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Emergency Medicine Journal 2005;22:738-741; doi:10.1136/emj.2005.025536
© 2005 BMJ Publishing Group Ltd and the College of Emergency Medicine.

PREHOSPITAL CARE

A qualitative study of paramedics’ attitudes to providing prehospital thrombolysis

L Price1, P Keeling2, G Brown3, D Hughes2 and A Barton1

1 Peninsula Research & Development Support Unit, Peninsula Medical School, Plymouth, Devon, UK
2 South Devon Healthcare NHS Trust, Torquay Devon, UK
3 Westcountry Ambulance Services Trust, Exeter, Devon, UK

Correspondence to:
Correspondence to:
Dr P Keeling
Heart/Lung Unit, Torbay District General Hospital, Lawes Bridge, Torquay TQ2 7AA, Devon, UK; keelingsec.sdhct{at}nhs.net

ABSTRACT

Objectives: To explore paramedics’ attitudes to administering prehospital thrombolysis (PHT).

Method: In-depth interviews with 20 paramedics were recorded and transcribed and analysed for emergent themes using the constant comparative method.

Results: Although there was a will to provide PHT because of its benefits to patients, its associated risks, aspects of pay and working conditions, and certain organisational factors undermined the willingness of some paramedics to administer thrombolysis. The eight minute response time standard is a competing imperative which can delay thrombolysis.

Conclusions: A minority of paramedics are likely to be unwilling to deliver PHT unless countervailing imperatives are addressed.

Abbreviations: PHT, prehospital thrombolysis; RRV, rapid response vehicle; STEMI, ST elevation acute myocardial infarction

Keywords: thrombolysis; paramedics; attitudes; qualitative


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