Our study clearly indicated that there were apparent differences in students’ knowledge of cardiopulmonary resuscitation between the two universities, with the knowledge level remaining generally low in both universities.
The results of the survey indicated that the largest percentage of students who attended a course on cardiopulmonary resuscitation were from Damascus University, with 81.9% of participants compared to 18.9% from the Syrian Private University, noting that most of them responded that this course was not organized by their university and was not obligatory. It included both practical and theoretical aspects.
However, it is worrying that the majority of students who attended the course from the University of Damascus do not consider it sufficient to intervene in the event of a heart attack in front of them, as 85.7% of those who answered no were from the University of Damascus compared to 14.3% from the private Syrian university.
However, when they were asked whether they felt they were able to save a person suffering from a cardiac arrest, the largest percentage of those who answered yes was for Damascus University students (74.3%).
Turning to the questions about awareness of the principles of resuscitation, awareness in general was better among Damascus University students. When answering the obvious question whether there is a difference between cardiopulmonary resuscitation for adults and children, the majority of those who answered there was no difference or (I do not know) were from the Syrian Private University with a percentage of 75.0. % and 61.8%, respectively.
As for knowledge of the survival rate of a person who suffered a cardiac arrest outside the hospital if cardiopulmonary resuscitation was provided to him, 77.7% of those who knew that it was 491 out of every 1,000 were from the University of Damascus, compared to 22.3% from the Syrian Private University.
Likewise, 82.4% of those who know that a person's chance of surviving a cardiac arrest decreases by about 18–20% every minute that CPR is not performed were from the University of Damascus, compared to 17.6% from the Syrian Private University.
Also, with regard to knowing how to apply cardiopulmonary resuscitation, the results were similar, as those who knew that the correct rate of chest compressions versus ventilation is 30:2, that the correct depth of each compression is (5–6) cm, and that the correct compression rate ranges between (100–120) compressions per minute most of them were from Damascus University, 78.9%, 77.3%, and 74.2%, respectively.
As for the theoretical level of knowledge, we find that the difference between the two universities has diminished somewhat. Of those who knew that the most common cause of heart attack among adults is myocardial infarction, 67.6% were from the University of Damascus and 32.4% were from the Syrian Private University, noting that most of the students are in both universities. Choose the correct answer. This may indicate that medical students may be more familiar with the pathophysiological aspects of cardiac arrest than they are prepared to actually engage in CPR maneuvers. Knowledge of these matters has been as high as 91% in other international studies. 2
Moving on to an important question about how to deal with one of the most common cases encountered by the public, which is suffocation, the gap between the two universities has widened again. Among those who knew that if the patient can cough, we are satisfied with just monitoring, the percentage of Damascus University students was 84.9%, while the percentage of Syrian University students was 15.1. % Just! Although a good number of students from both universities answered incorrectly that we perform 5 blows on the back or abdomen or examine the mouth to remove the foreign body, this indicates that medical students - especially at the Syrian Private University - are not completely sure how to deal with suffocation, which It was recently highlighted in a single-center study in Egypt. 3
When comparing these results with studies conducted in a number of European countries, the results were worse for the results of the University of Damascus regarding a person suffering from choking and coughing, where only 34.9% knew that we are content with observing without doing anything 1431, but they are better than the results of the private Syrian University.
As for the use of an automated external defibrillator (AED), more than half of those who knew that an AED must be used immediately when available from the Syrian Private University, in contrast to the rest of the questions, were 55.6% compared to 44.4% from Damascus University.
This percentage of knowledge in our study was somewhat low compared to the percentage indicated by international studies, where the average percentage of knowledge about the timing of using an automatic defibrillator was 69.7% among students. This percentage ranged between (30.8% in Kosovo, 31.5% in Molva, 44.4% in Bosnia, and the highest percentage is 91.3% in Germany).2
Damascus University students also constituted the largest percentage of students who correctly identified the AED code according to the American Society, at 79.6%.
Likewise, the largest percentage of those who were aware that ventricular fibrillation is the only shockable disorder compared to sinus tachycardia, pulseless electrical activity, and asystole were from the University of Damascus, at 74.0%, compared to only 26.0% from the Syrian Private University. What is most disturbing is that a large percentage of Students at the Syrian Private University stated that pulseless electrical activity and asystole are shockable at a rate of 73.7% and 67.6%, respectively, compared to 26.3% and 32.4%, respectively, at the University of Damascus.
It appears that the main reason for this little knowledge of cardiac arrest and associated life-saving techniques among students in general and Syrian Private University students in particular is the presence of a large percentage of students who did not attend the BLS course, most of whom were from the Syrian Private University. In fact, knowledge was higher among students who attended the course compared to students who did not attend it.
Also, the fact that the sample of Syrian Private University students constitutes about half of the sample of Damascus University students may have contributed to some extent to this result.
However, this alone cannot explain the problem, as knowledge appears to be insufficient even among those who have attended a BLS course. Possible explanations for this are:
1- Because the courses are not standardized and do not follow international recommendations, there is a significant percentage of students who attended the BLS course and answered wrong answers to a number of questions, perhaps as a result of a number of courses not adhering to the instructions recommended by the European or American Resuscitation Council. 4–5
2- The courses focus on the theoretical aspect more than the practical aspect, as students’ knowledge of practical information was less than theoretical information in general. This problem can be overcome by using high-accuracy simulation systems, as they have been proven to effectively increase the quality of CPR training.
3- Many students attend a BLS course in the first years of their studies, and the practical CPR skills they have learned quickly deteriorate within just a few months. Therefore, students must constantly update their knowledge through annual retraining courses.