BLS competency of doctors and nurses serving during the war in Gaza: insights from a cross-sectional study

Basic Life Support (BLS) is a standard of care and a crucial component of emergency medicine. In conflict-affected regions like Gaza, the importance of timely and effective BLS is ever more critical. However, the level of BLS knowledge among Gazan healthcare workers remains underexplored. Understanding current competency levels is vital for improving patient outcomes, guiding training programs, and enhancing emergency preparedness in this high-risk environment.

A cross-sectional survey conducted in November 2024 recruited 402 doctors and nurses from six main governmental hospitals using convenience sampling and a structured questionnaire. Using R Software, the Mann-Whitney test was used to assess the association between knowledge/practice scores and independent variables, and multivariate linear regression was applied to adjust for all baseline characteristics.

Most participants were male, aged 30 or younger, had less than five years of work experience, and 82.08% had received prior BLS training. High BLS knowledge was observed in areas such as the meaning of AED (84.08%), the adult chest compression-to-breath ratio (91.04%), and the management of myocardial infarction (84.83%). Moderate understanding was found in the initial trauma response (68.41%), and airway management for neck injuries (72.64%). However, significant knowledge gaps emerged, including the resuscitation sequence (26.62%), correct compression depth for adults (26.37%) and children (21.14%), ventilation with an advanced airway (16.67%), and appropriate response to choking incidents (18.41%). Most participants had positive attitudes toward BLS, but only 37.56% were willing to perform mouth-to-mouth ventilation on a person of the opposite sex. Being a doctor and having a prior BLS training were significantly associated with higher knowledge and practice.

The findings highlight the need for targeted BLS training programs that address knowledge deficiencies, practical hesitations, and negative attitudes. The fact that doctors and those with prior BLS training performed better supports the potential role that refresher training can play in improving the overall competency of Gaza healthcare providers.