Epidemiology of out-of-Hospital Cardiac Arrests, knowledge of cardiovascular disease and risk factors in a regional setting in India: The Warangal Area out-of-hospital Cardiac Arrest Registry (WACAR)

Ramaka, Srinivas; Nazir, Noreen; Murthy, Vemuri; Hoek, Terry L. Vanden; Prabhakar, Bellur S.; Chodavarapu, Ravikumar; Peri, Sundaresh; Uppuleti, Anveshini; Jatoth, Rakesh; Murthy, Sindgi Vasudeva; Mohammed, Adil Sarvar; Weine, Stevan

doi:10.1016/j.ihj.2020.10.002

Cited by 7 publications

(7 citation statements)

References 38 publications

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“…A multi-center study conducted in Pakistan showed that nearly 90% of OHCA patients are witnessed, yet only 2.3% received bystander CPR [ 25 ]. The high number of OHCA witness in Pakistan could be attributable to joint family system as most of the cases in this study occurred in residences, similar to what was seen in India [ 26 ]. However, nearly 50% of the witnessed cardiac arrest in European countries receive bystander CPR, particularly in public places [ 27 , 28 ].…”

Section: Discussionsupporting

confidence: 68%

Out of hospital cardiac arrest: experience of a bystander CPR training program in Karachi, Pakistan

et al. 2022

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Background Nearly 90% of out-of-hospital cardiac arrest (OHCA) patients are witnessed, yet only 2.3% received bystander cardiopulmonary resuscitation (CPR) in Pakistan. This study aimed to determine retention of knowledge and skills of Hands-Only CPR among community participants in early recognition of OHCA and initiation of CPR in Karachi, Pakistan. Methods Pre and post-tests were conducted among CPR training participants from diverse non-health-related backgrounds from July 2018 to October 2019. Participants were tested for knowledge and skills of CPR before training (pre-test), immediately after training (post-test), and 6 months after training (re-test). All the participants received CPR training through video and scenario-based demonstration using manikins. Post-training CPR skills of the participants were assessed using a pre-defined performance checklist. The facilitator read out numerous case scenarios to the participants, such as drowning, poisoning, and road traffic injuries, etc., and then asked them to perform the critical steps of CPR identified in the scenario on manikins. The primary outcome was the mean difference in the knowledge score and skills of the participants related to the recognition of OHCA and initiation of CPR. Results The pre and post-tests were completed by 652 participants, whereas the retention test after 6 months was completed by 322 participants. The mean knowledge score related to the recognition of OHCA, and initiation of CPR improved significantly (p < 0.001) from pre-test [47.8/100, Standard Deviation (SD) ±13.4] to post-test (70.2/100, SD ±12.1). Mean CPR knowledge after 6 months (retention) reduced slightly from (70.2/100, ±12.1) to (66.5/100, ±10.8). CPR skill retention for various components (check for scene safety, check for response, check for breathing and correct placement of the heel of hands) deteriorated significantly (p < 0.001) from 77.9% in the post-test to 72.8% in re-test. Participants performed slightly better on achieving an adequate rate of chest compressions from 73.1% in post-test to 76.7% in re-test (p 0.27). Conclusion Community members with non-health backgrounds can learn and retain CPR skills, allowing them to be effective bystander CPR providers in OHCA situations. We recommend mass population training in Pakistan for CPR to increase survival from OHCA.

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Section: Discussionsupporting

confidence: 68%

Out of hospital cardiac arrest: experience of a bystander CPR training program in Karachi, Pakistan

et al. 2022

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“…Currently, few studies and international registries provide preliminary data on OHCA in India. 6 , 7 , 13 , 14 , 15 , 16 , 17 , 18 These studies highlight a staggering rate of bystander CPR ranging from 0% to under 10% in these studies, except for a single study reporting bystander CPR delivery up to 27.8%. (WACAR Study) [ Table 1 ].…”

Section: Current Evidence and Review Of Literaturementioning

confidence: 88%

Outcomes of out of hospital sudden cardiac arrest in India: A review and proposed reforms

Patel,

Mahtani,

Mehta

et al. 2023

Indian Heart Journal

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“…The In low-and middle-income countries (LMICs), there is a dearth of literature on OHCA, but poor outcomes are widely reported. 18,19 In Nepal, where the health care system is fragile, and the emergency response system is in its infant stage, it is important to equip first responders with basic life-saving skills. As they are typically the first to respond to rural emergencies, police officers' knowledge of CPR can be beneficial to those in rural settings where, otherwise, no other health care help is available promptly.…”

Section: Discussionmentioning

confidence: 99%

Pilot Training Program on Hands-Only CPR and Choking First Aid for Frontline Police Responders in Rural Nepal

Thapa,

Sapkota,

Thapa

et al. 2024

Wilderness & Environmental Medicine

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Introduction Basic life support (BLS) is an emergency skill that includes performing appropriate cardiopulmonary resuscitation (CPR). Out-of-hospital cardiac arrest (OHCA) is a leading cause of mortality worldwide and is rising in Nepal. After an OHCA event, a bystander starting CPR quickly has been shown to increase the survival rate. While the Nepali police are generally the first responders to emergencies in rural parts, they are not trained in BLS. This program assesses a pilot training of hands-only CPR and choking first aid to the Nepal Police and Nepal Army participants in rural Nepal. Methods A community-based nonprofit organization, HAPSA-Nepal, coordinated with local government to pilot this program. The program included pre- and post-tests, lectures, videos, and small group hands-on exercises; facilitators included faculty emergency physicians, residents, and medical officers. Structured pre- andp post-test questionnaires, confidence surveys, and skills checklists were conducted. Descriptive analysis examined the respondent's characteristics, and paired t-test was used to compare pretest and post-test scores. Results A total of 126 participants received the training in this pilot phase. Prior to this training, 98.4% of the participants had not received any CPR training, and 100% of the participants had not received training on first aid for choking. The average pretest score was 4.4 with 95% CI ± 1.75, and the average post-test score was 8.06 with 95% CI ± 1.73 (out of a total of 11). All participants passed the skills assessment. Conclusions Locally adapted BLS training programs that included hands-only CPR and choking first aid showed a significant knowledge gain and skills competence among the frontline participants.

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Epidemiology of out-of-Hospital Cardiac Arrests, knowledge of cardiovascular disease and risk factors in a regional setting in India: The Warangal Area out-of-hospital Cardiac Arrest Registry (WACAR)

Cited by 7 publications

References 38 publications

Out of hospital cardiac arrest: experience of a bystander CPR training program in Karachi, Pakistan

Out of hospital cardiac arrest: experience of a bystander CPR training program in Karachi, Pakistan

Outcomes of out of hospital sudden cardiac arrest in India: A review and proposed reforms

Pilot Training Program on Hands-Only CPR and Choking First Aid for Frontline Police Responders in Rural Nepal

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