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Hastane Öncesi Acil Sağlık Hizmetlerinde Görev Yapan Paramediklerin Geniş QRS’li Taşikardilerin Tanı ve Tedavi Konusundaki Bilgi Düzeylerinin İncelenmesi

Year 2021, Volume: 4 Issue: 4, 118 - 124, 29.12.2021
https://doi.org/10.54996/anatolianjem.962768

Abstract

Amaç: Bu araştırma Konya ili hastane öncesi acil sağlık hizmetleri istasyonlarında çalışan paramediklerin geniş QRS’li taşikardilerin tanı ve tedavisi konusundaki bilgi düzeylerini incelemek amacıyla yapılmıştır.

Gereç ve Yöntemler: Araştırmanın örneklemini, Konya İl Ambulans Komuta Kontrol Merkezi Başhekimliği’ne bağlı acil sağlık hizmetleri istasyonlarında görev yapan 140 paramedik oluşturmuştur. Verilerin toplanmasında; araştırmacı tarafından hazırlanmış içerisinde demografik verilen de yer alığı geniş QRS’li taşikardilerin tanı ve tedavisi konusunda bilgi düzeyinin incelenmesi anketi kullanılmıştır.

Bulgular: Bu çalışmamızda araştırmaya katılan paramediklere bilgi düzeyi anketinde taşikardinin tanımı ve normal elektrokardiyografide QRS süresi sorulmuş; paramediklerin %22.1’inin taşikardinin tanımını, yaklaşık yarısının ise normal bir elektrokardiyografide olması beklenen QRS süresi gibi elektrokardiyografinin temel bilgilerini bilmedikleri görülmüştür. ventriküler taşkardinin tanısı, nabızsız ventriküler taşikardi, stabil ventriküler taşikardi ve anstabil ventriküler taşikardinin tedavisine yönelik sorular paremaediklerin sırasıyla %43,6 , %68.6, %62.1 ve %29.3’ü tarafından doğru cevaplanmıştır. Çalışmamızda mesleki kıdem ve yaş arttıkça paramediklerin bilgi düzeyinde artış olduğu görülmüştür.

Sonuç: Mesleki kıdem, yaş, mezun olunan lise türü ve senaryo temelli simülasyon eğitime katılım değişkenlerinin sorulara doğru yanıt verilmesindeki en önemli faktörler olduğu belirlenmiştir. Ayrıca; paramediklerin geniş QRS kompleksli taşikardilerin tanı ve tedavisi bilgi düzeyleri beklenenden daha az olmuştur.

References

  • Wilson MH, Habig K, Wright C, et al. Pre-hospital emergency medicine. Lancet. 2015;386:2526-34.
  • Miller JM, Das MK, Yadav AV et al. Value of the 12-lead ECG in wide QRS tachycardia. Cardiology Clinics. 2006;24(3):439-51.
  • Akhtar M, Electrophysiologic bases for wide QRS complex tachycardia. PACE. 1983;6(1):81-97.
  • Saxon LA, Sudden Cardiac Death: Epidemiology and Temporal Trends. Rev Cardiovasc Med. 2005;6:12-20.
  • Onat A, Uğur M, Çiçek G, et al. The Turkish adult risk factor survey 2009: similar cardiovascular mortality in rural and urban areas / TEKHARF 2009 taraması: Kırsal kesim ve kentlerde benzer kardiyovasküler ölüm riski. Arc Turk Soc Cardiol. 2010;38(3):159-63.
  • El Sayed M, Al Assad R, Abi Aad Y, et al. Measuring the impact of emergency medical services (EMS) on out-of-hospital cardiac arrest survival in a developing country: A key metric for EMS systems' performance. Medicine. 2017;96(29):e7570.
  • Tang PT, Do DH, Li A, et al. Team management of the ventricular tachycardia patient. Arrhythm Electrophysiol Rev. 2018;7(4):238-46.
  • Hoyle RJ, Walker KJ, Thomson G, et al. Accuracy of electrocardiogram interpretation improves with emergency medicine training. Emergency Medicine Australasia. 2007;19(2):143-50.
  • Efil S, Türen S. Ani kardiyak ölüm ve hemşirelik yaklaşımı. Yoğun Bakım Hemşireliği Dergisi. 2015;19(1):36-42.
  • Crocetti M, Thompson R, Electrocardiogram interpretation skills in pediatric residents. Ann Pediatr Cardiol. 2010;3(1):3-7.
  • Özışık O, Sayhan MB, Salt Ö. 112 acil sağlık personelinin elektrokardiyografi hakkındaki bilgi tutum ve davranışlarının saptanması / The knowledge, attitude and behaviorus of 112 emergency medical personnel about electrocardiography. Journal of Academic Research in Nursing. 2020;6(1):8-13 https://doi.org/10.5222/jaren.2018.10437. 2018;1:1-6.
  • Zhang H, Hsu LL. The effectiveness of an education program on nurses' knowledge of electrocardiogram interpretation. Int Emerg Nurs. 2013;21(4);247-51.
  • McManus J, Pfeifer L, Daya M. Accuracy of ECG rhythm strip interpretation by firefighter-paramedics. Prehospital Emergency Care. 2004;8(1):93.
  • Hale P, Lowe R, Seamon JP et al. Paramedic electrocardiogram and rhythm ıdentification: a convenient training device. Prehospital and Disaster Medicine. 2011;26(5);342-45.
  • Jablonover RS, Lundberg E, Zhang Y, et al. Competency in electrocardiogram interpretation among graduating medical students. Teaching and Learning in Medicine. 2014;26(3):279-84.
  • Akıllı NB, Cander B, Köylü R, et al. How much do we know about cardiopulmonary resuscitation? /Kardiyopulmoner resüsitasyonu ne kadar biliyoruz? JAEM. 2012;11:102-5.
  • Passali C, Pantazopoulos I, Dontas I, et al. Evaluation of nurses’ and doctors’ knowledge of basic & advanced life support resuscitation guidelines. Nurse Education in Practice. 2011;11(6):365-9.
  • Fischer H, Strunk G, Neuhold S, et al. The effectiveness of ERC advanced life support (ALS) provider courses for the retention of ALS knowledge. Resuscitation. 2012;83(2):227-231.
  • Snyder CS, Bricker JT, Fenrich AL, et al. Can pediatric residents interpret electrocardiograms? Pediatr Cardiol. 2005;26(4):396-9.
  • Mencl F, Wilber S, Frey J, et al. Paramedic ability to recognize ST-segment elevation myocardial infarction on prehospital electrocardiograms. Prehospital Emergency Care. 2013;17(2):203-10.
  • Morrison LJ, Allan R, Vermeulen M, et al. Conversion rates for prehospital paroxysmal supraventricular tachycardia (psvt) with the addition of adenosine: a before-and-after trial. Prehospital Emergency Care. 2001;5(4):353-9.
  • Goebel PJ, Daya MR, Gunnels MD. Accuracy of arrhythmia recognition in paramedic treatment of paroxysmal supraventricular tachycardia: a ten-year review. Prehospital Emergency Care. 2004;8(2):166-170.
  • Brady WJ, DeBehnke DJ, Wickman LL, et al. Treatment of out‐of‐hospital supraventricular tachycardia: adenosine vs verapamil. Acad Emerg Med. 1996;3(6):574-85.
  • McCabe JL, Adhar GC, Menegazzi JJ, et al. Intravenous adenosine in the prehospital treatment of paroxysmal supraventricular tachycardia. Ann Emerg Med. 1992;21(4):358-61.
  • Haynes BE. Two deaths after prehospital use of adenosine. The Journal of Emergency Medicine. 2001;21(2):151-4.
  • Khalil PA, Berkovich J, Maniaci V, et al. Performance of emergency medical service providers in pediatric and adult simulation of unstable supraventricular tachycardia. Pediatr Emer Care. 2019;00:00-00.
  • Lee CC, Im M, Kim TM, et al. Comparison of traditional advanced cardiac life support (ACLS) course instruction vs. a scenario-based, performance oriented team instruction (SPOTI) method for Korean paramedic students. The Journal of Emergency Medicine. 2010;38(1):89-92.
  • Kara H, Bayır A, Ak A, et al. Prehospital cardiopulmonary resuscitation: A survey of prehospital providers. J Exp Clin Med. 2015;32(3):103-7.

Assessment of the Knowledge Level of Paramedics, Who Serve in Pre-Hospital Emergency Medicine, Regarding the Diagnosis and Treatment of Wide QRS Complex Tachycardia

Year 2021, Volume: 4 Issue: 4, 118 - 124, 29.12.2021
https://doi.org/10.54996/anatolianjem.962768

Abstract

Aim: This study was conducted to investigate the knowledge level of paramedics who work in pre-hospital emergency medicine services in the Konya province, about the diagnosis and treatment of wide QRS complex tachycardia.

Material and Methods: The study sample consisted of 140 paramedics working in emergency health service stations affiliated with the Konya Provincial Ambulance Service. The data were collected through a questionnaire prepared by the researcher inquiring about the diagnosis and treatment of wide QRS complex tachycardia and the demographic characteristics.

Results: With the questionnaire, the definition of tachycardia and the duration of QRS on normal electrocardiography were inquired. It was found that 22.1% of the paramedics did not know the definition of tachycardia, and almost half of them did not know the basic electrocardiography knowledge including the normal duration of QRS. the questions about ventricular tachycardia, pulseless ventricular tachycardia, stable ventricular tachycardia and treatment of unstable ventricular tachycardia were ansewered correctly 43.6%,68.6%,62.1% and 29.3% respectively. The knowledge level of paramedics was seen to increase as professional seniority and age increased.

Conclusion: Working years, age, type of high school, and participation in scenario-based simulation training were determined to be the most important factors for correct answers to the questions. In addition, the knowledge level of paramedics about the diagnosis and treatment of wide QRS complex tachycardia was found to be poorer than expected.

References

  • Wilson MH, Habig K, Wright C, et al. Pre-hospital emergency medicine. Lancet. 2015;386:2526-34.
  • Miller JM, Das MK, Yadav AV et al. Value of the 12-lead ECG in wide QRS tachycardia. Cardiology Clinics. 2006;24(3):439-51.
  • Akhtar M, Electrophysiologic bases for wide QRS complex tachycardia. PACE. 1983;6(1):81-97.
  • Saxon LA, Sudden Cardiac Death: Epidemiology and Temporal Trends. Rev Cardiovasc Med. 2005;6:12-20.
  • Onat A, Uğur M, Çiçek G, et al. The Turkish adult risk factor survey 2009: similar cardiovascular mortality in rural and urban areas / TEKHARF 2009 taraması: Kırsal kesim ve kentlerde benzer kardiyovasküler ölüm riski. Arc Turk Soc Cardiol. 2010;38(3):159-63.
  • El Sayed M, Al Assad R, Abi Aad Y, et al. Measuring the impact of emergency medical services (EMS) on out-of-hospital cardiac arrest survival in a developing country: A key metric for EMS systems' performance. Medicine. 2017;96(29):e7570.
  • Tang PT, Do DH, Li A, et al. Team management of the ventricular tachycardia patient. Arrhythm Electrophysiol Rev. 2018;7(4):238-46.
  • Hoyle RJ, Walker KJ, Thomson G, et al. Accuracy of electrocardiogram interpretation improves with emergency medicine training. Emergency Medicine Australasia. 2007;19(2):143-50.
  • Efil S, Türen S. Ani kardiyak ölüm ve hemşirelik yaklaşımı. Yoğun Bakım Hemşireliği Dergisi. 2015;19(1):36-42.
  • Crocetti M, Thompson R, Electrocardiogram interpretation skills in pediatric residents. Ann Pediatr Cardiol. 2010;3(1):3-7.
  • Özışık O, Sayhan MB, Salt Ö. 112 acil sağlık personelinin elektrokardiyografi hakkındaki bilgi tutum ve davranışlarının saptanması / The knowledge, attitude and behaviorus of 112 emergency medical personnel about electrocardiography. Journal of Academic Research in Nursing. 2020;6(1):8-13 https://doi.org/10.5222/jaren.2018.10437. 2018;1:1-6.
  • Zhang H, Hsu LL. The effectiveness of an education program on nurses' knowledge of electrocardiogram interpretation. Int Emerg Nurs. 2013;21(4);247-51.
  • McManus J, Pfeifer L, Daya M. Accuracy of ECG rhythm strip interpretation by firefighter-paramedics. Prehospital Emergency Care. 2004;8(1):93.
  • Hale P, Lowe R, Seamon JP et al. Paramedic electrocardiogram and rhythm ıdentification: a convenient training device. Prehospital and Disaster Medicine. 2011;26(5);342-45.
  • Jablonover RS, Lundberg E, Zhang Y, et al. Competency in electrocardiogram interpretation among graduating medical students. Teaching and Learning in Medicine. 2014;26(3):279-84.
  • Akıllı NB, Cander B, Köylü R, et al. How much do we know about cardiopulmonary resuscitation? /Kardiyopulmoner resüsitasyonu ne kadar biliyoruz? JAEM. 2012;11:102-5.
  • Passali C, Pantazopoulos I, Dontas I, et al. Evaluation of nurses’ and doctors’ knowledge of basic & advanced life support resuscitation guidelines. Nurse Education in Practice. 2011;11(6):365-9.
  • Fischer H, Strunk G, Neuhold S, et al. The effectiveness of ERC advanced life support (ALS) provider courses for the retention of ALS knowledge. Resuscitation. 2012;83(2):227-231.
  • Snyder CS, Bricker JT, Fenrich AL, et al. Can pediatric residents interpret electrocardiograms? Pediatr Cardiol. 2005;26(4):396-9.
  • Mencl F, Wilber S, Frey J, et al. Paramedic ability to recognize ST-segment elevation myocardial infarction on prehospital electrocardiograms. Prehospital Emergency Care. 2013;17(2):203-10.
  • Morrison LJ, Allan R, Vermeulen M, et al. Conversion rates for prehospital paroxysmal supraventricular tachycardia (psvt) with the addition of adenosine: a before-and-after trial. Prehospital Emergency Care. 2001;5(4):353-9.
  • Goebel PJ, Daya MR, Gunnels MD. Accuracy of arrhythmia recognition in paramedic treatment of paroxysmal supraventricular tachycardia: a ten-year review. Prehospital Emergency Care. 2004;8(2):166-170.
  • Brady WJ, DeBehnke DJ, Wickman LL, et al. Treatment of out‐of‐hospital supraventricular tachycardia: adenosine vs verapamil. Acad Emerg Med. 1996;3(6):574-85.
  • McCabe JL, Adhar GC, Menegazzi JJ, et al. Intravenous adenosine in the prehospital treatment of paroxysmal supraventricular tachycardia. Ann Emerg Med. 1992;21(4):358-61.
  • Haynes BE. Two deaths after prehospital use of adenosine. The Journal of Emergency Medicine. 2001;21(2):151-4.
  • Khalil PA, Berkovich J, Maniaci V, et al. Performance of emergency medical service providers in pediatric and adult simulation of unstable supraventricular tachycardia. Pediatr Emer Care. 2019;00:00-00.
  • Lee CC, Im M, Kim TM, et al. Comparison of traditional advanced cardiac life support (ACLS) course instruction vs. a scenario-based, performance oriented team instruction (SPOTI) method for Korean paramedic students. The Journal of Emergency Medicine. 2010;38(1):89-92.
  • Kara H, Bayır A, Ak A, et al. Prehospital cardiopulmonary resuscitation: A survey of prehospital providers. J Exp Clin Med. 2015;32(3):103-7.
There are 28 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original Articles
Authors

Yasin Can 0000-0001-7197-7589

Hasan Kara 0000-0002-3839-7651

Publication Date December 29, 2021
Published in Issue Year 2021 Volume: 4 Issue: 4

Cite

AMA Can Y, Kara H. Assessment of the Knowledge Level of Paramedics, Who Serve in Pre-Hospital Emergency Medicine, Regarding the Diagnosis and Treatment of Wide QRS Complex Tachycardia. Anatolian J Emerg Med. December 2021;4(4):118-124. doi:10.54996/anatolianjem.962768