Assessment of the general knowledge of emergency physicians from hospitals of the city of Salvador (Brazil) on the care of cardiac arrest patients

Objective

To identify the proportion of emergency physicians certified in immersion courses – Advanced Cardiac Life Support (ACLS), Fundamental of Critical Care Support (FCCS) and Advanced Trauma Life Support (ATLS) – correlating the variables of age, gender, medical specialty, academic title, and two types of hospital with the level of theoretical knowledge on the care of cardiac arrest (CA) patients.

Methods

Emergency physicians from public and private hospitals of the city of Salvador, State of Bahia, Brazil, were consecutively evaluated from November 2003 to July 2004. The physicians volunteered to participate in the study, and responded to a questionnaire consisting of information on the following variables of interest: professional profile, participation or not in ACLS, FCCS and ATLS immersion courses, and cognitive assessment with 22 objective questions on cardiopulmonary resuscitation (CPR). A score of correct answers was calculated for each participant, and then designated as a score variable. This questionnaire was validated based on the result of the score obtained by ACLS course instructors in Salvador, BA.

Results

Of the 305 physicians who responded to the questionnaire, 83 (27.2%) had attended the ACLS course and had a mean score variable of 14.9 ± 3.0, compared with the 215 physicians (70.5%) who had not attended the course and whose mean was 10.5 ± 3.5 (P = 0.0001). The mean score of the 65 cardiologists (21.5%) was 14.1 ± 3.3 compared with the mean of 9.7 ± 3.7 (P = 0.0001) for the 238 physicians (78.5%) from other specialties. The mean score of the 37 physicians who had attended the FCCS course was 14.5 ± 3.1 compared with the mean of 11.3 ± 3.8 who had not attended this course (P = 0.0001). The mean score of the 24 physicians who had attended the ACLS and FCCS courses was 16.1 ± 2.6, compared with the 12 physicians who had attended the FCCS course and whose mean was 12.3 ± 2.5 (P = 0.0001). No difference was observed in the mean scores between physicians who had attended the ATLS course or not (P = 0.67).

Conclusion

In the sample studied, theoretical knowledge of CPR was higher among physicians who had attended the ACLS course, as opposed to those who had attended the ATLS course. Cardiologists who had attended the ACLS demonstrated a higher theoretical knowledge of the care of CA patients when compared with physicians from other specialties taken as whole – internal medicine, surgery, and orthopedics. Physicians who had attended the ACLS and FCCS courses demonstrated a higher theoretical knowledge of the care of CA patients when compared with physicians who had attended only one of those courses; continued education is therefore essential.