Proficiency, Prospects, and Barriers Regarding Basic and Comprehensive Cardiovascular Life Support Skills Among...

Out-of-hospital cardiac arrest is a major public health concern in India, with survival rates below 10%. Dental professionals, interacting with patients in diverse settings, represent an underutilized segment of the health system for emergency preparedness. This study aimed to assess knowledge, perceived barriers, and opportunities related to basic and advanced cardiovascular life support (BLS/ACLS) among dental professionals in India through a mixed-methods approach.

A convergent parallel mixed-method study was conducted between February and July 2025. Quantitative data were collected from 330 registered dental professionals using a validated questionnaire (Item-Content Validity Index = 0.82; Cronbach α = 0.86). The primary outcome was the mean knowledge score. Data were analyzed using descriptive statistics, t tests, analysis of variance, and multivariate linear regression with reporting of 95% confidence intervals (CIs). Multicollinearity was assessed using variance inflation factors. Qualitative data were obtained through two focus group discussions (n = 18) and analyzed using thematic analysis.

While 64.5% of participants had received BLS training, only 21.5% had ACLS exposure. The mean knowledge score was critically low at 35.59% (95% CI: 33.77-37.41). Multivariate regression (model fit: R ² = 0.188) identified prior BLS training (B = 6.93, P < 0.001; CI: 3.10-10.76) and higher qualification (e.g., Doctor of Philosophy (PhD) vs. Bachelor of Dental Surgery: B = -14.72, P = 0.011; 95% CI: -26.01 to -3.43) as significant predictors of knowledge. An attitude-based regression (model fit: R ² = 0.173) found that disagreement with mandatory automated external defibrillators (B = -19.37, P = 0.016; 95% CI: -35.08 to -3.65) and neutrality on the importance of compression-only life support (B = -10.20, P = 0.015; 95% CI: -18.33 to -2.06) were significantly associated with lower scores. Qualitative analysis yielded five major themes: training, medical emergencies, needs and role of dentists, barriers, and areas for improvement. These themes elucidated factors such as low confidence, significant infrastructure deficits, and systemic obstacles to training, especially in small towns.

This study highlights critical deficiencies and quantitatively low knowledge scores in cardiovascular life support preparedness among dental professionals. The findings underscore a missed opportunity to expand India's emergency response capacity, pointing to an urgent need for mandatory, standardized training and systemic infrastructure improvements.