EFFECTIVENESS OF STRUCTURED TEACHING

PROGRAMME ON KNOWLEDGE OF BASIC LIFE

SUPPORT STRATEGIES AMONG THE STUDENTS OF
VIDHYA SAGAR WOMEN‟S TEACHER TRAINING
INSTITUTE, CHENGALPET

By

Ms. BHUVANESWARI.S

A Dissertation submitted to
THE TAMILNADU Dr.M.G.R MEDICAL UNIVERSITY,
CHENNAI.

IN PARTIAL FULFILMENT OF THE REQUIREMENT FOR THE

DEGREE OF MASTER OF SCIENCE IN NURSING

APRIL – 2012
 CERTIFIED THAT THIS IS A BONAFIDE WORK OF

Ms. BHUVANESWARI. S

ADHIPARASAKTHI COLLEGE OF NURSING,

MELMARUVATHUR.

SUBMITTED IN PARTIAL FULFILMENT OF THE

REQUIREMENT FOR THE DEGREE OF MASTER OF SCIENCE
IN NURSING FOR THE TAMILNADU DR.M.G.R. MEDICAL
UNIVERSITY, CHENNAI.

COLLEGE SEAL

SIGNATURE

Dr.N.KOKILAVANI, M.Sc.(N)., M.A., M.Phil., Ph.D.,

Principal,
Head of the Department of Medical Surgical Nursing,
Adhiparasakthi College Of Nursing,
Melmaruvathur – 603 319,
Kanchipuram District,
TamilNadu.
 EFFECTIVENESS OF STRUCTURED TEACHING
PROGRAMME ON KNOWLEDGE OF BASIC LIFE
SUPPORT STRATEGIES AMONG THE STUDENTS OF
VIDHYA SAGAR WOMEN‟S TEACHER TRAINING
INSTITUTE, CHENGALPET

By

Ms. BHUVANESWARI.S

M. Sc (Nursing) Degree Examination,

Branch – I, Medical Surgical Nursing,
Adhiparasakthi College of Nursing,
Melmaruvathur – 603 319.

A Dissertation submitted to
THE TAMILNADU DR. M.G.R. MEDICAL UNIVERSITY,
CHENNAI.

IN PARTIAL FULFILMENT OF THE REQUIREMENT FOR THE

DEGREE OF MASTER OF SCIENCE IN NURSING

APRIL – 2012.
 EFFECTIVENESS OF STRUCTURED TEACHING
PROGRAMME ON KNOWLEDGE OF BASIC LIFE
SUPPORT STRATEGIES AMONG THE STUDENTS OF
VIDHYA SAGAR WOMEN‟S TEACHER TRAINING
INSTITUTE, CHENGALPET

APPROVED BY DISSERTATION COMMITTEE

April – 2012

Signature

Dr. N. KOKILAVANI, M.Sc.( N).,Ph.D.,

PRINCIPAL,
HEAD OF THE DEPARTMENT – MEDICAL SURGICAL NURSING,
ADHIPARASAKTHI COLLEGE OF NURSING,
MELMARUVATHUR - 603 319.

Signature

Dr. SRINIVASAN.S, M.D.,

ASSISSTANT PROFESSOR,
MAPIMS,
MELMARUVATHUR - 603 319.

A DISSERTATION SUBMITTED TO
THE TAMILNADU DR.M.G.R. MEDICAL UNIVERSITY,
CHENNAI IN PARTIAL FULFILMENT OF THE REQUIREMENT
FOR THE DEGREE OF MASTER OF SCIENCE IN NURSING

APRIL-2012
 EFFECTIVENESS OF STRUCTURED TEACHING
PROGRAMME ON KNOWLEDGE OF BASIC LIFE
SUPPORT STRATEGIES AMONG THE STUDENTS OF
VIDHYA SAGAR WOMEN‟S TEACHER TRAINING
INSTITUTE, CHENGALPET

By
Ms. BHUVANESWARI. S

M. Sc (Nursing) Degree Examination,

Branch – I, Medical Surgical Nursing,
Adhiparasakthi College of Nursing,
Melmaruvathur – 603 319.

A Dissertation submitted to THE TAMILNADU

DR.M.G.R.MEDICAL UNIVERSITY, CHENNAI in partial fulfillment
of the requirement for the Degree of Master of Science in
Nursing, April-2012.

Internal Examiner External Examiner

ACKNOWLEDGEMENT
 ACKNOWLEDGEMENT

I express my deep sense of gratitude to

HIS HOLINESS ARUL THIRU AMMA, Founder, for his blessings

which enabled me to reach up to this level and to complete my

study.

I express my heartfelt thanks to THIRUMATHI

LAKSHMI BANGARU ADIGALAR, Chief Executive Officer,

Adhiparasakthi College of Nursing, Melmaruvathur for giving me

the opportunity to pursue my study in this prestigious institution.

I wish to express my thanks to SAKTHI THIRUMATHI

B.UMADEVI, M.Pharm., Ph.D., Correspondent, Adhiparasakthi

College Of Nursing, Melmaruvathur for valuable caring sprit and

enduring support by giving all the facilities for pursuing my study.

With great pleasure I extend my gratitude and sincere

thanks to Dr. N. KOKILAVANI, M.Sc.(N), Ph.D., Principal, and

Head of the Department - Medical Surgical Nursing,

Adhiparasakthi College Of Nursing, Melmaruvathur for her

excellent guidance and motivation, without whom this study would

not have been molded in this shape. Her rich professional

experience and efficient guidance helped me to step cautiously in

the right direction.

 I feel pleasure to extend my gratitude and sincere

thanks to DR.SRINIVASAN.S, M.D., Associate professor,

Department of Accident and Emergency Medicine, MAPIMS,

Melmaruvathur for his constant support ,guidance, suggestions,

patience to complete this study.

I wish to express my gratitude to Dr. PRASANNA

BABY, M.Sc(N), Ph.D., Principal, Saveetha College of Nursing,

Chennai for giving her valuable suggestions and opinion regarding

the content and for its validity.

I feel immense pleasure to extend my gratitude and

sincere thanks to Prof. B.VARALAKSHMI, M.Sc(N)., M.Phil,

Vice principal, Adhiparasakthi College Of Nursing, Melmaruvathur

for her constant support ,guidance, suggestions, patience and

encouragement to complete my study.

I feel pleasure to extend my gratitude and sincere

thanks to Prof. B.SHEEBA, M.Sc(N)., M.Phil., Professor,

Adhiparasakthi College Of Nursing, Melmaruvathur, for her

encouragement throughout the study.

I wish to extend my heartfelt thanks to Prof. M.GIRIJA,

M.Sc(N), M.Phil., Associate professor, Adhiparasakthi College of

Nursing, for her valuable suggestions and guidance throughout the

study.
 I wish to express my sincere thanks to Mr. M.ANAND

M.Sc(N), Reader, Adhiparasakthi College of Nursing,

Melmaruvathur, for his suggestions and guidance throughout this

study.

I wish to express my sincere thanks to

Mrs. P. TAMILSELVI, M.Sc (N), Reader, Adhiparasakthi College

of Nursing, Melmaruvathur, for her support throughout the study.

I wish to express my sincere thanks to

Mrs. J. BHARATHI, M.Sc (N), Lecturer, Adhiparasakthi College

of Nursing, Melmaruvathur, for her support and encouragement

throughout the study.

I feel pleasure to extend my gratitude and sincere

thanks to Mr. ASHOK.B, M.Sc., M.Phil., Department of

Bio-Statistics, Adhiparasakthi College of Nursing, Melmaruvathur

for his constant support, patience, encouragement and guidance

and support in statistical analysis for this study.

I feel pleasure to extend my gratitude and sincere

thanks to Mr.A.SURIYANARAYANAN, M.A, M.Phil., Lecturer,

Department of English, Adhiparasakthi College of Nursing,

Melmaruvathur for his constant support, patience, encouragement

and guidance, which led to the completion of the study.

I wish to express my thanks to all the teaching staff of

Adhiparasakthi College of Nursing, Melmaruvathur who

encouraged me and provided support throughout my study.

I also sincerely thank Mr. A.CHANDRAN, Librarian,

Adhiparasakthi College of Nursing, and all the Non teaching staff

of Adhiparasakthi College of Nursing, Melmaruvathur, for their

guidance and co-operation.

I would like to express my immense thanks to

THE TAMILNADU DR. M.G.R. MEDICAL UNIVERSITY Library

which helped me to refer books and journals for my dissertation.

My grateful thanks to the Principal, Faculty members,

and the Students of Vidhya Sagar Women‟s Teacher Training

Institute, Chengalpet, for their sincere co operation and interest

which showered upon the successful completion of my study.

Finally, I thank all of them who contributed to this work.

 LIST OF
CONTENTS
 LIST OF CONTENTS

CHAPTER CONTENTS PAGE

NUMBER NUMBER
I INTRODUCTION 1

Need for the study 4

Statement of the problem 8
Objectives of the study 8
Operational definitions 9
Assumption 10
Hypothesis 11
Delimitation 11
Projected outcome 11
Conceptual frame work 11
II REVIEW OF LITERATURE 14

III METHODOLOGY 43

Research approach 43
Research Design 43
Setting 44
Population 44
Sample size 44
Sampling technique 44
Criteria for sample selection 44
Development and description of the tool 45
IV DATA ANALYSIS AND 48

INTERPRETATION
V RESULTS AND DISCUSSION 65

VI SUMMARY AND CONCLUSION 69

BIBILIOGRAPHY 74

APPENDICES i
LIST OF TABLES
 LIST OF TABLES

TABLE Page
TABLES
No. No.

4.1 Data analysis technique 54

4.2 Frequency and percentage distribution of 56

demographic variables among the students.

4.3 Frequency and percentage distribution of pretest 59

and post test level of knowledge on basic life
support strategies among the students.

4.4 Mean, standard deviation of pretest and post test 60

level of knowledge on basic life support strategies
among the students.

4.5 Mean and standard deviation of improvement 61

score of knowledge on basic life support
strategies among the students.

4.6 Association of post test level of knowledge on 62

basic life support strategies with selected
demographic variables among the students.
 LIST OF
FIGURES
 LIST OF FIGURES

FIG No. FIGURE P. NO

1.1 Global incidence rate of sudden cardiac I

arrest
1.2 Mortality rate in India in 2010 II

1.3 Conceptual Frame Work III

4.2.1 Percentage distribution of samples IV

according to age

4.2.2 Percentage distribution of samples V

according to religion

4.2.3 Percentage distribution of samples VI

according to level of education

Percentage distribution of samples

4.2.4 VII
according to locality

Percentage distribution of samples

4.2.5 according to source of health related VIII
informations obtained

4.2.6 Percentage distribution of samples IX

according to previous experience regarding
basic life support

4.3.1 Percentage distribution of pretest and post X

test level of knowledge regarding basic life
support strategies among the students
 LIST OF
APPENDICES
 LIST OF APPENDIX

SI. NO APPENDICES PAGE NO

I Demographic data i

II Questionnaire to assess the knowledge

iii
on basic life support strategies

III Lesson plan

xiii

IV Annexures
xxxviii
 CHAPTER I

INTRODUCTION
 CHAPTER I

INTRODUCTION

Atmospheric air that is essential for life contains

approximately 21% oxygen. Oxygen must be present in every

breathing gas. This is because it is essential to the human body‟s

metabolic process, which sustains the life. The human body

cannot store oxygen for later use as it does with food. If the body is

deprived of oxygen for more than a few minutes, it could result in

unconsciousness and death. The tissues and organs within the

body (notably the heart and brain) are damaged if deprived of

oxygen for much longer than four minutes.

Basic life support is maintenance of the ABCs (airway,

breathing, and circulation) without any auxiliary equipment. The

primary importance is placed on establishing and maintaining an

adequate open airway. Airway obstruction alone may be the

emergency: a shipmate begins choking on a piece of food. Restore

breathing to reverse respiratory arrest (stopped breathing)

commonly caused by electric shock, drowning, head injuries, and

allergic reactions. Restore circulation to keep blood circulating and

carrying oxygen to the heart, lungs, brain, and body.

 Cardio pulmonary resuscitation is the current trend in

performing basic life support. The immediate applicant of modern

cardio pulmonary resuscitation is often capable of reversing clinical

death and thereby preventing brain death and vegetative survival.

Poor outcome is predicated by delaying cardio

pulmonary resuscitation and inadequate tissue perfusion during

cardio pulmonary arrest. Optimal survival is achieved only if basic

life support is started within 0.4 minutes and treating the underlying

causes of cardio pulmonary arrest. This effort provides artificial

circulation and ventilation if instituted within a few golden

minutes.

Airway, breathing and circulation are essential for basic

life support. When encountering an unconscious patient these

guidelines have been recommended. Basic life support (BLS) is

the level of medical care which is used for patients with life-

threatening illnesses or injuries until the patient can be given full

medical care at a hospital. It can be provided by trained medical

personnel, including emergency medical technicians, paramedics,

and by laypersons who have received basic life support training.

Basic life support is generally used in the pre-hospital setting, and

can be provided without medical equipment.

 The algorithm for the management of a number of

conditions, such as cardiac arrest, choking and drowning. Basic

life support generally does not include the use of drugs or invasive

skills, and can be contrasted with the provision of Advanced Life

Support (ALS). Most laypersons can master basic life support skills

after attending a short course. Firefighter, lifeguards, and police

officers are often required to be Basic Life Support certified. Basic

Life Support is also immensely useful for many other professions,

such as daycare providers, teachers and security personnel and

social workers especially working in the hospitals and ambulance

drivers.

Cardio pulmonary resuscitation provided in the field

increases the time available for higher medical responders to

arrive and provide advanced life support care. An important

advance in providing basic life support is the availability of the

automated external defibrillator. This improves survival outcomes

in cardiac arrest cases.

Basic life support consists of a number of life-saving

techniques focused on the medicine "CAB"s (previously known as

ABC, ie., Airway, Breathing, Circulation was recently changed by

the American Heart Association) of pre-hospital emergency care.

 Circulation refers to providing an adequate blood

supply to tissue, especially critical organs, so as to deliver oxygen

to all cells and remove metabolic waste, via the perfusion of blood

throughout the body. Airway refers to the protection and

maintenance of a clear passageway for gases (principally oxygen

and carbon dioxide) to pass between the lungs and the

atmosphere. Breathing refers to inflation and deflation of the lungs

(respiration) via the airway

Healthy people maintain the CABs (circulation, airway,

breathing), by themselves. In an emergency situation, due to

illness or trauma, Basic life support helps the patient ensure his or

her own CABs (circulation, airway, breathing), or assists in

maintaining for the patient who is unable to do so.

NEED FOR THE STUDY

GLOBAL LEVEL

The frequency of sudden cardiac death in Western

industrialized nations is similar to that in the United States. The

incidence of sudden cardiac death in other countries varies as a

reflection of the prevalence of coronary artery disease or other

high-frequency cardiomyopathies in those populations. The trend

toward increasing sudden cardiac death events in developing

nations of the world is thought to reflect a change in dietary and

lifestyle habits in these nations. It has been estimated that sudden

cardiac death claims more than 7,000,000 lives per year

worldwide.

FIG. 1: GLOBAL INCIDENCE RATE OF SUDDEN CARDIAC

ARREST

51cases
80cases 183cases

115cases

KEY
176cases USA
118cases India
Europe
123cases UK
Germany
INCIDENCE RATE PER ONE LAKH POPULATION Finland
Norway

Source: American Heart Association,2010

report

NATIONAL LEVEL

Sudden Cardiac Deaths account for more than 40-45

% of cardiovascular deaths in India. India is the second most

populous country in the world with an estimated population of over

1 billion. Rapid industrialization and urbanization have resulted in

tremendous growth in the economy over the last decade. The

higher prevalence of sudden cardiac death might also be due to

absence of the "chain of survival" i.e. emergency medical services

in rural areas, and lack of awareness of the symptoms of

myocardial infarction.

FIG. 2.: MORTALITY RATE IN INDIA IN 2010

25% 10%
49%
24.00%

KEY
26.80% 42%
Punjab
Goa
27% Tamil nadu Andhra pradesh New delhi Kera
36%
29%
31%

SOURCE: INDIAN JOURNAL OF CARDIOLOGY,

NOVEMBER,2010

NATIONAL THREATS

HEART ATTACK DEATHS IN INDIA TO BE DOUBLED BY 2015

India has the highest incidence of heart related

diseases in the world and the number of those affected is likely to

be doubled in the coming years. "If no initiative is taken to check

the disease, the most predictable and also preventable among all

chronic diseases, India will have 62 million patients with heart

disease by 2015, compared to 16 million in the US,"If urgent

preventive steps are not taken, heart attack deaths in India are

likely to be doubled by 2015," .The percentage of people having

heart disease have increased from 1-2 to 3-5 per cent in rural India

and from 2-3 to 10-11 per cent in urban India. This represented an

overall increase of 300 per cent over the past 30 years as reported

by Enas .

Students are always changing and challenging. They

cannot stop learning the new trends. Education is a continuous

and ongoing endless process. Students need to have skills and

talents in an emergency situation to aid the people at times. Cardio

pulmonary resuscitation is a technique of basic life support for the

purpose of oxygenating the brain and heart until appropriate

definitive medical treatment can restore the normal heart and

ventilator action.

With the gaps in knowledge and lack of adequate

trained professionals, its necessary to impart the basic knowledge

for the students to provide right aid at right times for right persons.

Structured teaching programme will provide the

knowledge for the students to identify their significant role in active

participation for survival of the patients.

 In the light of the above it is desirable to assess the

knowledge in cardio pulmonary resuscitation technique among the

students and also to update their knowledge. There is a need to

educate the students who are active in shouldering responsibilities

to cater to the needs of the patients.

Therefore the study aims at providing knowledge about

cardio pulmonary resuscitation technique, which should be

provided at times of emergency situations and thus help in saving

the lives.

STATEMENT OF THE PROBLEM

Effectiveness Of Structured Teaching Programme

On Knowledge Of Basic Life Support Strategies Among The

Students Of Vidhya Sagar Women‟s Teacher Training

Institute, Chengalpet.

OBJECTIVES

 to assess the level of knowledge on basic life support among

the students.

 to evaluate the effectiveness of structured teaching

programme on basic life support among the students

  to explore the association between the level of knowledge

with selected demographic variables among the students.

OPERATIONAL DEFINITIONS

EFFECTIVENESS

It refers to the significant increase in the level of

knowledge of the students through the structured teaching

programme.

STRUCTURED TEACHING PROGRAMME

It refers to a planned series of information to the group

of people so as to help them to learn. In this study it refers to a

structured set of information regarding basic life support strategies

along with the use of different audio visual aids.

KNOWLEDGE

It refers to the fact or condition of knowing with

familiarity gained through experience or acquaintance with or

understanding of a science, art, or technique.

BASIC LIFE SUPPORT STRATEGIES

It is the level of medical care which is used for patients

with life-threatening illnesses or injuries until the patient can be

given full medical care at a hospital.

STUDENTS

It refers to those students‟ studying at Vidhya Sagar

Women‟s Teacher Training Institute, Chengalpet.

ASSUMPTIONS

It is assumed that,

 The students‟ have inadequate knowledge regarding basic

life support

 The students‟ have lack of confidence in performing basic

life support measures since this procedure is used

occasionally.

 The students‟ knowledge regarding basic life support

strategies will improve after participating structured teaching

programme.

HYPOTHESIS

H1: The students will have inadequate knowledge

regarding basic life support strategies.

 H2: There will be a significant relationship between the

structured teaching programme and increase in level of knowledge

regarding basic life support strategies among the students.

H3: There will be significant association between the level

of knowledge with selected demographic variables.

DELIMITATION

 Samples had been limited to 100 individuals.

 The period of study had been limited to six weeks.

PROJECTED OUTCOME

 The study would throw light on the knowledge of individuals

about basic life support strategies.

 The study would help them to provide first aid for the right

persons at the right time effectively.

CONCEPTUAL FRAMEWORK

The conceptual framework facilitates communications

and provides for systemic approach to the nursing research,

education, administration and practice.

The conceptual framework selected for the study had

been based on the general system theory with input, throughput,

output, and feedback. This was first introduced by Ludwig Von

Bertalanffy and it was later modified by J W Kenny.

According to this theory, a system is a group of

elements that interact with one another in order to achieve the

goal. An individual is a system because he/she receives input from

the environment; this input when processed provides an output. All

living system is open. There is a continual exchange of matter,

energy, and information.

The system is cyclical in nature and continues to be so

as long as the four parts-input, process, output and feedback keep

interacting with each other. If there are changes in any parts, there

will be alterations in all the parts. Feedback from within the system

or from the environment provides information, which helps the

system to determine its effectiveness.

INPUT: It consists of information, material or energy

that enters the system. In this study, students of Vidhya Sagar

Women‟s Teacher Training Institute, is a system with an input from

self asnd that acquired from the environment. The input includes

learner‟s background like demographic variables and existing

knowledge on basic life support. The input also includes

administration of structured teaching programme on basic life

support and its strategies.

 THROUGHPUT: After the input is absorbed by the

system, it is processed in a way useful to the system. Here it refers

to transformation of knowledge among the students regarding the

basic life support strategies, through the teaching programme.

OUTPUT: It refers to the energy, matter, or information

disposed by the system as a result of its process. In this study, it

refers to the increase in knowledge of the students of Vidhya

Sagar Women‟s Teacher Training Institute, regarding basic life

support strategies.

FEEDBACK: It is the process that enables a system to

regulate itself and provides information about the system‟s output

and its feedback as input. Accordingly, higher knowledge scores

obtained by the subjects in the post test indicate that the structured

teaching progarmme on basic life support strategies is effective

and gain knowledge regarding those techniques. A low score in

post test indicates the need for repeating the teaching programme

on basic life support and its strategies.

 THROUGHPUT POST
PR INPUT TEST OUTPUT
E

ASSESSMENT
OF KNOWLEDGE
REGARDING ASSESSMENT ADEQUATE
DEMOGRAPHIC OF KNOWLEDG
STRUCTURED
VARIABLES, AND KNOWLEDGE E
TEACHING TRANSFORMAT
BASIC LIFE BY SELF
PROGRAMME ION OF
SUPPORT ADMINISTER MODERATELY
ON BASIC KNOWLEDGE
THROUGH SELF ED ADEQUATE
LIFE REGARDING
ADMINISTERED QUESTIONNAI KNOWLEDGE
SUPPORT BASIC LIFE
KNOWLEDGE RE
AND ITS SUPPORT
QUESTIONNAIRE
TECHNIQUES, STRATEGIES INADEQUATE
AMONG THE
BY USING TO THE KNOWLEDGE
STUDENTS
DIFFERENT STUDENTS
AUDIO-
VISUAL AIDS

FEEDBACK
FIGURE 1.1 MODIFIED CONCEPTUAL FRAMEWORK BASED ON GENERAL SYSTEM THOERY BY BERTALANFFY, 2011
CHAPTER II

REVIEW OF
LITERATURE
 CHAPTER II
REVIEW OF LITERATURE

A literature review is a body of text that aims to review

the critical points of current knowledge including substantive

findings as well as theoretical and methodological contributions to

a particular topic. Here the literature is reviewed under the

following headings:

PART I Review of literature related to basic life support

PART II Review of literature related to teaching programme

on cardiopulmonary resuscitation

PART III Review of literature related to cardio pulmonary

resuscitation

PART I REVIEW OF LITERATURE RELATED TO BASIC LIFE

SUPPORT

DEFINITION

Basic life support (BLS) is the level of medical care which is

used for patients with life-threatening illnesses or injuries until the

patient can be given full medical care at a hospital.

It can be provided by trained medical personnel, including

emergency medical technicians, paramedics, and by laypersons

who have received basic life support training. Basic life support is

generally used in the pre-hospital setting, and can be provided

without medical equipment. It consists of essential non-invasive life

saving procedures including cardio pulmonary resuscitation,

bleeding control, splinting broken bones, artificial ventilation and

basic airway management.

CARDIO PULMONARY RESUSCITATION

DEFINITION

Cardiopulmonary resuscitation (CPR) is a combination of

mouth-to-mouth resuscitation and chest compressions that

delivers oxygen and artificial blood circulation to a person who is in

cardiac arrest.

- DEYO R A.,

OBJECTIVES

Basic life support / cardio pulmonary resuscitation helps the

patient ensure his or her own circulation, airway, breathing (CAB)

or assists in maintaining for the patients who is unable to do so.

PURPOSES

 To establish and maintain an adequate open airway.

 To restore breathing.
  To restore circulation to keep blood circulation and

oxygenation of the tissues.

INDICATIONS

A heart attack occurs when the heart is starved of oxygen. A

heart attack can „stun‟ the heart and interrupt its rhythm and ability

to pump. If the heart stops pumping, it‟s known as “cardiac arrest”.

A cardiac arrest can be caused by:

 Heart disease-the most common cause.

 Drowning

 Suffocation

 Poisonous gases inhalation

 Head injury

 Electric shock

 Asphyxiation

SIGNS OF CARDIAC ARREST

 Unconsciousness

 Unresponsiveness

 Absence of breathing/abnormal breathing

 No pulse in neck, wrist or groin

 No heart beat

 Not moving
  A bluish color of skin, lips, or beds of finger nails

SEQUENCE OF BASIC LIFE SUPPORT

 D – check for Danger

 R – check for Response

 S – ask for support/help

 C – Chest compressions – directs rescuers to perform 30

compressions to patients who are unresponsive and donot

breathe normally, followed by 2 rescue breathing

 A – Airway - directs rescuers to open the airway

 B – Breathing- directs rescuers to check breathing but no

need to deliver rescue breaths.

CARDIO PULMONARY RESUSCITATION

 C-A-B (Circulation, Airway, Breathing) is recommended in the

new sequence introduced by AHA (American heart association)

guidelines 2010 in learning and teaching basic life support.

 Ensure that the scene is safe.

 Assess the victim's level of consciousness by asking loudly and

shaking at the shoulders "Are you okay?" and scan chest for

breathing movement visually. If no response call for help by

shouting for ambulance or emergency medical services (EMS)

and ask for an AED (automated electric defibrillator) which is

 available in offices and building floors. Assess: If the patient is

breathing normally, and pulse is present then the patient should

be placed in the recovery position and monitored. Transport if

required, or wait for the EMS (emergency medical services) to

arrive and take over.

 If patient is not breathing assess pulse at the carotid on your

side for an adult, at the brachial for a child and infant for 5

seconds and not more than 10 seconds; begin immediately with

chest compressions at a rate of 30 chest compressions in 18

seconds followed by two rescue breaths in 5 seconds each

lasting for 1 second.

If the victim has no suspected cervical spine trauma, open the

airway using the head-tilt/chin-lift maneuver; if the victim has

suspected neck trauma, the airway should be opened with the

jaw-thrust technique. If the jaw-thrust is ineffective at

opening/maintaining the airway, a very careful head-tilt/chin-lift

should be performed.

 Blind finger-sweeps should never be performed, as they may

push foreign objects deeper into the airway. This procedure has

been discarded as this may push the foreign body down the

airway and increase chances of an obstruction.

 Continue chest compression at a rate of 100 compressions per

minute for all age groups, allowing chest to recoil in between.

For adults push upto 5cm and for child up to 4cm. For infants

up to 3cm or 1/3 of the chest diameter antero-posteriorly. Keep

counting aloud. Press hard and fast maintaining the rate of at

about 100/minute. Allow recoil of chest fully between each

compression. After every 30 chest compressions give two

rescue breaths in adult and child victim, continue for five cycles

or two minutes before re-assessing pulse.

 Look, listen, and feel for breathing for at least 5 seconds and no

more than 10 seconds. This is another step that has been

discarded and considered loss of valuable time.

 Attempt to administer two artificial ventilations using the mouth-

to-mouth technique, or a bag-valve-mask. The mouth-to-mouth

technique is no longer recommended, unless a face shield is

present. Verify that the chest rises and falls; if it does not,

reposition (i.e. re-open) the airway using the appropriate

technique and try again. If ventilation is still unsuccessful, and

the victim is unconscious, it is possible that they have a foreign

body in their airway. Begin chest compressions, stopping every

 30 compressions, re-checking the airway for obstructions,

removing any found, and re-attempting ventilation.

 If the ventilations are successful, assess for the presence of a

pulse at the carotid artery. If a pulse is detected, then the

patient should continue to receive artificial ventilation's at an

appropriate rate and transported immediately. Otherwise, begin

cardio pulmonary resuscitation at a ratio of 30:2 compressions

to ventilation's at 100 compressions/minute for 5 cycles.

 After 5 cycles of cardio pulmonary resuscitation, the Basic life

support protocol should be repeated from the beginning,

assessing the patient's airway, checking for spontaneous

breathing, and checking for a spontaneous pulse as per new

protocol sequence C-A-B(circulation, airway, breathing).

Laypersons are commonly instructed not to perform re-

assessment, but this step is always performed by healthcare

professionals.

If an automated electric defibrillator is available it should be

activated immediately and its directives followed and (if

indicated), call for clearance before defibrillation/shock should

be performed. If defibrillation is performed, begin chest

compression immediately after shock.

 Basic life support protocols continue until

 (1) the patient regains a pulse,

 (2) the rescuer is relieved by another rescuer of equivalent or

higher training ,

 (3) the rescuer is too physically tired to continue cardio

pulmonary resuscitation,

 (4) the patient is pronounced dead by a medical doctor.

 Note: cardio pulmonary resuscitation for children uses a 15:2

cycle when two rescuers are performing cardio pulmonary

resuscitation (but still uses a 30:2 if there is only one

rescuer).Two person cardiopulmonary resuscitation for an infant

also requires the "two hands encircling thumbs" technique for

the rescuer performing compressions.

REVISED GUIDELINES FOR CARDIO PULMONARY

RESUSCITATION
I Change in BLS sequence of steps from “A-B-C” to “C-

A-B” for adults and pediatric patients (except

newborns)

II “Look- Listen- Feel” removed from BLS algorithm.

III Recommended chest compression rate changed from

“approx 100/min” to “at least 100/min”

IV Recommended compression depth changed from “1.5 – 2

inches” to “at least 2 inches”

V Cricoid pressure no longer recommended.

VI New circular ACLS algorithm replaces older box & arrows

algorithm.

VII Use of continuous quantitative capnography emphasized

for intubated patients.

VIII Atropine no longer recommended for PEA or asystole.

IX Adenosine recommended for initial diagnosis & treatment

of stable, monomorphic wide complex tachycardia.

X Emphasis on post cardiac arrest care.

XI Ethical issues: Prognostic indicators defined to assess poor

outcomes and withdrawal of support.

Source: American Heart Association, 2010 Guidelines,

SIGNS OF SUCCESSFUL CARDIO PULMONARY

RESUSCITATION

 Lung expansion will occur with each breath.

 Each time the sternum is compressed the pulse will be

perceptible.

 Normal heart beat will return.

 A spontaneous gasp or breathing will occur.

 Victim may move legs or arms and color may improve.

IMPORTANT POINTS TO FOLLOW IN CARDIO PULMONARY

RESUSCITATION

 Do not interrupt cardio pulmonary resuscitation for more than

5 seconds for any reason.

 Do not move the victim to a more convenient site until he/she

has been stabilized.

 Never compress over the xiphoid process at the tip of the

sternum. Pressure on it may cause laceration (tear) of the

liver.

 Sudden or jerky movements should be avoided when

compressing the chest.

 The shoulder of the first aider should be directly over the

victim‟s sternum. Elbows should be straight. Pressure is to

be applied vertically downwards on the lower sternum.

 Depth of compression should be appropriate.

WHEN TO STOP CARDIO PULMONARY RESUSCITATION:

One should continue resuscitation efforts until one of the

following occurs:

 Effective, spontaneous ventilation and circulation has

established.

 Professional help arrives.

  Victim is transferred to emergency medical services (EMS).

NOTE:

 If unsure, if breathing is normal, treat as though it is not.

 Only stop to recheck casualty if they start breathing normally.

 If possible change rescuers every 1-2mts to reduce fatigue.

 Send or go for help as soon as possible.

 Rescuers should focus on delivering high-quality cardio

pulmonary resuscitation: providing chest compressions of

adequate rate (at least 100/minute) providing chest

compressions of adequate depth adults: a compression

depth of at least 2 inches (5 cm)infants and children: a depth

of least one third the anterior-posterior (AP) diameter of the

chest or about 1 ½ inches (4 cm) in infants and about 2

inches (5 cm) in

 Children allowing complete chest recoil after each

compression minimizing interruptions in compressions

avoiding excessive ventilation if multiple rescuers are

available, they should rotate the task of compressions every

2 minutes.
PART II REVIEW OF LITERATURE RELATED TO TEACHING

PROGRAMME ON CARDIO PULMONARY RESUSCITATION

Lešnik D, Lešnik B (2011), conducted a study on impact of

additional module training on the level of basic life support

knowledge of first year students at University of Maribor. Additional

basic life support training (two Basic Life Support training sessions:

high school and university) improves retention of knowledge and

attitudes concerning performing cardiopulmonary resuscitation in

first year university students. An audiovisual feedback device for

compression depth, rate and complete chest recoil can improve

the cardiopulmonary resuscitation performance of lay persons

during self-training on a manikin.

Krasteva V, Jekova I (2011), conducted a study on abilities

of untrained lay persons to perform hands-only cardio-pulmonary

resuscitation on a manikin and the improvement of their skills

during training with an autonomous cardiopulmonary resuscitation

feedback device. The study confirmed the need for developing

cardiopulmonary resuscitation abilities in untrained lay persons via

training by real-time feedback from instructor or Chest

compression-Device.
 Einspruch EL, Lembach J, Lynch B(2011),conducted a

study on Basic life support instructor training: comparison of

instructor-led and self-guided training. In this randomized trial, the

authors compared the instructional quality of instructor candidates

trained in instructional methods through an Internet-based versus

a traditional classroom-led version of the American Heart

Association Core Instructor Course. The self-guided, Internet-

based group had significantly higher post test scores than did the

traditional instructor-led group The Internet-based course

appeared to be a suitable alternative to the traditional course.

Cho GC, Sohn YD, Kang KH (2011), conducted a study on

the effect of basic life support education on laypersons' willingness

in performing bystander hands only cardiopulmonary resuscitation.

The Basic life support training increases laypersons' confidence

and willingness to perform bystander cardiopulmonary

resuscitation on a stranger. However, laypersons are more willing

to perform hands only cardiopulmonary resuscitation rather than to

perform standard cardiopulmonary resuscitation on a stranger

regardless of the Basic life support training.

Pergola AM, Araujo IE,(2011), stated a comment on training

laypeople regarding basic life support to give first aid in emergency

situations in order to save lives and avoid sequelae. It was verified

that only 9.9% know the mouth-to-mouth ventilation maneuver;

11.5% knew the chest compression technique (CCT), and of these

knew its purpose. Only 14.5% know how to position the victim to

perform CCT; 82.4% reported a frequency below 60 chest

compression technique minute. Since they do not have adequate

information and foundations regarding the stages of basic life

support, laypeople can give incorrect first aid to victims, which can

harm resuscitation.

Fleischhackl R, Nuernberger A,(2011), conducted a

prospective investigation among the school children in applying

life supporting first aid. The usefulness of cardiopulmonary

resuscitation training in schools has been questioned because

young students may not have the physical and cognitive skills

needed to correctly perform such complex tasks correctly.

Students as young as 9 years are able to do successfully and

effectively learn basic life support skills including AED (automated

electric defibrillator) deployment, correct recovery position and

emergency calling. As in adults, physical strength may limit depth

of chest compressions and ventilation volumes but skill retention is

good.

Altintaş KH, Yildiz AN, Aslan D,(2010), conducted a study

on firstaid and basic life support training for first year medical
students Hacettepe University, Ankara, They developed 24 and

12-h programs for first aid and basic life support (FA-BLS)training

for first-year medical students and evaluated the opinions of both

the trainers and trainees on the effectiveness of the programs. For

the 12-h training program, 84.4% of the students felt themselves

competent in first aid and basic life support applications. The

trainers considered both of the programs as effective.

Sim MS, Jo IJ, Song HG,(2010), conducted a study on

basic cardiac life support education for non-medical hospital

employees, Sungkyunkwan University. The International Liaison

Committee on Resuscitation (ILCOR) recommends that strategies

should be implemented that promote cardiopulmonary

resuscitation (CPR) training in the workplace. Non-medical

employees at a hospital were therefore trained to conduct basic life

support (BLS).

Hamasu S, Morimoto T,(2010), conducted a study to

elucidate the factors for willingness to perform cardiopulmonary

resuscitation among the college students at Kyoto University.The

proportion of students showing willingness to perform basic life

support increased after the training. Significant association

between "anxiety for infection" and willingness to perform basic life

support might indicate that those who wish to perform basic life
support developed their awareness of risk of infection more than

the counterparts.

Dare L, Davies P, Benger J,(2010), elicited the

effectiveness of basic life support for untrained individuals during a

cardiac arrest. The objective of this study was to determine

whether a trained rescuer could teach untrained bystanders to

perform basic life support (BLS) during simulated cardiac arrest.

Untrained individuals showed an improvement in BLS skills when

taught during a cardiac arrest.

Vries W, Handley AJ,(2010),conducted a study on web-

based micro-simulation program for self-learning basic life support

skills and the use of an automated electric defibrillator. The results

suggested that it may be possible to train people in Basic life

support and automated electric defibrillator skills using a micro-

simulation web-based interactive program but without any practice

on a manikin.

Toner P, Connolly M, Laverty L,(2010), conducted a study

on teaching basic life support to school children using medical

students and teachers in a 'peer-training' model--results of the

'ABC for life' programme. The 'ABC for life' programme was

designed to facilitate the wider dissemination of basic life support

skills and knowledge in the population. This study demonstrated

that primary school teachers, previously trained by medical

students, can teach basic life support effectively to 10-12-year-old

children using the 'ABC (airway, breathing, circulation) for life'

programme.

Sosada K, Zurawiński W,(2009), conducted a study on

evaluation of the knowledge of teachers and high school students

in Silesia on the principles of first aid. The results showed that the

knowledge of secondary school students and teachers appear to

be insufficient to perform basic life support. Education programs in

secondary school should be initiated in terms of extending social

safety.

Connolly M, Toner P, Connolly D,(2009), enrolled the 'ABC

(airway, breathing, circulation) for life' programme - teaching basic

life support in schools, United Kingdom. The aim of the study was

to assess retention of knowledge of basic life support 6 months

after a single course of instruction in cardiopulmonary resuscitation

designed specifically for school children. A training programme

designed and taught as part of the school curriculum would have a

significant impact on public health.

Perkins GD, Hulme J, Shore HR, (2009), conducted a study

on basic life support training for health care students. This paper

described a novel method for delivering basic life support training

to undergraduate healthcare students. A comprehensive 8 h

programme is organized and delivered by undergraduate students

to their peers. It forms part of an overall strategy for improving

resuscitation training for undergraduates from all disciplines.

PART III: LITERATURE RELATED TO CARDIO PULMONARY

RESUSCITATION

Taniguchi T, Omi W, Inaba H, (2011), conducted a study on

attitudes toward the performance of bystander cardiopulmonary

resuscitation in Japan. The findings suggested that MMV (mouth to

mouth ventilation) training should be de-emphasized and the

awareness of chest compressions alone should be emphasized

because, for whatever reason, people do not want to perform

MMV(mouth to mouth ventilation).

Swor R, Khan I, Domeier R, Honeycutt L, (2011),

conducted a study on cardio pulmonary resuscitation training and

cardio pulmonary resuscitation performance to determine factors

associated with cardiopulmonary resuscitation (CPR) provision by

cardiopulmonary resuscitation -trained bystanders. Previously

espoused reasons for not doing cardio pulmonary resuscitation

(mouth-to-mouth, infectious-disease risk) were not the reasons

that bystanders cited for not performing cardio pulmonary

resuscitation.

Kuramoto N, Morimoto T, Kubota Y,(2011), conducted a

study on public perception of and willingness to perform bystander

cardio pulmonary resuscitation in Japan. Experience of

cardiopulmonary resuscitation training closely associated with

willingness to attempt cardio pulmonary resuscitation, and

awareness of automated electric defibrillator in a public space are

significant factors in cardiopulmonary resuscitation training.

Automated electric defibrillator placement might call attention to

cardiopulmonary resuscitation training and develops willingness to

attempt cardio pulmonary resuscitation.

Coons SJ, Guy MC.,(2011), conducted a study on

bystander cardio pulmonary resuscitation for sudden cardiac

arrest: behavioral intentions among the general adult population in

Arizona. Based on the reasons reported, there is potential to

change the cardio pulmonary resuscitation -related attitudes,

beliefs, and skill levels of the general public to enhance the

number of people willing and able to perform bystander cardio

pulmonary resuscitation.

Iwami T, Kawamura T, Hiraide A, Berg RA,(2011),

conducted study on effectiveness of bystander-initiated cardiac-

only resuscitation for patients with out-of-hospital cardiac arrest.

Bystander-initiated cardiac-only resuscitation and conventional

cardio pulmonary resuscitation are similarly effective for most adult

out-of-hospital cardiac arrests. For very prolonged cardiac arrests,

the addition of rescue breathing may be of some help.

Einspruch EL, Lynch B, Aufderheide TP,(2011),

conducted a controlled randomized study on retention of cardio

pulmonary resuscitation skills learned in a traditional course versus

30-min video self-training. Training with a brief video self-

instruction (VSI) program has shown that this type of training can

produce short-term skill performance at least as good as that seen

with traditional American Heart Association (AHA) Heartsaver

training. The video self-instruction program produced retention

performance at least as good as that seen with traditional training.

Jelinek GA, Gennat H, Celenza T,(2011), stated the

community attitudes towards performing cardiopulmonary

resuscitation in Western Australia. Those with better skills were

less reluctant to use them. They recommended increasing cardio

pulmonary resuscitation training in the community, greater

frequency of refresher courses and public education on the risks of

cardio pulmonary resuscitation to improve rates of bystander

cardio pulmonary resuscitation.

 Idris AH, Gabrielli A,(2011), conducted a study on

advances in airway management. Emergency ventilation is an

essential component of basic life support. Emergency assisted

ventilation is often difficult to perform and is associated with

several adverse complications, such as gastric inflation,

regurgitation, and pulmonary aspiration. The advances in

emergency airway management, focusing on noninvasive

techniques for ventilation (mouth-to-mouth ventilation, bag mask

ventilation) and alternative airway devices.

Dorph E, Wik L, (2011), conducted a study on oxygen

delivery and return of spontaneous circulation with ventilation :

compression ratio 2:30 versus chest compressions only

cardiopulmonary resuscitation. Compressions –only achieved

return of spontaneous circulation before the experiment was

terminated, the median time to return of spontaneous circulation

was shorter in the ventilated group. They believed that in cardiac

arrest with an obstructed airway, pulmonary ventilation should still

be strongly recommended.

Copley DP, Mantle JA,(2011), conducted a study on

improved outcome for pre hospital cardiopulmonary collapse with

resuscitation by bystanders. The early-resuscitated patients also

had less residual central nervous system and myocardial damage

on discharge than the late-resuscitated patients. Training laymen

to initiate early basic life support can benefit the cardiopulmonary

collapse victim.

Khalid U, Juma A,(2011), stated on the paradigm shift:

'ABC'(airway, breathing, circulation) to 'CAB' (circulation, airway,

breathing) for cardiac arrests. The 2010 American heart

association guidelines for Cardio pulmonary Resuscitation and

Emergency Cardiovascular Care corrects this by changing the A-

B-C (airway, breathing, circulation) of cardiopulmonary

resuscitation to C-A-B, (circulation, airway,

breathing)acknowledging that chest compressions are the most

important aspect of the cardiac arrest management.

Winkelman JL, Fischbach,(2011), conducted a study on

assessing cardiopulmonary resuscitation training and the

willingness of teaching credential candidates to provide

cardiopulmonary resuscitation in a school setting.

Recommendations based on these findings include pedagogical

changes to cardio pulmonary resuscitation curricula, focusing on

the importance of cardiopulmonary resuscitation as a teacher skill

and additional time for hands-on practice.

Lim BL,(2011), conducted a study on airway management

keeping the airway patent and protected is the crucial first step in
resuscitation of collapsed patients. The patency of the airway can

be maintained by head tilt, chin lift and jaw thrust, with or without

the assistance of airway adjunct, for example oropharyngeal or

nasopharyngeal airways. Laryngeal mask airway may have a role

in resuscitation. In order to ensure survival of collapsed patients,

all medical and nursing staff must know when and how to manage

the airways.

Savary-Borioli G,(2011), conducted a study on basic life

support- the primary ABC(D) of cardiopulmonary resuscitation

focuses on the primary survey A B C [D]: Airway [to open the

airway]-Breath to assess the presence or absence of spontaneous

breathing and to provide ventilation-Circulation. The key for

successful ACLS (advanced cardiac life support), especially

defibrillation, is the prompt initiation of correct rescue breathing,

and correct chest compressions in a patient with a cardiac arrest.

Promptly and optimally performed basic life support is most

effective.

Smythe M,(2011), conducted a study on new

cardiopulmonary resuscitation technique for out-of-hospital cardiac

arrest increases survival by 53 percent. Based on the findings,

active compression-decompression cardio pulmonary resuscitation

with augmentation of negative intrathoracic pressure should be

considered as an alternative to standard cardio pulmonary

resuscitation to increase long-term survival after cardiac arrest.

Russell,(2011), conducted a study on the recent

advancements in cardio pulmonary resuscitation. He concluded

that the chance of surviving an out-of-hospital cardiac arrest has

improved since the 1950s, The variables studied include,

witnessed by emergency medical services provider; bystander

cardio pulmonary resuscitation; types of heart rhythm--asystole

(motionless) vs. ventricular fibrillation (rapid or twitching); and

return of spontaneous circulation.

Strømme TA, Eriksen,(2010), conducted a study on Chest

compression and conventional cardiopulmonary resuscitation

during out of hospital cardiac arrest. Reasons for the public not

starting resuscitation include fear of infection, fear of litigation, and

the complexity of conventional cardiopulmonary resuscitation.

Consequently, it might be possible to improve participation in

community cardiopulmonary resuscitation by removing the rescue

breathing component of conventional cardio pulmonary

resuscitation.

Bentley J. Bobrow,(2010), conducted a study on chest

compression–only cardiopulmonary resuscitation by lay rescuers

and survival from out-of-hospital cardiac arrest among patients

with out-of-hospital cardiac arrest. Layperson compression-only

cardiopulmonary resuscitation was associated with increased

survival compared with conventional cardiopulmonary

resuscitation and no bystander cardiopulmonary resuscitation in

this setting with public endorsement of chest compression–only

cardiopulmonary resuscitation.

Valerie J. De Maio, (2010), conducted a study on

cardiopulmonary resuscitation -only survivors of out-of-hospital

cardiac arrest cardiopulmonary resuscitation -only survivors of true

out-of-hospital cardiac arrest do exist; some victims of out-of-

hospital cardiac arrest of primary cardiac cause can survive after

provision of out-of-hospital basic life support care only. Survival

rates from cardiac arrest may actually be lower if one excludes

survivors who never had a true arrest.

Tetsuhisa Kitamura, (2010), conducted a study on

bystander-initiated rescue breathing for out-of-hospital cardiac

arrests of non cardiac origin. This nationwide observational study

indicates that rescue breathing has an incremental benefit for out-

of-hospital cardiac arrest of non cardiac origin, but the impact on

the overall survival after out-of-hospital cardiac arrest was small.

 Sos-Kanto,(2010), conducted an observational study on

cardiopulmonary resuscitation by bystanders with chest

compression. Mouth-to-mouth ventilation is a barrier to bystanders

doing cardiopulmonary resuscitation (CPR), Cardiac-only

resuscitation by bystanders is the preferable approach to

resuscitation for adult patients with witnessed out-of-hospital

cardiac arrest, especially those with apnoea, shockable rhythm, or

short periods of untreated arrest.

Taku Iwami,(2010), conducted study on effectiveness of

bystander-initiated cardiac-only resuscitation for patients with out-

of-hospital cardiac arrest . Conventional bystander

cardiopulmonary resuscitation would improve outcomes from out-

of-hospital cardiac arrests of ≤15 minutes‟ duration, whereas the

addition of rescue breathing would improve outcomes for cardiac

arrests lasting >15 minutes. Bystander-initiated cardiac-only

resuscitation and conventional cardiopulmonary resuscitation are

similarly effective for most adult out-of-hospital cardiac arrests.

Soichi Koike,(2010), conducted an observational study on

outcomes of chest compression only cardiopulmonary

resuscitation versus conventional cardiopulmonary resuscitation.

Conventional cardiopulmonary resuscitation is associated with

better outcomes than chest compression only cardiopulmonary

resuscitation for selected patients with out of hospital

cardiopulmonary arrest, such as those with arrests of non-cardiac

origin and younger people, and people in whom there was delay in

the start of cardiopulmonary resuscitation.

P M Guzy, M L Pearce, and S Greenfield,(2010),

conducted a study on the survival benefit of bystander

cardiopulmonary resuscitation in a paramedic served metropolitan

area. They concluded that bystander cardiopulmonary

resuscitation, initiated prior to arrival of paramedics, and produced

a fourfold improvement in survival. Overall there was a 10 per cent

survival rate at hospital discharge.

Leif Svensson, MD; Bob Fellows,(2010), conducted a

study on quality of cardiopulmonary resuscitation during out-of-

hospital cardiac arrest Cardiopulmonary resuscitation (CPR)

guidelines recommend target values for compressions,

ventilations, and Cardiopulmonary resuscitation -free intervals

allowed for rhythm analysis and defibrillation, for high quality

cardio pulmonary resuscitation. Electrocardiographic analysis and

defibrillation accounted for only small parts of intervals without

chest compressions.
 Richard O. Cummins,(2010), conducted a study on

Cerebral preservation during cardiopulmonary resuscitation and

survival of out-of-hospital cardiac arrest with early initiation of

cardiopulmonary resuscitation They concluded that early initiation

of cardiopulmonary resuscitation by bystanders significantly

improves survival from out-of-hospital cardiac arrest, and they

suggest that it may do so by prolonging the duration of VF after

collapse and by increasing cardiac susceptibility to defibrillation. It

must be started within 4–6 minutes from the time of collapse and

must be followed within 10–12 minutes of the collapse by

advanced life support in order to be effective.

 CHAPTER III

METHODOLOGY
 CHAPTER III

METHODOLOGY

Research methodology is a method to solve the

research problem systemically. It includes description of research

approach, research design, study setting, population, sample,

sampling technique, development and description of tool, and plan

for data analysis.

RESEARCH APPROACH

In this study quantitative evaluatory approach has

been used to assess the effectiveness of structured teaching

programme on basic life support strategies among the students.

RESEARCH DESIGN

Quasi experimental design in which one group

pretest – posttest design had been used to assess the

effectiveness of structured teaching programme on basic life

support strategies among the students.

SETTING OF THE STUDY

The study had been conducted at Vidhya Sagar

Women‟s Teacher Training Institute in Chengalpet.

POPULATION

Students studying in I and II year at Vidhya Sagar

Women‟s Teacher Training Institute at Chengalpet.

SAMPLING AND SAMPLING TECHNIQUE

SAMPLE SIZE

100 students studying in I and II year at Vidhya

Sagar Women‟s Teacher Training Institute, Chengalpet, during the

period of data collection are selected as samples.

SAMPLING TECHNIQUE

Simple random sampling technique had been used.

Samples had been selected by using lottery method.

CRITERIA FOR SELECTION OF SAMPLES

INCLUSION CRITERIA

 Students who are studying I and II year.

 Students who are willing to participate in the study.

 Students who are present at the time of data collection.

EXCLUSION CRITERIA

 Students who suffer from chronic illness.

 Students who have already undergone a course in basic life

support.

 Students who participated in the pilot study.

DEVELOPMENT AND DESCRIPTION OF THE TOOL

SELECTION AND DEVELOPMENT OF THE INSTRUMENT

Research instruments also called research tool are the

devices used to collect data. The tool facilitates the measurement

of variables.

The following instruments have been developed for the study.

Section I: Demographic variables of the students

Section II: Structured questionnaire on basic life support

DEVELOPMENT OF THE INSTRUMENT

The tool had been prepared in order to attain the objectives

of the study. The following steps had been adopted in the

development of the instrument.

 Related literature were reviewed

 Guidance and consultation of the subject experts had been

taken and alterations were made accordingly

  Knowledge questionnaire had been constructed

The structured tool had been organized in to two

sections as section I, section II.

SECTION I

DEMOGRAPHIC VARIABLES OF THE STUDENTS

A demographic variable consists of items seeking

information about age, education, year, source of health

information, knowledge on first aid measures, etc.

SECTION II

KNOWLEDGE QUESTIONNAIRE ON BASIC LIFE SUPPORT

It consists of 40 closed ended multiple choice

questions to assess the knowledge of the samples regarding basic

cardiac life support. The questions have been classified into

Part I : Anatomy and physiology of respiratory and cardio vascular

system.

Part II : Concept of cardio pulmonary resuscitation

Part III: Knowledge regarding airway

Part IV: Knowledge regarding breathing

Part V : Knowledge regarding circulation

Part VI: Technique of performing cardio pulmonary resuscitation

 The structured questionnaire had three options.

The correct option was given a score of „one‟ and incorrect was

scored as „zero‟. The total knowledge questionnaire score were

40. An arbitrary classification of knowledge score had been done

as follows:

Inadequate knowledge - 50% and below

Moderately adequate knowledge - 51% to 74%

Adequate knowledge - 75% and

above

DEVELOPMENT OF THE STRUCTURED TEACHING

PROGRAMME

The draft of the structured teaching programme was

developed based on the objectives; review of literature and to the

level of understanding of the students.

 CHAPTER IV

DATA ANALYSIS &

INTERPRETATION
 CHAPTER – IV

DATA ANALYSIS AND INTERPRETATION

This chapter deals with statistical analysis. Statistical

analysis is a method of rendering quantitative information

meaningful and intelligent manner. Statistical procedure enables

the researcher to analyse, organize, evaluate, interpret and

communicate numerical information meaningfully. The data

collected from the students had been tabulated, analyzed and

interpreted under the following headings.

DESCRIPTION OF THE TOOL

SELECTION AND DEVELOPMENT OF THE INSTRUMENT

Research instruments also called research tool are the

devices used to collect data. The tool facilitates the measurement

of variables.

The following instruments have been developed for the study.

Section I: Demographic variables of the students.

Section II: Structured questionnaire on basic life support

strategies.
DEVELOPMENT OF THE INSTRUMENT

The tool was prepared in order to attain the

objectives of the study. The following steps were adopted in the

development of the instrument.

 Related literature were reviewed

 Guidance and consultation of the subject experts were taken

and alterations were made accordingly

 Knowledge questionnaire had been constructed

The tool had been organized in to two sections as

section I, section II.

SECTION I

DEMOGRAPHIC VARIABLES OF THE STUDENTS

A demographic variable consists of items seeking

information about age, education, year, source of health

information, knowledge on first aid measures, etc.

SECTION II

KNOWLEDGE QUESTIONNAIRE ON BASIC LIFE SUPPORT

It consists of 40 closed ended multiple choice

questions to assess the knowledge of the samples regarding basic

life support. The questions have been classified into

Part I : Anatomy and physiology of respiratory and cardio vascular

system
Part II : Concept of cardio pulmonary resuscitation

Part III: Knowledge regarding airway

Part IV: Knowledge regarding breathing

Part V : Knowledge regarding circulation

Part VI: Technique of performing of cardio pulmonary

resuscitation

The structured questionnaire had three options.

The correct option was given a score of „one‟ and incorrect was

scored as „zero‟. The total knowledge questionnaire score was 40.

An arbitrary classification of knowledge score was done as follows:

Inadequate knowledge - 50% and below

Moderately adequate knowledge - 51% to 74%

Adequate knowledge - 75% and above

DEVELOPMENT OF THE STRUCTURED TEACHING

PROGRAMME

The draft of the structured teaching programme was

developed based on the objectives, review of literature and to the

level of understanding of the students.

REPORT OF THE PILOT STUDY

The pilot study was conducted to assess the

reliability, practicability, content validity and feasibility of the tool. It

was conducted for two weeks at Vidhya Sagar Women‟s Teacher

Training Institute, Chengalpet. Ten samples who met the inclusion

criteria had been selected by simple random sampling technique.

The knowledge on basic life support among the students had been

assessed by using self administered questionnaire. The structured

teaching programme had been given to enhance the knowledge of

the students with the help of charts, handouts, model, and video

through lecture, discussion and demonstration which took around

45 minutes. Post test was conducted by using the same

questionnaire on the 8th day. The result of the pilot study showed

that there was a significant relationship between the structure

teaching programme and improvement of students‟ knowledge on

basic life support strategies.

VALIDITY

The tool was prepared by the investigator based on

literature review, under the guidance of experts and on the basis of

objectives, which had been assessed and evaluated, and

approved by experts of Research committee. The content validity

of the tool was obtained from research experts from the medical

surgical nursing department.

RELIABILITY

The reliability was checked by interrator method. After the

structured teaching programme the reliability was 0.79 and then

paired„t‟ test was used to assess the effectiveness of structured

teaching programme on knowledge of basic life support among the

students.

INFORMED CONSENT

Permission was obtained from the principal of Vidhya

Sagar Women‟s Teacher Training Institute, Chengalpet and oral

consent from each student was obtained before starting the data

collection.

DATA COLLECTION PROCEDURE

The data was collected through the well prepared

structured questionnaire and evaluated with the help of inferential

and descriptive statistics.

The main study was conducted for six weeks.

Selected groups are taken to provide the teaching programme on

the first day the pretest was conducted by using the structured

questionnaire. After the pretest selected group was exposed to the

educational programme which took around 45 minutes. Post test

was conducted with the same participants by using the same

questionnaire after seven days.

TABLE 4.1: DATA ANALYSIS TECHNIQUE

S.NO. DATA METHODS REMARKS

ANALYSIS

1 Descriptive Frequency To describe the

statistics distribution, demographic variables

percentage

mean, standard To assess

deviation the knowledge of pre

and post test on basic

life support

2 Inferential Paired „t‟ test Analyzing the

statistics effectiveness between

pre and post test

knowledge

Chi-square test Analyzing

association between

demographic

characteristics and

knowledge score of

basic life support.

DATA ANALYSIS AND INTERPRETATION

SECTION –A
Frequency and percentage distribution of demographic

variables among the students.

SECTION – B

Frequency and percentage distribution of level of knowledge

on basic life support strategies between pre and post test among

the students.

SECTION – C

Comparison between mean and standard deviation of pre and

post test scores of knowledge on basic life support strategies

among the students.

SECTION – D

Mean and standard deviation of improvement score for

knowledge on basic life support strategies among the students.

SECTION – E

Analyzing the association between the post test level of

knowledge on basic life support strategies with selected

demographic variables among the students.

 SECTION –A

TABLE 4.2: FREQUENCY AND PERCENTAGE DISTRIBUTION

OF DEMOGRAPHIC VARIABLES AMONG THE STUDENTS OF

VIDHYA SAGAR WOMEN‟S TEACHER TRAINING INSTITUTE,

CHENGALPET N=100

S.NO DEMOGRAPHIC NUMBER PERCENTAGE

VARIABLES (%)

1. Age in years
a) 18 – 20 78 78
b) 21 – 23 10 10
c) 24 and above 12 12

2. Religion
a) Hindu 86 86
b) Christian 11 11
c) Muslim 3 3
d) Others 0 0

3. Level of education
a) First year 40 40
b) Second year 60 60

4. Locality
a) Urban 34 34
b) Rural 66 66

5. Source of health
information
a) Media 58 58
b) Health care 8 8
professionals
c) Family members and 32 32
relatives
d) Friends and 2 2
neighbours
6. Previous experience
 regarding basic life
support
a) Observer 16 16
b) Active participant 0 0
c) Both observer and 0 0
active participant
d) No experience 84 84

Table 4.2 depicts the frequency and percentage

distribution of the personal factors of demographic variables

includes age, religion, level of education, locality, source of health

information, previous experience regarding basic life support. Out

of 100 students, 78 (78%) aged between 18-21 years, 10 (10%) in

21-23 years, and 12 (12%) 24 and above age group. Regarding

religion, 86 (86%) Hindus, 11(11%) Christians,3 (3%) Muslims,

and none were in others. With regard to level of education

40(40%) were in first year and 60 (60%) were second year.

Regarding to locality 34 (34%) from urban and 66 (66%) from rural.

With regard to source of health information 58 (58%) got from

media, 8 (8%) got from health professionals, 32 (32%) got from

family members and relatives, 2 (2%) got from friends and

relatives. Regarding previous experience regarding basic life

support, 16 (16%) were observers, none were active participants

and both, 84 (84%) had no experience.

 78%

80

70

60

50
PERCENTA

40

30
KEY
20 10% 12%

18-20
10
21-23

24 and
0
18-20 21-23 24 and above
AGE IN YEARS

FIG. 4.2.1 PERCENTAGE DISTRIBUTION OF AGE IN YEARS AMONG THE STUDENTS

 86%

90

80

P 70
E
R 60
C
50
E
N 40
T
A 30
G 11%
E 20
3%
0% KEY
10
Hindu
0 Christian Muslim Others
Hindu Christian Muslim Others
RELIGION

FIG.4.2.2 PERCENTAGE DISTRIBUTION OF RELIGION AMONG THE STUDENTS

40%

60%

KEY
First year Second Year

FIG.4.2.3 PERCENTAGE DISTRIBUTION OF LEVEL OF EDUCATION AMONG THE

STUDENTS
34%

66%

KEY

Urban
Rural

FIG.4.2.4 PERCENTAGE DISTRIBUTION OF LOCALITY AMONG THE STUDENTS

 58%
60

P 50
ERCEN
T 40
32%

30

A 208%
G
E 10 2% KEY
Media
0 Health care professionals Family members and relative
Media Health care Family members and Friends and
professionals relatives neighbours
SOURCE OF HEALTH INFORMATION

FIG 4.2.5 PERCENTAGE DISTRIBUTION OF SOURCE OF HEALTH INFORMATION AMONG THE STUDENTS
 84%
90

80

70

60

50
PERCENTA

40

30

16%
20
KEY
10 0% 0%

OBSERVER
0 ACTIVE PARTICIPANT
OBSERVER ACTIVE PARTICIPANT OBSERVER AND NO EXPERIENCE OBSERVER AND ACTIVE PARTICIPANT NO EXPERIENCE
ACTIVE PARTICIPANT
PREVIOUS EXPERIENCE

FIG.4.2.6 PERCENTAGE DISTRIBUTION OF PREVIOUS EXPERIENCE REGARDING BASIC LIFE SUPPORT AMONG THE
STUDENTS
 SECTION – B

TABLE – 4.3: FREQUENCY AND PERCENTAGE

DISTRIBUTION OF LEVEL OF KNOWLEDGE REGARDING

BASIC LIFE SUPPORT STRATEGIES ON PRE AND POST

TEST AMONG THE STUDENTS.

N=100
INADEQUAT
ADEQUATE MODERATEL
LEVEL OF E
KNOWLED Y ADEQUATE TOTAL
KNOWLEDG KNOWLEDG
GE KNOWLEDGE
E E
No % No % No % No %

Pre test 0 0 16 16 84 84 100 100

Post test 71 71 29 29 0 0 100 100

Table 4.3 shows the knowledge regarding basic life support

strategies among the students through pre test and post test

based on questionnaire method. In the pre test among 100

students 84 (84%) had inadequate knowledge and 16 (16%) had

moderately adequate knowledge and none had adequate

knowledge. In the post test majority of the students, 71(71%) had

adequate knowledge, 29 (29%) had moderately adequate

knowledge and none had inadequate knowledge.

 84%
P
71%
ERCENTAG
E

29%

16%

0%

0% KEY
pre test

post test

LEVEL OF KNOWLEDGE
FIG.4.3.1 PERCENTAGE DISTRIBUTION OF THE PRE AND POST TEST
LEVEL OF KNOWLEDGE ON BASIC LIFE SUPPORT STRATEGIES AMONG
THE STUDENTS
 SECTION-C

TABLE –4.4 MEAN AND STANDARD DEVIATION OF PRETEST

AND POSTTEST KNOWLEDGE SCORE ON BASIC LIFE

SUPPORT STRATEGIES AMONG THE STUDENTS OF VIDHYA

SAGAR WOMEN‟S TEACHER TRAINING INSTITUTE,

CHENGALPET.

N=100

S. LEVEL OF STANDARD CONFIDENCE

No KNOWLEDGE MEAN DEVIATION INTERVAL

1. Pre test 5.90 -

14.79 4.49 15.53

2. Post test 16.04-

29.91 5.67 17.92

Table 4.4 reveals that the overall mean of level of

knowledge regarding basic life support strategies among the

students during pre test had been 14.79, standard deviation had

been 4.49 and in post test the mean had been 29.91, standard

deviation had been 5.67.The confidence interval in the pretest was

5.90-15.53 and post test was 16.04-17.92.

 SECTION – D

TABLE 4.5 MEAN AND STANDARD DEVIATION OF

IMPROVEMENT SCORE OF KNOWLEDGE ON BASIC LIFE

SUPPORT STRATEGIES AMONG THE STUDENTS OF VIDHYA

SAGAR WOMEN‟S TEACHER TRAINING INSTITUTE,

CHENGALPET.

N=100

S.NO LEVEL OF MEAN STANDARD PAIRED

DEVIATION
KNOWLEDGE „t‟ TEST

Improvement 15.12 1.18 27.33

1.
score

Table 4.5 reveals that the improvement mean score value

was 15.12 with a standard deviation of 1.18 and „t‟ value was

27.33 more than the table value at the level of significance at 5%.

It implies that there was statistically significant improvement in the

knowledge level regarding basic life support strategies among the

students at vidhya sagar women‟s teacher training institute.

 SECTION- E

TABLE 4.6: ASSOCIATION OF THE POST TEST LEVEL OF

KNOWLEDGE ON BASIC LIFE SUPPORT STRATEGIES WITH

SELECTED DEMOGRAPHIC VARIABLES AMONG THE

STUDENTS OF VIDHYA SAGAR WOMEN‟S TEACHER

TRAINING INSTITUTE, CHENGALPET

N=100

S. POSTTEST
N DEMOGRAPHI Adequat Moderatel 
O C VARIABLES e y Inadequat
adequate e VALUE
No % No % No %
1. Age In Years

A) 18 –20 59 59 19 19 0 0

B) 21-23 6 6 4 4 0 0 3.706*
C) 24 and above 6 6 6 6 0 0

2. Religion

A)Hindu 58 58 28 28 0 0

B) Christian 10 10 1 1 0 0

C) Muslim 3 3 0 0 0 0 3.776*
D) Others 0 0 0 0 0 0

3. Level of education

A )First year 29 29 11 11 0 0
0.071*
B )Second year 42 42 18 18 0 0
4. Locality

A )Urban 32 32 2 2 0 0 13.344**
B )Rural 39 39 27 27 0 0

Source of health
information
5.
A )Media 46 46 12 12 0 0

B )Health 6 6 2 2 0 0 4.617*
professionals

C) Family 17 17 15 15 0 0
members
and relatives
2 2 0 0 0 0
D) Friends
and
neighbors

6. Previous
experience
regarding basic
life support

A )Observer 14 14 2 2 0 0

B )Active 0 0 0 0 0 0 3.712*
participant

C )Both 0 0 0 0 0 0

D )No experience 57 57 27 27 0 0

P significant at 5%

* Not significant; ** Significant

Table 4.6 depicts the association between post test

knowledge score and the demographic variables among the

students. It reveals that there had been no significant association

between the age, religion, level of education, source of health

information and previous experience regarding basic life support

and the knowledge level among the students. It also reveals that

there was a significant association between locality and the

knowledge scores gained in the post test. It shows that their

dwelling place either urban or rural it is necessary to provide first

aid at right times to save the lives of the victims.

 CHAPTER V

RESULTS AND
DISCUSSION
 CHAPTER V

RESULTS AND DISCUSSION

The study had been undertaken to evaluate the effectiveness of

structured teaching programme on basic life support strategies in terms

of knowledge among the students at Vidhya Sagar Women‟s Teacher

Training Institute. The main objective of the study was to address the

adequacy of knowledge of students at Vidhya Sagar Women‟s Teacher

Training Institute.

This study was conducted for a period of six weeks by using a

quasi experimental research design at Vidhya Sagar Women‟s Teacher

Training Institute. Students had been selected by simple random

sampling technique through lottery method. The sample size was

hundred.

A well formated structured questionnaire has been used to assess

their knowledge regarding basic life support. Pre test and structured

teaching programme had been carried on the first day. On the eighth day

by using the structured questionnaire post test had been carried out.
 The first objective was to assess the level of knowledge

regarding basic life support strategies among the students.

The assessment of the knowledge regarding basic life support

strategies was carried among the students of vidhya sagar women‟s

teacher training, Chengalpet. The students who met inclusion criteria had

been selected as samples and their demographic variables and the

knowledge were assessed through questionnaires. The data analyses

showed that among 100 students 84 (84%) had inadequate knowledge

and 16 (16%) had moderately adequate knowledge in the pre test. It

reveals that the students need an educational programme to improve

their knowledge on basic life support strategies.

The second objective was to evaluate the effectiveness of

structured teaching programme on knowledge of basic life support

strategies among the students.

Table 4.3 reveals that among 100 students 84 (84%) had

inadequate knowledge and 16 (16%) had moderately adequate

knowledge in the pre test. In the post test, 71(71%) students had

adequate knowledge and 29(29%) had moderately adequate knowledge.

The overall mean of level of knowledge regarding basic life support

strategies among the students during pre test had been 14.79, standard
deviation had been 4.49 and in post test the mean had been 29.91,

standard deviation had been 5.67. By comparing pre test and post test

confidence interval may conclude that post test knowledge had been

increased. The paired„t‟ test value had been 27.33. It reveals that the

teaching programme had been effective.

The third objective was to associate the post test level of

knowledge with the selected demographic variables among the

students.

Table 4.6 depicts the association between post test knowledge

score and the demographic variables among the students. It reveals that

there is no significant association between the age, religion, level of

education, source of health information and previous experience

regarding basic life support and the knowledge level among the students.

It also reveals that there is a significant association between locality and

the knowledge scores gained in the post test. It shows that their dwelling

place either urban or rural it is necessary to provide first aid at right times

to save the lives of the victims.

On the whole, the study confirmed that the assumptions which

have been formulated at the beginning was factual and the study had
been effective in improving the knowledge regarding basic life support

strategies, through the teaching programme among the students of

vidhya sagar women‟s teacher training institute.

 CHAPTER-VI

SUMMARY &
CONCLUSION
 CHAPTER –VI

SUMMARY & CONCLUSION

SUMMARY

The present study had been conducted to assess the effectiveness

of knowledge on basic life support strategies among the students of

Vidhya Sagar Women‟s Teacher Training Institute, Chengalpet. Quasi

experimental research design was used for this study .100 students who

met inclusion criteria were selected by using simple random sampling

technique through lottery method. The investigator first introduced herself

to the students and developed a rapport with them. The pre test had

beenconducted among the students with the questionnaire regarding

basic life support. Then the teaching programme had been given. Seven

days after, the post test had been conducted by using same evaluation

tool. The data collected had been grouped and analyzed by using

descriptive statistics and inferential statistics.

CONCLUSION

In the pretest out of 100 students, 84 (84%) students possessed

inadequate knowledge and 16(16%) had moderately adequate

knowledge. In the post test 29(29%) had moderately adequate

knowledge and 71 (71%) had adequate knowledge. The„t‟ value 27 .33

had been compared with tabulated table value at the level of P< 0.05

was significant. Thus statistically it was concluded that teaching

programme had been effective.

NURSING IMPLICATIONS

The findings of the study have implications in different

branches of nursing that is nursing practice, nursing education, nursing

administration and nursing research. The investigator had portrayed a

clear picture regarding the different steps to be taken in different field to

improve the same.

IMPLICATION FOR NURSING PRACTICE

 Educating and creating awareness is an integral part of the nursing

service. Based on the findings of this study, structured teaching

programme can be planned for the nurses to increase the

knowledge and efficiency in performing the cardio pulmonary

resuscitation. It helps to improve the efficiency and skill and also to

implement at right times.

IMPLICATIONS FOR NURSING EDUCATION

  Nurse as an educator plays a major role in educating the students

regarding basic life support. So the nurse educator must be

educated regarding basic life support and its strategies in order to

impart the knowledge to the students and guide them properly in all

the settings.

 Nurse educators should provide opportunities for the students to

gain knowledge and skills regarding basic life support.

 Nursing personnel should be given in-service education to update

their knowledge.

IMPLICATIONS FOR NURSING ADMINISTRATION

 With advanced technology and ever growing challenges of health

care needs. The college and hospital administration, have a

responsibility to provide nurses, nurse educators and nurse

students with continuing education on recent advancements in

basic life support strategies. This will enable them to update their

knowledge and skills.

 The study finding will help the administrator to arrange continuing

education programme for nurses regarding basic life support

 strategies. It helps to prepare adequate learning material for giving

health education.

 The nurse administrator should take active part in the policy

making, developing protocol, standing orders related health care

measures.

IMPLICATIONS FOR NURSING RESEARCH

 There is a need for intensive and extensive research in this area. It

opens a big avenue for research on innovative methods of creating

awareness, development of teaching material and setting up

multimedia centers for teaching and for creating awareness among

the students, nurses, public and other health care professionals.

 The study findings will reveal the current knowledge status about

the basic life support strategies and the extent to which the

knowledge should be improved.

 This study will motivate other investigator to conduct future studies

regarding basic life support.

 This study will help the nurse researchers to develop insight into

the developing module and set information towards creating

awareness regarding basic life support strategies.

RECOMMENDATIONS

Based on the research findings the following recommendations can be

made:

 A similar study can be repeated on a large sample to generalize

the findings.

 A study can be conducted in different settings for different group

and also by using control and experimental group.

 A study can be done by comparing the effectiveness of different

teaching module.

 A cross sectional study can be conducted on knowledge, skills and

attitudes regarding cardio pulmonary resuscitation.

 Protocol can be given.

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APPENDICES
 APPENDIX-I
SECTION 1: DEMOGRAPHIC VARIABLES
INSTRUCTIONS
This section requires your personal information. Each item has few
options. Please write the option in the corresponding box which is more
appropriate to you:
1. Age in years ( )
a. 18-20

b. 21-23

c. 24 and above

2. Religion ( )
a. Hindu
b. Christian
c. Muslim
d. Others

3. Level of education ( )
a. first year
b. second year
4. Locality ( )
a. Urban
b. Rural
5. Source of health information ( )
a. Media
b. Health professionals
c. Family members and relatives
d. friends and neighbours

6. Previous experience regarding basic life support ( )

a. observer
b. Active participant
c. observer and active participant
d. no experience
 APPENDIX-II
SECTION 2: KNOWLEDGE QUESTIONNAIRE
PART I: KNOWLEDGE REGARDING ANATOMY AND PHYSIOLOGY
OF RESPIRATORY AND CARDIAC VASCULAR SYSTEM

1. The organ that plays an important role in circulation is ( )

a. Kidneys
b. Liver
c. Heart

2. The shape of the heart is ( )

a. Irregular
b. Round
c. cone

3. Heart lies in ( )
a. Abdominal cavity
b. Thoracic cavity
c. Cranial cavity

4. The system which excretes carbon dioxide is ( )

a. Respiratory system
b. Circulatory system
c. Central nervous system
5. Exchange of gas between the blood and tissues is called ( )
a. Internal respiration
b. External respiration
c. Internal and external respiration

PART II: KNOWLEDGE REGARDING CONCEPT OF CARDIO

PULMONARY RESUSCITATION
6. CPR stands for ( )
a. Cardio pulmonary resuscitation
b. Call , plan , respond
c. Carotid process reperfusion

7. The ABC of cardio pulmonary resuscitation is ( )

a. Artery , blood, capillaries
b. Angina, bronchial asthma, coma
c. Air way, breathing , circulation

8. The purpose of basic life support is to ( )

a. Maintain ventilation only
b. Maintain ventilation and circulation
c. Maintain bodily functions

9. The indication for basic life support is ( )

a. Renal failure
b. Cardiac arrest
c. Fracture
10. The meaning of the word “RESUSCITATION” is ( )
a. Restore
b. Regain
c. Renew

PART III: KNOWLEDGE REGARDING AIRWAY

11. The first step in assessing a patient‟s airway is ( )
a. Use the head tilt, chin lift technique
b. Look , listen, and feel for signs of breathing
c. Place the patient on his/her back

12. Head tilt and chin lift maneuver is used to ( )

a. Increase blood pressure
b. Increase respiration
c. Open the airway

13. The safe maneuver for a victim with neck injury is ( )

a. Jaw thrust maneuver
b. Head tilt and chin maneuver
c. Head tilt maneuver

14.The airway is most commonly obstructed by ( )

a. Dentures
b. Food
c. Back fall of tongue

15.The Jaw thrust is performed by ( )

 a. Placing both the hands behind the angle of the jaw and lift the
jaw lateral
b. Placing both the hands behind the angle of the jaw and lift the
jaw backward
c. Placing both the hands behind the angle of the jaw and lift the
jaw forward

PART IV: KNOWLEDGE REGARDING BREATHING

16.The science of normal breathing are all EXCEPT ( )

a. Chest movement
b. Sound from chest, feel of air on your cheek
c. Sound from abdomen

17.When the victim regains normal breathing then ( )

a. Turn him/her into prone position
b. Turn him/her into recovery position (side lying)
c. Elevate the head end of the patient

18.The rescuing breathing is given as ( )

a. Deep breathing and shallow breathing
b. Normal breathing
c. Fast breathing

19.During rescue breathing, for better seal, the rescuer should ( )

a. pinch the nose of the victim
b. Cover the nose of the victim
 c. Place the victim in a sitting position

20.Recovery position means ( )

a. Placing the victim on his/her side
b. Placing the victim in a sitting position
c. Rising the feet up above the heart

`PART V: KNOWLEDGE REGARDING CIRCULATION

21.The breathe to compression ratio during cardio pulmonary
resuscitation is ( )
a. Two breaths for 15 compression
b. Two breaths for 30 compression
c. Two breaths for 60 compression

22.Number of chest compressions performed in a minute is ( )

a. At least 40 compressions
b. At least 60 compressions
c. At least 100 compressions

23.Circulation can be assessed by palpitating ( )

a. Jugular vein
b. Heart beat
c. Carotid artery

24.Chest compression is given at ( )

a. Centre of the chest, at the nipple line
b. One hand with above the ribs meeting point
 c. 4” below the sternum

25.During cardio pulmonary resuscitation procedure the fingers should

be ( )
a. Interlocked together
b. Made as fist
c. Diverged apart

26.Depth of pressure applied on the sternum during cardio pulmonary

resuscitation for an adult is ( )
a. 4cms
b. 5cms
c. 8cms

27.The rescuer should apply pressure over the chest through ( )

a. Two fingers
b. Through palms
c. Back

28.If there is more than one rescuer present, the duration of change
over the rescuer is ( )
a. Every five cycles
b. Every ten cycles
c. Every thirty cycles
29.The complication that can occur due to chest compression is ( )
a. Head injury
b. Rib fracture
c. Damage to liver

30.During cardio pulmonary resuscitation the position of elbow and

back of the rescuer should be ( )
a. Straight back and straight elbow
b. Flexed back and flexed elbow
c. Straight back and flexed elbow
PART VI: KNOWLEDGE REGARDING CARDIO PULMONARY
RESUSCITATION PROCEDURE
31.The signs of no life is ( )
a. Unconscious , unresponsive, no normal breathing , not moving
b. Coma
c. Chest pain, shallow breathing

32.The victim‟s responsiveness is checked by ( )

a. Pinching the ear lobe
b. Shaking him and shouting” are you o.k”?
c. Sprinkle water on his face

33.If the victim remains un responsiveness then ( )

a. Start resuscitation before calling for help
b. Call for help
c. Perform 5 back slaps
34.The position of the victim during cardio pulmonary resuscitation is
( )
a. Flat on a floor
b. Flat on a table
c. Sitting position

35.The carotid pulse is felt for ( )

a. Less than 5 seconds
b. Less than 10 seconds
c. Less than
d. 15 seconds

36.The breathing is rechecked every ( )

a. 5 cycles
b. 15 cycles
c. 20 cycles

37.The resuscitation is continued until ( )

a. The rescuer becomes exhausted
b. The victim starts breathing normally
c. The victim dies

38.The recovery position helps in ( )

a. Flow of saliva downwards and prevent choking/ aspiration
b. Victim to be relaxed
c. Preventing vomiting
 39.The victim should not be moved or shaked if he/she has ( )
a. Coma
b. Spinal cord injury
c. Irresponsive
40. One of the signs of successful cardio pulmonary resuscitation is ( )
a. Occurrence of spontaneous gasp , breathing,
or regaining pulse
b. Absence of normal of heart beat
c. Absence of lung expansion
 APPENDIX III

LESSON PLAN ON BASIC LIFE SUPPORT STRATEGIES

TOPIC : BASIC LIFE SUPPORT STRATEGIES
GROUP : D.T.Ed I YEAR AND II YEAR STUDENTS
VENUE : VIDHYA SAGAR WOMEN‟S TEACHER TRAINING
INSTITUTE AUDIO VISUAL AIDS USED : CHARTS, MODEL, PAMPHLETS, VIDEO,
HANDOUTS
NAME OF THE INSTRUCTOR: BHUVANESWARI. S
COURSE : M.SC (NURSING) II YEAR
COLLEGE : ADHIPARASAKTHI COLLEGE OF NURSING, MELMARUVATHUR
CENTRAL OBJECTIVE
The group will be able to understand and gain knowledge regarding basic life support and develop

desirable attitudes towards performing the procedure at necessary times and in all settings.

CONTRIBUTING OBJECTIVE

The group will be able to

 review the anatomy and physiology of cardiovascular system and respiratory system

 define cardio pulmonary resuscitation

 enumerate the objectives and purposes of cardio pulmonary resuscitation

 enlist the indications of cardio pulmonary resuscitation

 describe the sequence of basic life support

 demonstrate the procedure

 describe the basic life support algorithm.

INTRODUCTION TO CARDIO PULMONARY RESUSCITATION

Basic life support is the maintenance of airway, breathing, circulation without auxiliary equipment. The

primary importance is placed on establishing and maintaining an adequate open airway. Restore breathing to reverse respiratory

arrest (stopped breathing), restore circulation to keep blood circulating and carrying oxygen to the heart, lungs, brain, and brain.

Basic life support consists of a number of life-saving techniques focused on the medicine „CAB‟ (circulation, airway, breathing),

through cardio pulmonary resuscitation. Cardio pulmonary resuscitation provided in the field increases the time available for higher

medical responders to arrive and provide advanced cardiac life support (ACLS) care. This improves survival outcomes in cardiac

arrest cases.
S.NO CONTRIBUTORY TIME CONTENT TEACHER‟S LEARNER‟S
OBJECTIVE ACTIVITY ACTIVITY
1. Review the 10
anatomy and
mts REVIEW THE ANATOMY AND PHYSIOLOGY OF CARDIO
physiology of
VASCULAR SYSTEM:
cardiovascular
and respiratory The cardiovascular system consists of the heart and the explaining listening
system blood vessels. The blood vessels that take blood from the heart with the help
to various tissues is called arteries. The smallest arteries are of model
called arterioles. Arterioles open in to a network of capillaries
that provide the tissues. Exchange of various substances
between the blood and the tissues take place through the walls
of capillaries. Blood from capillaries is collected by small venules
that join to form veins. The veins return blood to heart.
THE HEART:
The heart is a muscular pump designed to ensure the
circulation of blood through the tissues of the body, both
structurally and functionally it consists of two halves, right and
left. The right side heart circulates blood only through the lungs
for the purpose of oxygenation. The left side heart circulates
blood to tissues of the entire body. It has an inflow chamber
called atrium and an outflow chamber called ventricles.

Each chamber of the heart is connected to one or

more large blood vessels. The right atrium receives
deoxygenated from the tissues of the entire body through the
superior vena cavae. This blood passes into the right ventricle. It
leaves the right ventricle through a large outflow vessel called
the pulmonary trunk. This trunk is divided into right and left explaining
listening
pulmonary arteries that carry blood in to the lungs. Blood form
the lungs is brought back to the heart by four pulmonary veins
that end in the left atrium. This blood passes into the left
ventricle. The left ventricle pumps this blood into the large
outflow vessel called the aorta: the aorta and its branches
distribute blood to tissues of the entire body. It is returned to the
heart through the vena cavae, thus completing the circuit. Blood
is circulated through the regular contraction and relaxation of the
heart.
STRUCTURE OF HEART

explaining
listening
REVIEW THE ANATOMY AND PHYSIOLOGY OF
RESPIRATORY SYSTEM:
The respiratory system is meant, primarily for the
oxygenation of blood. The chief organs of the system are right
and left lungs. Air from outside enters the body through the right
and left external nares, which opens into the right and left nasal
cavities. At their posterior ends the nasal cavities have openings
called posterior nares, through which they open into the pharynx.
Air from the pharynx enters into a box like structure called larynx
which continues as the trachea.
explaining
listening
The trachea passes into the lower part of the neck
and upper part of the thorax. At the level of lower border of the
manubrium sternum the trachea bifurcates in the right and left
principal bronchi, which carry air to the right and left lungs
respectively. Within the lung each bronchus divides into
bronchioles. The bronchioles open into microscopic sac-like
structures called alveoli. The walls of the alveoli contain a rich
network of blood capillaries is separated from the air in the
alveoli by a very thin membrane through which the oxygen can
pass into the blood and carbon dioxide can pass into the alveolar
air.
The pumping of air in and out of the lungs is a result of
respiratory movements performed by the respiratory muscles.
The most important of these is the diaphragm, which forms the
partition between the thorax and the abdomen. Another
important set of muscles is the intercostals muscles that occupy
the intercostal spaces.

RESPIRATORY CYCLE:
Each respiratory cycle consists of
INSPIRATION: in which air is taken into the lungs.
EXPIRATION: in which air is breathed out, and
A short pause before the next inspiration. explaining
listening

During respiration the thoracic cavity expands

because of the contraction of diaphragm and some of the
intercostals muscles. Expansion of the thoracic wall creates a
negative pressure in the pleural cavity. The negative pressure in
the pleural cavity causes the lung to expand.
Structure Of

explaining
listening
 As the lungs expand, air is drawn into the them.
Expiration is caused by relaxation of the muscles that caused
inspiration. The size of the thoracic cavity is reduced and air is
forced out of the lungs.

EXTERNAL AND INTERNAL RESPIRATION:

The exchange of gases between the air in the alveoli of
the lungs and the blood is called the external respiration.
Exchange of gases between the blood and body cells is called
internal respiration. When blood circulates through tissue oxygen
passes from blood to tissue fluid, and from tissue fluid to cells. explaining
Carbon dioxide passes from cells to tissue fluid and from there to listening
blood. This process is the reverse of what happens in the lungs.
Oxygen absorbed in the lungs combines with
hemoglobin to form oxy hemoglobin and travels through blood in
this form. In the tissues oxygen is released from oxy hemoglobin.
Carbon dioxide is produced in tissues. Respiration is controlled
by the nervous system. In the medulla and pons there is a
respiratory centre that influences respiration. The respiratory
receives input from chemo –receptors (carotid body, aortic
body). When carbon dioxide content of blood increases

chemo receptors send impulses to the respiratory centre. The

respiratory centre sends impulses that increase the rate and explaining listening
depth of respiration, So that carbon dioxide level returns to
normal. The respiratory centre ensures that necessary changes
in respiration are made to meet the extra requirements in
exercises, fever, speech, or coughing.
S.NO CONTRIBUTORY TIME CONTENT TEACHER‟S LEARNER‟S
OBJECTIVE ACTIVITY ACTIVITY
CARDIO PULMONARY RESUSCITATION
Define cardio DEFINITION
2. 2mts
pulmonary Cardio pulmonary resuscitation (CPR) is a explaining listening
cerebral combination of mouth to mouth ventilation and chest with the help
resuscitation compressions that delivers oxygen and artificial blood circulation of roller
to a person who is in cardiac arrest. board
-DEYO R A.,
OBJECTIVES
3. Enumerate the 2mts Basic life support / cardio pulmonary resuscitation
objectives and helps the patient ensure his or her own circulation, airway, listening
purposes of breathing (CAB) or assists in maintaining for the patients who is explaining
cardio pulmonary unable to do so. with help of
cerebral PURPOSES hand out.
resuscitation  To establish and maintain an adequate open airway.
 To restore breathing.
 To restore circulation to keep blood circulation and
oxygenation of the tissues.
S.NO CONTRIBUTORY TIME CONTENT TEACHER‟S LEARNER‟S
OBJECTIVE
ACTIVITY ACTIVITY
4. Enlist the 2mts INDICATIONS
indications of A heart attack occurs when the heart is starved of oxygen. A
cardio pulmonary heart attack can „stun‟ the heart and interrupt its rhythm and
cerebral ability to pump. If the heart stops pumping, its known as “cardiac
resuscitation arrest”. A cardiac arrest can be caused by: explaining listening
 Heart disease-the most common cause. with the help
 Drowning of hand out.
 Suffocation
 Poisonous gases inhalation
 Head injury
 Electric shock
 Asphyxiation
SIGNS OF CARDIAC ARREST
 Unconsciousness, no heart beat, not moving
 Absence of breathing/abnormal breathing
 Unresponsiveness,No pulse in neck, wrist or groin
 A bluish color of skin, lips, or beds of finger nails
S.NO CONTRIBUTORY TIME CONTENT TEACHER‟S LEARNER‟S
OBJECTIVE ACTIVITY ACTIVITY
5. Describe the 8mts SEQUENCE OF BASIC LIFE SUPPORT
sequence of basic D – check for Danger explaining listening
cardiac life B – check for Response with the help
support S – ask for support/help of chart
C – Chest compressions – directs rescuers to perform 30
compressions to patients who are unresponsive and donot
breathe normally, followed by 2 rescue breathing
A – Airway - directs rescuers to open the airway
B – Breathing- directs rescuers to check breathing but no need
to deliver rescue breaths.
PROCEDURE:
6.
 Ensure that the scene is safe.
Demonstrate the 25  Assess the victim‟s level of consciousness by asking explaining observing
procedure of loudly and shaking at the shoulders “are you okay?” and with the help
mts
cardio pulmonary scan chest for breathing movement visually. If no of video
cerebral response call for help by shouting for ambulance .
resuscitation
S.NO CONTRIBUTORY TIME CONTENT TEACHER‟S LEARNER‟S
OBJECTIVE ACTIVITY ACTIVITY
 If the patient is not breathing assess pulse at the carotid
on your side for an adult, at the brachial for a child and
infant for 5 seconds and not more than 10 seconds; begin
immediately .
CHEST COMPRESSIONS:
 Place the heel of one hand on the lower half of the
person‟s breast bone (two inches above the xiphoid
process parallel to the long axis of the body). explaining listening
 Place the other hand on top of the first hand and interlock
your fingers.
 Press down firmly and smoothly (compressing to one third
of chest depth)30 times. For adults push upto 5cm and for
child upto 4cm.
 Administer two breaths (mouth to mouth ventilation).
Pinch the nose while providing ventilation to prevent air
leak through nose
S.NO CONTRIBUTORY TIME CONTENT TEACHER‟S LEARNER‟S
OBJECTIVE ACTIVITY ACTIVITY
 The ratio of 30 chest compressions followed by 2
breathes is the same, whether resuscitation is performed
alone or with the assistance of a second person.
 Continue chest compression at a rate of 100
compressions per minute for all groups allowing chest to
recoil in between. Continue for five cycles or two minutes explaining listening
before re-assessing the pulse.

MOUTH TO MOUTH VENTILATION:

 If the person is not breathing normally, make sure that
they are lying on their back and
 Open the airway by tilting the head back and lifting the
chin forward (head tilt and chin lift maneuver).
 Close their nostrils with your finger and thumb.
 Take full breath and blow in to their mouth.
 Give two full breaths to the person (rescue breathing).
S.NO CONTRIBUTORY TIME CONTENT TEACHER‟S LEARNER‟S
OBJECTIVE ACTIVITY ACTIVITY
CHECK THE AIRWAY:
 Don‟t move the person. Tilt their head back, open their
mouth and look inside for any foreign material inside.
 Remove the obstruction as early as possible.
CHECK BREATHING:
 Check for the presence of rise and fall of chest and
presence of pulse.
 If pulse is detected, then the patient should continue to explaining listening
receive artificial ventilations at an appropriate rate and
transport immediately. Otherwise begin resuscitation at a
ratio of 30:2, compressions to ventilations to atleast 100
compressions per minute for five cycles.
 After five cycles, the basic cardiac life support should be
repeated from assessing airway, breathing and checking
pulse as per new protocol sequence ( C-A-B).
S.NO CONTRIBUTORY TIME CONTENT TEACHER‟S LEARNER‟S
OBJECTIVE ACTIVITY ACTIVITY

CHEST COMPRESSION(CHILDREN):
 Face the child‟s chest.
 With your middle and index fingers of the hand nearest
the child‟s legs, locate the lower edge of the rib cage to
the notch at end of the breast bone.
 Place the heel on breast bone at nipple line.
 Perform chest compression as same as for adults but explaining listening
upto 4cm depth.

CHECK PULSE:
 While maintaining an open airway, locate the carotid
Pulse or brachial pulse on the inside of the upper arm:
feel the pulse for 5 to 10 seconds.
 Transport as quickly as possible
S.NO CONTRIBUTORY TIME CONTENT TEACHER‟S LEARNER‟S
OBJECTIVE ACTIVITY ACTIVITY
SIGNS OF SUCCESSFUL CARDIO PULMONARY
RRESUSCITATION:
 Lung expansion will occur with each breath.
 Each time the sternum is compressed the pulse will be
perceptible.
 Normal heart beat will return.
 A spontaneous gasp or breathing will occur.
 Victim may move legs or arms and color may improve.
CHECKING FOR SUCCESSFUL CARDIO PULMONARY explaining listening
RESUSCITATION:
 Check the carotid or brachial pulse periodically.
 Watch for spontaneous heart beat to be re-established,
spontaneous breathing to be resumed and conscious to
return.
IMPORTANT POINTS TO FOLLOW IN CARDIO PULMONARY
RESUSCITATION:
 Do not interrupt CPR for more than 5 seconds for any
reason.
S.NO CONTRIBUTORY TIME CONTENT TEACHER‟S LEARNER‟S
OBJECTIVE ACTIVITY ACTIVITY
 Do not move the victim to a more convenient site until
he/she has been stabilized.
 Never compress over the xiphoid process at the tip of the
sternum. Pressure on it may cause laceration (tear) of the
liver.
 Sudden or jerky movements should be avoided when
compressing the chest.
 The shoulder of the first aider should be directly over the explaining listening
victim‟s sternum. Elbows should be straight. Pressure is
to be applied vertically downwards on the lower sternum.
 Depth of compression should be appropriate.

WHEN TO STOP CARDIO PULMONARY RESUSCITATION:

One should continue resuscitation efforts until one of the
following occurs:
S.NO CONTRIBUTORY TIME CONTENT TEACHER‟S LEARNER‟S
OBJECTIVE ACTIVITY ACTIVITY
 Effective, spontaneous ventilation and circulation has
established.
 Professional help arrives.
 Victim is transferred to emergency medical services
(EMS).
Children allowing complete chest recoil after each
compression minimizing interruptions in compressions
avoiding excessive ventilation If multiple rescuers are
available, they should rotate the task of compressions every explaining listening
2 minutes
S.NO CONTRIBUTORY TIME CONTENT TEACHER‟S LEARNER‟S
OBJECTIVE ACTIVITY ACTIVITY
SIMPLIFIED BASIC LIFE SUPPORT ALGORITHM

explaining listening

Source: American Heart Association,2010 Guidelines

S.NO CONTRIBUTORY TIME CONTENT TEACHER‟S LEARNER‟S
OBJECTIVE ACTIVITY ACTIVITY
RECOMMENDATIONS FOR CARDIO PULMONARY
RESUSCITATION
COMPONENTS ADULTS
Unresponsive,
No breathing or no normal
Recognition breathing,
No pulse palpated within 10
seconds for all ages
CPR sequence Circulation-Airway-Breathing
Compression rate Atleast 100/min
Compression depth Atleast 2 inches(5cm)
Chest wall recoil Allow complete recoil
between compressions,
rotate every 2 minutes
Compression interruptions Minimise interruptions in
chest compressions, attempt
to limit interruptions to less
than 10 seconds
Airway Head tilt-chin lift (suspected
trauma : jaw thrust)
Compression to ventilation 30:2
ratio
Ventilation with advanced 1 breath every 6-8 seconds
airway (8-10 breaths/ min)
Source: American Heart Association,2010 Guidelines
SUMMARY

So far we have discussed regarding the anatomy and physiology of cardio vascular system and respiratory system, cardio
pulmonary resuscitation –definition, purposes, indications, sequential steps, procedure for adults and children, signs of successful
cardio pulmonary resuscitation, etc.

CONCLUSION

Basic life support (BLS) is the level of medical care which is used for patients with life-threatening illnesses or injuries until
the patient can be given full medical care at a hospital. CPR (cardio pulmonary resuscitation) provided in the field increases the
time available for higher medical responders to arrive and provide ALS (advanced life support) care. BLS ( Basic life support) helps
the patient ensure his or her own CABs(circulation, airway, breathing), or assists in maintaining for the patient who is unable to do
so.
ANNEXURES
 CERTIFICATE FOR CONTENT VALIDITY

This is to certify that the tool developed by Ms. BHUVANESWARI. S, M.Sc.(N),

Branch MEDICAL SURGICAL NURSING, Student of Adhiparasakthi College of

Nursing Melmaruvathur, for her study on "EFFECTIVENESS OF STRUCTURED

TEACHING PROGRAMME ON KNOWLEDGE OF BASIC LIFE SUPPORT

STRATEGIES AMONG THE STUDENTS OF VIDHYA SAGAR WOMENS TEACHER

TRAINING INSTITUTE, CHENGALPET" is validated by the under signed and this

may be proceeded with this tool to conduct the main study.

Place: Signature
PftlNCl
C-1\ea:c of' Nurslfl9
Date: a1Uf£E1HA UNIVERSfT"f
I 7"1
 OSa/al,; m

ADHIPARASAKTlll·coU£6E OF NURSING
MELMARUVAntuR-603 319
Kancheepuram District, Tamil Nadu, INDIA
Phone: 044- 27529581(0ffice), 044- 27529089
(Principal)
www. apcon.org e-mail: apcon_mel@yahoo.com, contactapcon@gmail.com
Approved by the GovemmentofTamil Nadu G.O. Ms. No. 801 & 169, H&FW(ME.11) Dept. Ot. 07.06.1993 & 22.05.2007
Recognized by the IndianNlning Council, New Delhi - Cert. No. 18-104712()()().INC, Dt. 27.07.2001. Resolution No. 75/10/June 2001.
Affiliated to The Tamil Nadu Or. MGR Medical University, Chennai Re. No. 21904/Afl'ln. (3)/93, Dt. 14.12.1993
Recognized by Tamil Nadu Nurses & Midwives council, Chennai - Ref.No.368/NC/99 DI. 12.08.1999.
Sakt i. G.B. ANBALAGAN SakthJ. B.UMADEVI
MANAGING TRUSTEE CORRESPONDENT

Or. N. KOKILAVANI, M.Sc.(N).M.A..M.Phll.,PILI>..

Principal.

Ref: APC0N/NURSING/2011-12/

To
The Principal,
Vidhya Sagar Women's Teacher Trainning Institute,
Chengalpet

Sir,
Sub: Requesting permission for Research Project- M.Sc. (Nursing) -Reg.
*****
Greetings from Principal, Adhiparasakthi College of Nursing, Melmaruvathur. This is for
your kind information that one of our post graduate M.Sc.(Nursing) II year student
Ms. BHUVANESWARI. S is planning to conduct a Research Project on "Effectiveness of
Structured Teaching Programme on Knowledge of Basic Life Support trategiesamong the
Students". Under The Tamil Nadu Dr. M.G.R. Medical University, Chennai. So we request
you to kindly permit our student to conduct her research in your Institution. We will abide
the Institution rules and regulations. Kindly consider and do the needful.

Thanking you,

PRINCIPAL
z
(1:·V1 asagap
-----
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= 2 =r:
WOMEN'STEACHER

To,
The Principal
Adhiparasakthi College of Nursing.
Melmaruvathur .

Respected Madam ,

Greetings from the Principal , Here with I authorize

that Ms.Bhuvaneswari S, M.Sc(Nursing) II year student or

yourinstitution has conducted a project on " Effectiveness of

structured teaching programme on Knowledge of basiccardiac

lifesupport strategies among the students" in our institution.

Principal

J.t
PRINCIPAL
ilDHYASAGAR WOMEN'STEACHERTRAININGl!ISTITll1I
VEOANAAAVANAPURAM• 608111.
Cl:iENGALPATTU

(Managed by:vidhya sagar charitable trust)Administraliveoffice:94,M.Croad,Wanarpet, Chennai-600 021.Tel:25956733

A HANDOUT ON CARDIO PULMONARY
RESUSCITATION
SCHOLAR IN THE DATA COLLECTION

SCHOLAR CONDUCTING PRETEST

SCHOLAR TEACHING BASIC LIFE SUPPORT

STRATEGIES
SCHOLAR EXPLAINING CPR TECHNIQUE THROUGH
VIDEO

SCHOLAR CONDUCTING POST TEST