Paramedic electrocardiogram interpretation in acute coronary syndrome

Abstract

Background: The paramedic use of electrocardiogram (ECG) is the gold standard for prehospital identification of acute myocardial infarction. Following an extension to their scope of practice, all paramedics have the capability to identify an ST-elevation myocardial infarction (STEMI). However, there have been no investigations into paramedic ECG interpretation. Aims: This study aimed to investigate paramedic accuracy regarding ECG interpretation and compare findings with international literature. Methods: Anonymous participants were voluntarily recruited to interpret 12 ECGs. A literature review was undertaken to compare results with previous studies. Findings: Paramedics correctly identified the ECGs with a mean score of 63%. Accuracy in ECG interpretation increased with a higher educational background and specialist training. Postgraduate mean accuracy was 83.33%, with specialist accuracy at 83.53%. Conclusions: Further education and research into interpreting difficult ECGs is necessary. Australian services may consider the implementation of modified cardiac protocols to include suspected non-STEMI.