|Year : 2022 | Volume
| Issue : 2 | Page : 190-194
Awareness, attitude, and practice about basic life support among dental students
Savita Bansal, Jigyasa Gupta, Juhi Singhla, Kadambari Harit, Kajasai Ragesvari, Manya Jain
Department of Pathology, FDS, MRIIRS, Faridabad, Haryana, India
|Date of Submission||10-Sep-2021|
|Date of Acceptance||15-Jun-2022|
|Date of Web Publication||23-Aug-2022|
Department of Pathology, FDS, MRIIRS, Faridabad - 121 004, Haryana
Source of Support: None, Conflict of Interest: None
Introduction: A medical emergency can be described as a sudden onset of serious illness or injury requiring immediate medical attention otherwise it can put a patient's health in serious jeopardy, often referred to as a situation risking “life or limb.” It is thus imperative that dental students are competent enough to administer basic life support (BLS) to manage emergencies which can occur anywhere and anytime. Materials and Methods: A cross-sectional survey was conducted to assess the knowledge, attitude, and perception among dental students of Manav Rachna Dental College, Faridabad, about BLS. A total of 177 students participated in the study. The respondents were provided with a prevalidated, self-administered questionnaire which comprised 23 closed-ended questions about knowledge, three questions about attitude, and five questions about practice of BLS. The questionnaire was administered in an online mode using Google Forms. Results: The results showed that majority of students lacked adequate knowledge about BLS protocol. The average score of 177 respondents was 7.8/23 points which is significantly low. Discussion: Life-threatening medical emergencies can occur at any time. There have been reports of Cardiopulmonary Arrest (CPA) and deaths in dental clinics. Therefore, it is crucial for dental practitioners to have adequate knowledge about BLS or CAB consisting of (C) circulation, (B) breathing, and (A) airway opening. Conclusion: The dental students lack adequate knowledge to perform BLS procedures with ease and confidence. However, they had a positive attitude toward it.
Keywords: Basic life support, dental students, knowledge, medical emergency
|How to cite this article:|
Bansal S, Gupta J, Singhla J, Harit K, Ragesvari K, Jain M. Awareness, attitude, and practice about basic life support among dental students. J Sci Soc 2022;49:190-4
|How to cite this URL:|
Bansal S, Gupta J, Singhla J, Harit K, Ragesvari K, Jain M. Awareness, attitude, and practice about basic life support among dental students. J Sci Soc [serial online] 2022 [cited 2022 Oct 3];49:190-4. Available from: https://www.jscisociety.com/text.asp?2022/49/2/190/354258
| Introduction|| |
A medical emergency is a sudden onset of serious illness or injury requiring immediate medical attention. Basic life support (BLS) can be defined as the first level of care given by health-care professionals and qualified bystanders following a cardiac arrest and helps in opening the airway and maintaining proper ventilation and circulation., According to the American Red Cross, BLS requires instant recognition of signs of cardiac arrest, skills in cardiopulmonary resuscitation (CPR), competence in using automated external defibrillators (AED), and relieving airway obstruction.
The WHO, in 2019, recorded that the main causes of death are related primarily to cardiovascular, respiratory, and neonatal conditions. The world's biggest killer by far is ischemic heart disease accounting for 16% of the total mortality. According to injury facts 2017, choking is also a leading cause of death. Dental practitioners have a high probability of facing medical emergencies. Studies from France and England suggest the occurrences of cardiac arrest in dental clinics.,,,, Dental clinics are not well equipped for managing such emergencies.,,,, Delay in commencement of CPR reduces the chances of patients' survival., The purpose of this study was to evaluate the knowledge, attitude, and perception of dental students regarding BLS training and its implementation.
| Materials and Methods|| |
A cross-sectional survey was conducted to assess the knowledge, attitude, and practice among dental students of Manav Rachna Dental College, Faridabad, India about BLS. A total of 177 students participated in the study which included undergraduate students, interns, and postgraduate students. The respondents were provided with a prevalidated, self-administered questionnaire which comprised three questions related to demographic data, 23 closed-ended questions about knowledge, three questions about attitude, and five questions about practice of BLS. The questionnaire was administered in an online mode using Google Forms. The consent to contribute in the study was duly obtained through Google Forms itself. The participants were informed about the purpose of the study and ensured about its confidentiality. The knowledge questions were given a score of +1.0 for each correct answer and 0 for incorrect and do not know responses. The respondents could evaluate their answers and score (maximum marks of 23.0) only after submitting the form. The scores were graded as 0–5 as poor, 6–11 as fair, 12–17 as good, and 18–23 as excellent. Data were analyzed and presented in tabulated form.
The aspects which the questions touched upon were the abbreviation of BLS, AED, emergency medical service, sequential steps in BLS, assessment and resuscitation techniques with regard to the airway, breathing, circulation in unresponsive victims of different age groups, techniques regarding removal of foreign body obstruction, recognition of early signs of stroke, and acute coronary syndrome. Their attitude about the inclusion of BLS training to dental curriculum was also assessed.
| Results|| |
The present study was conducted to assess the knowledge, attitude, and perception of dental students regarding BLS. A total of 177 students participated in the study out of which 146 respondents were undergraduate students, 18 participants were interns, and 13 respondents were postgraduate students [Table 1].
|Table 1: Demographic data of dental students who participated in the study|
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The results show that majority of the students lack adequate knowledge about BLS protocol. The average score of 177 respondents was 7.8/23 points which is significantly low. Only three students had excellent scores between 18 and 23 marks [Figure 1]. Although majority (91.5%) of the students were aware of the full form of BLS, only 33% of participants knew that the correct position of the person receiving CPR is on the back and the person giving CPR should position himself next to the shoulder. Only 49.4% of respondents were aware of the fact that midchest is the correct position for chest compression. One-half to the one-third depth of the chest should be the depth of compression in children during CPR was known to 11% of respondents only. Only 26% of participants knew that 100–120 compression per minute are to be given in adults and children during CPR [Table 2].
|Figure 1: The distribution and grading of knowledge scores (maximum marks 23). poor (0–5), fair (6–11), good (12–17), and excellent (18–23)|
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|Table 2: Knowledge assessment questions with the percentage of students marking the correct answer|
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Almost all students (91.5%) responded that BLS is important for a health-care professional and should be an integral part of the dental undergraduate curriculum. About 88.1% of respondents were willing to attend any training program regarding BLS if given a chance. Only 7.5% of the respondents were of the view that BLS training is not essential for dental practitioners, majorly said that emergencies do not present in dental clinics [Figure 2].
|Figure 2: The attitude of the students regarding the importance of BLS training. BLS: Basic life support|
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The study revealed that only 15.8% of the students had received training for administering BLS and only 21.6% of them were satisfied with the level of their training. About 56.8% were not confident about performing BLS activities such as CPR or using a defibrillator, etc., on a person in need. The lack of confidence was due to a lack of practice [Figure 3].
|Figure 3: The practice assessment of dental students regarding BLS training. BLS: Basic life support|
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| Discussion|| |
Life-threatening medical emergencies can occur at any time in the dental clinic. It can occur due to local anesthesia administration, the fear of unknown surgical procedures, or any other reason. Minimal knowledge about these conditions and their treatment can be hazardous not only for the patient but also for the dentist. There have been reports of CPA and deaths in dental clinics.,, Therefore, it is crucial for dental practitioners to have adequate knowledge about BLS or CAB of life support consisting of (C) circulation, (B) breathing, and (A) airway opening. Awareness about the chain of survival can improve the chances of survival and recovery in conditions such as heart attack, stroke, or other emergencies. This chain comprises immediate recognition of cardiac arrest and activation of the emergency response system, early CPR, rapid defibrillation, and effective advanced life support with postcardiac arrest care. Thus, this study was planned to assess BLS knowledge among undergraduate, interns, and postgraduate students of Manav Rachna Dental College, Faridabad, Haryana.
Our study showed that only 18.07% of students had a knowledge score of 12 or above. This can be attributed to the fact that the dental curriculum has by far ignored the importance of BLS among dental and paradental staff. These findings are in accordance with previous studies conducted by Owojuyigbe et al., and Chandrasekaran et al. and signify that awareness and knowledge of BLS and decision about appropriate actions to be taken during resuscitation among dental students (average score of 7.6) is very poor and needs to be improvised and updated.,,, About 91.5% of participants are of the opinion that dental students should be skilled to offer BLS and it should be integrated in the dental curriculum. About 88.1% of participants wished to enroll in BLS training programs considering it fundamental to health-care sector. This highlights the fact that the BLS training should be standardized and formalized to give an in-depth knowledge of the theoretical and practical components. However, it is imperative to know that theoretical knowledge about CPR does not translate to competence in the practice of CPR. Competence as well as confidence in CPR can be achieved through regular practical training and re-training on BLS, otherwise, the health-care workers will be reluctant to perform CPR and provide BLS., This signifies that the readiness of health-care providers to perform BLS is enhanced when their knowledge level is high. The awareness of emergency medicine is increasing and the National Medical Council of India has already approved emergency medicine as a separate specialty. The prime role of this specialty would be teaching the basics of life support not only to the medical and paramedical team but to spread awareness regarding BLS and first aid to the community as a whole.
| Conclusion|| |
The results of the present study revealed that dental students lack adequate knowledge to perform BLS procedures with ease and confidence. However, they had positive attitudes toward it and willingness to learn BLS protocol. Dentistry is a health profession that should provide comprehensive medical care and treat medical emergencies as well, rather than focusing on the oral cavity alone. Dental professionals should be competent in BLS procedures to handle emergency situations. This signifies the need to revise the undergraduate dental curriculum and ensure proper BLS training. Educational institutions can play a key role in the training of students and professionals for CPR and other emergencies that can occur in the dental office. Hence, regular workshops, hands-on training, and simulation techniques are necessary for dental students to bridge the lacunae in their knowledge regarding BLS. Similarly, after graduation, the dentist should regularly take theoretical and practical courses. This would maximize their professional abilities and help to improve patient management and outcome in cases of medical emergencies.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Fasoyiro O, Oyapero A, Onigbinde OO, Sorunke ME, Akinleye AI. Assessment of Knowledge and self-rated emergency preparedness amongst undergraduate dental students in Lagos State: A pilot study. Adv Hum Biol 2019;9:54. [Full text]
Berg RA, Hemphill R, Abella BS, Aufderheide TP, Cave DM, Hazinski MF, et al.
Part 5: Adult basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010;122:S685-705.
Basheer SV, Shabna M, Hakkim S, Sanjeev S, Sadanandan S, Majid SA. Knowledge and Attitude of Dental Students and Staffs towards Basic life Support (BLS). International Journal of Advanced Engineering, Management and science 2018;4:240002.
Chilappa R, Waxman MJ. Basic Life Support Awareness and Knowledge in High School Students. Kansas journal of medicine 2021;14:38.
Lee M, Chen CH, Ovbiagele B. Covert COVID-19 complications: continuing the use of evidence-based drugs to minimize potentially lethal indirect effects of the pandemic in stroke patients. Journal of the neurological sciences 2020:15;414.
Kukielka E. Accidental Choking Among Hospitalized Patients in Pennsylvania: A 15-Year Retrospective Review. Patient Safety. 2020;2:42-53.
Atherton GJ, McCaul JA, Williams SA. Medical emergencies in general dental practice in Great Britain Part 1: Their prevalence over a 10-year period. Br Dent J 1999;186:72-9.
Dreyphus PH, Foissac JC, Freysz M. Caractéristique des appels d'urgence au centre 15 provenant des cabinets dentaires. Méd Buccale Chir Buccale 2000;6:40-1.
Girdler NM, Smith DG. Prevalence of emergency events in British dental practice and emergency management skills of British dentists. Resuscitation 1999;41:159-67.
Müller MP, Hänsel M, Stehr SN, Weber S, Koch T. A state-wide survey of medical emergency management in dental practices: Incidence of emergencies and training experience. Emerg Med J 2008;25:296-300.
Laurent F, Augustin P, Nabet C, Ackers S, Zamaroczy D, Maman L. Managing a cardiac arrest: Evaluation of final-year predoctoral dental students. J Dent Educ 2009;73:2117.
Sopka S, Biermann H, Druener S, Skorning M, Knops A, Fitzner C, et al.
Practical skills training influences knowledge and attitude of dental students towards emergency medical care. Eur J Dent Educ 2012;16:179-86.
Chapman PJ. A questionnaire survey of dentists regarding knowledge and perceived competence in resuscitation and occurrence of resuscitation emergencies. Aust Dent J 1995;40:98-103.
Adewole RA, Sote EO, Oke DA, Agbelusi AG. An assessment of the competence and experience of dentists with the management of medical emergencies in a Nigerian teaching hospital. Nig Q J Hosp Med 2009;19:190-4.
Arsati F, Montalli VA, Flório FM, Ramacciato JC, da Cunha FL, Cecanho R, et al.
Brazilian dentists' attitudes about medical emergencies during dental treatment. J Dent Educ 2010;74:661-6.
Carvalho RM, Costa LR, Marcelo VC. Brazilian dental students' perceptions about medical emergencies: A qualitative exploratory study. J Dent Educ 2008;72:1343-9.
Stafuzza TC, Carrara CF, Oliveira FV, Santos CF, Oliveira TM. Evaluation of the dentists' knowledge on medical urgency and emergency. Braz Oral Res 2014;28:S1806-83242014000100240.
Grzanka A, Misiolek H, Filipowska A, Miskiewicz-Orczyk K, Jarzab J. Adverse effects of local anaesthetics – Allergy, toxic reactions or hypersensitivity. Anestezjol Intens Ter 2010;42:175-8.
Marsden AK. Guidelines for Cardiopulmonary Resuscitation. Basic life support. Revised recommendations of the Resuscitation Council (UK) BMJ 1989;299:442-5.
Brahams D. Death in the dentist's chair. Lancet 1989;2:991-2.
Hunter PL. Cardiac arrest in the dental surgery. Br Dent J 1991;170:284.
McCarthy FM. Emergencias en Odontología. Buenos Aires: WB Saunders; 1972. p. 281-92.
Businger A, Rinderknecht S, Blank R, Merki L, Carrel T. Students' knowledge of symptoms and risk factors of potential life-threatening medical conditions. Swiss Med Wkly 2010;140:78-84.
Owojuyigbe AM, Adenekan AT, Faponle AF, Olateju SO. Impact of basic life support training on the knowledge of basic life support in a group of Nigerian Dental Students. Niger Postgrad Med J 2015;22:164-8.
] [Full text]
Shrestha R, Batajoo KH, Piryani RM, Sharma MW. Basic life support: Knowledge and attitude of medical/paramedical professionals World J Emerg Med 2012;3:141-5.
Chandrasekaran S, Kumar S, Bhat SA, Shabbir PM, Chandrasekaran VP. Awareness of basic life support among medical, dental, nursing students and doctors. Indian journal of Anaesthesia 2010;54:121.
Sahithi R, Dolar D, Padma R, Suhas K, Srikanth R, Chaudhary A, et al
. Current scenario: Knowledge of basic life support in medical college. Nat J Med Res 2011;1:80-2.
Adekola OO, Menkiti DI, Desalu I. How much do we Remember after CPR Training?–Experience from a Sub-Saharan Teaching Hospital. Analg Resusc: Curr Res S1. of. 2013;4:5-6.
Wynne G. ABC of resuscitation. Training and retention of skills. Br Med J (Clin Res Ed) 1986;293:30-2.
Edomwonyi NP, Isesele TO, Edobor FE, Esangbedo S, Afolayan J. A survey of the knowledge of cardiopulmonary rescucitation and the impact of training on nurses at the University of Benin teaching hospital, Nigeria. West Afr J Med 2013;32:239-42.
[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2]