From the Guidelines
Paramedics are generally proficient in reading EKGs, as evidenced by their training and competency requirements, although the quality of interpretation may vary depending on individual skill and experience. According to the American Heart Association, paramedics are expected to identify ECG changes characteristically seen during the evolution of an acute myocardial infarction, such as ST-segment elevation 1. The National Association of EMS Educators has included 12-lead ECG interpretation as a required competency for paramedics, indicating a recognition of the importance of this skill in prehospital care. While there may be variations in the level of training and expertise among paramedics, the fact that they are expected to acquire and interpret ECGs in the field suggests a certain level of proficiency.
Some key points to consider include:
- Paramedics receive training in cardiac monitoring and EKG interpretation as part of their education
- They are expected to recognize normal sinus rhythms, common arrhythmias, and life-threatening conditions such as myocardial infarction
- Paramedics must be able to quickly identify critical patterns like ST-segment elevation, ventricular fibrillation, and heart blocks to make time-sensitive treatment decisions in the field
- Their proficiency allows them to administer appropriate medications and determine when defibrillation or other interventions are needed, as noted in the context of prehospital ECG acquisition and interpretation 1.
It is also worth noting that while paramedics may not have the same level of specialized training as cardiologists, their ability to identify clinically significant EKG abnormalities in emergency situations is a critical component of prehospital care. As such, paramedics can be relied upon to provide accurate and timely EKG interpretations in the field, which is essential for providing high-quality patient care and improving outcomes.
From the Research
Paramedic EKG Interpretation Accuracy
- Paramedics' accuracy in reading 12-lead ECGs can range from 86% to 94% 2.
- The availability of prior ECGs can improve paramedic accuracy in ECG interpretation, increasing accuracy from 75.5% to 80.5% (p=0.015) 2.
- A study using a convenient training device (flip book) to improve field interpretation of certain cardiac rhythms found no statistically significant improvements in global ECG interpretation or individual rhythm interpretations 3.
Comparison to Other Healthcare Professionals
- A study evaluating ECG interpretation proficiency among healthcare professionals found that cardiology fellows-in-training demonstrated superior performance across all metrics, while primary care physicians had a higher accuracy compared to nurses and advanced practice providers 4.
- The same study found that allied health professionals outperformed nurses and advanced practice providers in every metric and showed comparable performance to resident physicians and primary care physicians 4.
Limitations and Areas for Improvement
- Paramedics' accuracy in reading ECGs can be limited by the lack of availability of prior ECGs for comparison 2.
- The use of training devices, such as flip books, may not be effective in improving paramedic identification of ECG rhythms without additional support or instruction 3.
- Further studies are needed to evaluate the impact of prior ECGs on paramedic accuracy in a clinical setting 2 and to inform educational interventions for addressing challenges in ECG interpretation proficiency among healthcare professionals 4.