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

Introduction: Basic life support (BLS) is an emergency skill that includes performing appropriate cardiopulmonary resuscitation (CPR). Out-of-hospital cardiac arrest (OHCA) is a leading cause of mortality worldwide and is rising in Nepal, the country with high vulnerability, 11 th and 16 th globally to Earthquakes and multi-hazards, respectively. After an OHCA event, a bystander starting CPR quickly has been shown to increase the survival rate. While the Nepali police are generally the first responders to the disasters and emergencies in rural parts, they are not trained in BLS. This program assesses a pilot training of hands-only CPR and choking first aid to the Nepal Police and Nepal Army participants in rural Nepal. Methods: A community-based nonprofit organization, HAPSA-Nepal, coordinated with the local government to pilot this program. The program included pre- and post-tests, lectures, videos, and small group hands-on exercises; facilitators included faculty emergency physicians, residents, and medical officers. Structured pre- and post-test questionnaires, confidence surveys, and skills checklists were conducted. Descriptive analysis examined the respondents’ characteristics, and a paired t-test was used to compare pretest and post-test scores. Results: A total of 126 participants received the training in this pilot phase. Before this training, 98.4% of the participants had not received any CPR training, and 100% of the participants had not received training on first aid for choking. The average pretest score was 4.4 with 95% CI±1.75, and the average post-test score was 8.06 with 95% CI ±1.73 (out of a total of 11). All participants passed the skills assessment. Conclusion: Locally adapted BLS training programs that included hands-only CPR and choking first aid showed a significant knowledge gain and skills competence among the frontline participants.