Department of Emergency Medical Care, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Department of Academic Affairs and Training, Saudi Red Crescent Authority, Dammam, Saudi Arabia.
PLoS One. 2023 Oct 19;18(10):e0292868. doi: 10.1371/journal.pone.0292868. eCollection 2023.
Management of acute myocardial infarction (AMI) and cardiac arrhythmias in prehospital settings is largely determined by providers of emergency medical services (EMS) who can proficiently interpret the electrocardiography (ECG). The aim of this study was to assess the ECG competency of EMS providers in Saudi Arabia.
Between Aug and Sep 2022, we invited all EMS providers working for the Saudi Red Crescent Authority in Makkah, Riyadh, and Sharqiyah regions to complete a cross-sectional survey. The survey was used to assess the ability of EMS providers to interpret 12 ECG strips. Characteristics and ECG competency were summarized using descriptive statistics. Differences in ECG competency across paramedics with lower and higher qualifications were assessed.
During the study period, 231 participants completed the survey, and all were included. The overall mean age was 33.4, and most participants were male (94.8%). Nearly half of the participants were paramedics with an associate degree and 46.4% were paramedics with higher degrees. The average rate of correct answers to the 12 ECG strips was 43.3% (95% CI: 35.4%, 51.3%). Atrial flutter, ventricular fibrillation, atrial fibrillation, 3rd degree heart block, and ventricular tachycardia were identified by 52.8%, 60.2%, 42.0%, 40.7%, and 49.4% of the participants, respectively. The strip with an AMI was identified by 41.1%, while a pathological Q wave and ventricular extrasystole were identified by 19.1% and 24.7%, respectively. Paramedics with higher qualifications were as 28.0%-61.0% more likely to correctly interpret the 12 ECG strips compared to those with an associate degree (p-value across all variables was ≤ 0.001).
While the majority of participants in our region were unable to correctly answer the 12 ECG questionnaire, paramedics with higher qualifications were. Our study indicates that there is a need for evidenced-based ECG curricula targeting different levels of EMS professionals.
在院前环境中，急性心肌梗死（AMI）和心脏心律失常的管理主要由能够熟练解读心电图（ECG）的紧急医疗服务（EMS）提供者决定。本研究旨在评估沙特阿拉伯 EMS 提供者的 ECG 能力。
在 2022 年 8 月至 9 月期间，我们邀请了在麦加、利雅得和沙迦地区工作的所有沙特红新月会 EMS 提供者完成一项横断面调查。该调查用于评估 EMS 提供者解读 12 条 ECG 条带的能力。使用描述性统计方法总结特征和 ECG 能力。评估具有较低和较高资格的 EMS 提供者在 ECG 能力方面的差异。
在研究期间，有 231 名参与者完成了调查，所有参与者均被纳入。总体平均年龄为 33.4 岁，大多数参与者为男性（94.8%）。近一半的参与者是具有副学士学位的护理人员，而 46.4%是具有更高学位的护理人员。对 12 条 ECG 条带的正确答案的平均比率为 43.3%（95%CI：35.4%，51.3%）。参与者分别识别出 52.8%、60.2%、42.0%、40.7%和 49.4%的心房扑动、心室颤动、心房颤动、三度心脏阻滞和室性心动过速。41.1%的参与者识别出 AMI 条带，而 19.1%和 24.7%的参与者分别识别出病理性 Q 波和室性期前收缩。与具有副学士学位的护理人员相比，具有更高资格的护理人员正确解读 12 条 ECG 条带的可能性高 28.0%-61.0%（所有变量的 p 值均≤0.001）。
尽管我们所在地区的大多数参与者无法正确回答 12 个 ECG 问卷，但具有较高资格的护理人员可以。我们的研究表明，需要针对不同级别的 EMS 专业人员制定基于证据的 ECG 课程。
