Paramedic Ability in Interpreting Electrocardiogram with ST-segment Elevation Myocardial Infarction (STEMI) in Saudi Arabia

Overview

Journal J Multidiscip Healthc

Publisher Dove Medical Press

Specialty Health Services

Date 2022 Aug 12

PMID 35959233

Authors

Abdullah A Alrumayh

Abdullah M Mubarak

Abdulkarim A Almazrua

Musab Z Alharthi

Deem F Alatef

Turki B Albacker

Fahad M Samarkandy

Yousef M Alsofayan

Muath Alobaida

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate paramedic ability in recognizing 12-lead Electrocardiogram (ECG) with ST-segment Elevation myocardial infarction (STEMI) in Saudi Arabia.

Methods: This is a quantitative exploratory cross-sectional study using an electronic survey of paramedics was conducted between June and September 2021. The survey included demographics, educational and clinical experiences, and multiple 12-lead ECG strip questions to assess participants' ability to recognize STEMI. We reported the overall sensitivity, specificity, and correct proportions with 95% Confidence Intervals (CI).

Results: Eighty-four paramedics completed the survey, and 65% of them were between 24 and 29 years old, with a median, of three years of field experience. Overall sensitivity and specificity were 58.39% (95% CI, 50.4% to 66.1%) and 29.01% (95% CI, 25.15% to 33.1%), respectively. In total, 67.1% correctly identified inferior STEMI, whereas only 50% correctly identified lateral STEMI. Both STEMIs were correctly identified by 41%, and the majority misinterpreted STEMI mimics (ECG rhythms with similar ECG morphology to STEMI). The proportion who correctly recognized left bundle branch block was 14.8%, pericarditis was 10.9%, and ventricular pacing was 1.4%. However, almost third of participants correctly identified right bundle branch block (32.9%) and left ventricle hypertrophy (30.7%). Overall, there was no correlation between the correct ECG interpretation of STEMIs and educational and clinical experiences.

Conclusion: Paramedics were able to identify STEMI events in prehospital settings with moderate sensitivity and low specificity with limited ability to differentiate between STEMI and STEMI mimics. Therefore, additional training in ECG interpretation could improve their clinical decision-making, and to ensure that proper care and treatment is provided. Further research on a large, representative sample of paramedics across the country could provide more definitive evidence to establish a greater degree of accuracy in detecting STEMI in prehospital settings.

Citing Articles

Electrocardiographic interpretation by emergency medical services professionals in Saudi Arabia: A cross sectional study.

Alalwan M, Alshammari T, Alawjan H, Alkhayat H, Alsaleh A, Alamri I PLoS One. 2023; 18(10):e0292868.

PMID: 37856426 PMC: 10586609. DOI: 10.1371/journal.pone.0292868.

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