I agree with Rowley; I still foresee many problems. For example, our SHOs
have had several years' training on normal and abnormal ECGs (plus variants)
before being let loose on MI treatment - and they still need help with most
of their MI patients! Paramedics have little or no experience of 12-lead ECG
analysis, as far as I'm aware, although it could be argued that future
training might include this. But when a department of our size only
thrombolyses a couple of MIs per week, it's going to take a long time to
build up experience and confidence among our local paramedic population.
But performing ECGs at scene for MI patients means performing ECGs at scene
for all chest pains. There would then be further delays for non-MI patients
receiving opioid analgesia etc, unless paramedics are going to take this on
too. Basically this needs to be carefully thought through. At the end of the
day these are very expensive drugs with very serious side-effects; I just
don't see paramedics in my patch taking on this level of responsibility, at
least not when judging by the levels of decision making that they're
currently required to undertake.
Adrian Fogarty
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