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further education
role evolution
staff
professional
training

Beyond STEMI: paramedics' views on how to improve their ability to interpret ECGs

02 December 2021
Features
02 December 2021
Volume 13 · Issue 12

Abstract

Background:

Internationally, the paramedic scope of practice is developing. Bypassing emergency departments in favour of direct access to primary percutaneous coronary intervention laboratories has been limited largely to cases of ST-elevation myocardial infarction and new-onset left bundle branch block, but updates to international guidelines suggest that enhancing paramedics' skills in interpreting electrocardiograms (ECGs) and widening the bypass criteria could be beneficial.

Aim:

The aim of the study is to explore paramedics' views on ways to improve their ECG interpretation abilities.

Method:

A two-arm design was used with an online questionnaire (quantitative) and one-to-one interviews (qualitative). The questionnaire results were used to inform the interview guide.

Findings:

One hundred and eighteen paramedics completed the survey, and 11 took part in interviews. The major themes identified from the template analysis of the interviews were ‘a profession in transition’, ‘lagging professional development’ and ‘supporting the frontline’. Self-directed learning resources before, during and after action were proposed.

Conclusion:

Paramedicine is evolving in Ireland and practitioners have reported undertaking self-directed learning activities. The resulting heterogeneity in skills such as ECG interpretation, and perceived barriers to education, can cause feelings of vulnerability within the profession. Supporting the frontline by introducing some Group-Orchestrated Self-Directed Learning resources could empower practitioners and contribute to the evolution of prehospital care in Ireland.

Paramedic practice around the world is rapidly evolving (Vertesi, 1978; Munger, 2000; O'Meara et al, 2012; Batt, 2016), demonstrated by the international transition towards third-level education (Donaghy, 2008; Hou et al, 2013; Maguire et al, 2016; Caffrey et al, 2019).

In Ireland, healthcare has been moving towards a collaborative, integrated system (Darker, 2013), exemplified by the management of cardiovascular emergencies, which requires cooperation between prehospital emergency medical services (EMS), emergency departments, cardiology services and primary percutaneous coronary intervention (PPCI) centres (Tubaro et al, 2011; Bagai et al, 2014; Jennings et al, 2017).

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Electrocardiogram (ECG)
ST-elevation myocardial infarction (STEMI)
Prehospital
Continuing professional development
Self-directed learning