PMID- 19746252
OWN - NLM
STAT- MEDLINE
DCOM- 20090929
LR  - 20211020
IS  - 1916-7075 (Electronic)
IS  - 0828-282X (Print)
IS  - 0828-282X (Linking)
VI  - 25
IP  - 9
DP  - 2009 Sep
TI  - Evaluating the views of paramedics, cardiologists, emergency department 
      physicians and nurses on advanced prehospital management of acute ST elevation 
      myocardial infarction.
PG  - e323-8
AB  - BACKGROUND: Although advanced prehospital management (PHM) in ST elevation 
      myocardial infarction (STEMI) reduces reperfusion delay and improves patient 
      outcomes, its use in North America remains uncommon. Understanding perceived 
      barriers to and facilitators of PHM implementation may support the expansion of 
      programs, with associated patient benefit. OBJECTIVE: To explore the attitudes 
      and beliefs of paramedics, cardiologists, emergency physicians and nurses 
      regarding these issues. METHODS: To maximize the potential to identify 
      unpredictable issues within each of the four groups, focus group sessions were 
      recorded, transcribed and analyzed for themes using the constant comparative 
      method. RESULTS: All 18 participants believed that PHM of STEMI decreased time to 
      treatment and improved health outcomes. Despite agreeing that most paramedics 
      were capable of providing PHM, regular maintenance of competence and medical 
      overview were emphasized. Significant variations in perceptions were revealed 
      regarding practical aspects of the PHM process and protocol, as well as ownership 
      and responsibility of the patient. Success and failures of technology were also 
      expressed. Varying arguments against a signed 'informed consent' were presented 
      by the majority. CONCLUSIONS: Focus group discussions provided key insights into 
      potential barriers to and facilitators of PHM in STEMI. Although all groups were 
      supportive of the concept and its benefits, concerns were expressed and potential 
      barriers identified. This novel body of knowledge will help elucidate future 
      educational programs and protocol development, and identify future challenges to 
      ensure successful PHM of STEMI, thereby reducing reperfusion delay and improving 
      patient outcomes.
FAU - Rajabali, Naheed A
AU  - Rajabali NA
AD  - Walter C Mackenzie Health Sciences Centre, University of Alberta Hospital, 
      Edmonton, Alberta T6G 2B7, Canada.
FAU - Tsuyuki, Ross T
AU  - Tsuyuki RT
FAU - Sookram, Sunil
AU  - Sookram S
FAU - Simpson, Scot H
AU  - Simpson SH
FAU - Welsh, Robert C
AU  - Welsh RC
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PL  - England
TA  - Can J Cardiol
JT  - The Canadian journal of cardiology
JID - 8510280
SB  - IM
MH  - Alberta/epidemiology
MH  - Allied Health Personnel/*standards
MH  - Attitude of Health Personnel
MH  - Delivery of Health Care/organization & administration
MH  - *Electrocardiography
MH  - Emergency Medical Services/*organization & administration
MH  - Emergency Nursing/organization & administration
MH  - Follow-Up Studies
MH  - *Health Knowledge, Attitudes, Practice
MH  - Humans
MH  - Informed Consent
MH  - Morbidity/trends
MH  - Myocardial Infarction/epidemiology/physiopathology/*therapy
MH  - Nurses/*standards
MH  - Physicians/*standards
MH  - Rural Health Services/organization & administration
MH  - Urban Health Services/organization & administration
PMC - PMC2780893
EDAT- 2009/09/12 06:00
MHDA- 2009/09/30 06:00
PMCR- 2010/09/01
CRDT- 2009/09/12 06:00
PHST- 2009/09/12 06:00 [entrez]
PHST- 2009/09/12 06:00 [pubmed]
PHST- 2009/09/30 06:00 [medline]
PHST- 2010/09/01 00:00 [pmc-release]
AID - S0828-282X(09)70146-1 [pii]
AID - cjc25e323 [pii]
AID - 10.1016/s0828-282x(09)70146-1 [doi]
PST - ppublish
SO  - Can J Cardiol. 2009 Sep;25(9):e323-8. doi: 10.1016/s0828-282x(09)70146-1.