Abstract
Introduction
A qualitative exploration into the views, opinions and decision-making of paramedics involved in undertaking prehospital 12-lead electrocardiograms (PHECGs) for stroke patients was undertaken, in order to gain a deeper understanding of the clinical and occupational context that the paramedics work within; the acceptability of the paramedics in using PHECGs for stroke patients and the consequences and influences of their decision-making.
Methods
Data were collected via semi-structured interviews and analysed using the framework method with the underpinning theoretical framework of cognitive continuum theory (CCT). A purposive sample of 14 paramedics were recruited and interviewed.
Results
Five themes were generated from the analysis of the interviews:
• “Time is brain”: minimising delays and rapid transport to definitive care
• Barriers and facilitators to undertaking PHECGs for stroke patients
• Recognising and gaining cues
• Maintaining patient dignity, self-protection and fully informed consent
• Education, experience, and engagement with evidence.
Conclusion
The study showed mixed views on the usefulness of PHECGs, but all participants agreed that PHECGs should not cause additional delays. Paramedic decision-making on recording PHECGs relies on intuitive and quasirational cognitive modes and requires a number of clinical, logistical and ethical considerations. The findings suggest careful consideration of the benefits and potential drawbacks of incorporating PHECGs into prehospital stroke care.