association's BLS/ACLS teaching manual and the results were analysed.
  
  
  RESULTS
  Among 461 healthcare professionals, 141 (30.6%) were practicing physicians, 268 (58.1%) were nurses and 52 (11.3%) supporting staff. The maximum achievable score was 20 (BLS 15/ACLS 5). The mean score amongst all healthcare professionals was 8.9±4.7. The mean score among physicians, nurses and support staff were 8.6±3.4, 9±3.6 and 9±3.3 respectively. The majority of healthcare professionals scored ≤50% (237, 51.4%); 204 (44.3%) scored 51%-80% and 20 (4.34%) scored >80%. Mean scores decreased with age, male sex and across occupation. Nurses who underwent BLS/ACLS training previously had significantly higher mean scores (10.2±3.4) than untrained (8.2±3.6,P=0.001). Physicians with <5 years experience (P=0.002) and nurses in the private sector (P=0.003) had significantly higher scores. One hundred and sixty three (35.3%) healthcare professionals knew the correct airway opening manoeuvres like head tilt, chin lift and jaw thrust. Only 54 (11.7%) respondents were aware that atropine is not used in ACLS for cardiac arrest resuscitation and 79 (17.1%) correctly opted ventricular fibrillation and pulseless ventricular tachycardia as shockable rhythms. The majority of healthcare professionals (356, 77.2%) suggested that BLS/ACLS be included in academic curriculum.
  
  
  CONCLUSIONS
  Inadequate knowledge of BLS/ACLS principles amongst healthcare professionals, especially physicians, illuminate lacunae in existing training systems and merit urgent redressal.
authors.affiliation: Department of Emergency Medicine, Academy of Medical Sciences, Pariyaram, Kannur, Kerala, India.
authors.forename: Madavan
authors.initials: M
authors.lastname: Nambiar
authors.affiliation: Department of Emergency Medicine, Academy of Medical Sciences, Pariyaram, Kannur, Kerala, India.
authors.forename: Nisanth Menon
authors.initials: NM
authors.lastname: Nedungalaparambil
authors.affiliation: Department of Emergency Medicine, Academy of Medical Sciences, Pariyaram, Kannur, Kerala, India.
authors.forename: Ottapura Prabhakaran
authors.initials: OP
authors.lastname: Aslesh
keywords: Advanced cardiac life support; Awareness; Basic life support; Cardiopulmonary resuscitation; Healthcare professionals