Descriptive statistics of the study population.

Background
Management of acute myocardial infarction (AMI) and cardiac arrhythmias in prehospital settings is largely determined by providers of emergency medical services (EMS) who can proficiently interpret the electrocardiography (ECG). The aim of this study was to assess the ECG competency of EMS providers in Saudi Arabia.
Methods
Between Aug and Sep 2022, we invited all EMS providers working for the Saudi Red Crescent Authority in Makkah, Riyadh, and Sharqiyah regions to complete a cross-sectional survey. The survey was used to assess the ability of EMS providers to interpret 12 ECG strips. Characteristics and ECG competency were summarized using descriptive statistics. Differences in ECG competency across paramedics with lower and higher qualifications were assessed.
Results
During the study period, 231 participants completed the survey, and all were included. The overall mean age was 33.4, and most participants were male (94.8%). Nearly half of the participants were paramedics with an associate degree and 46.4% were paramedics with higher degrees. The average rate of correct answers to the 12 ECG strips was 43.3% (95% CI: 35.4%, 51.3%). Atrial flutter, ventricular fibrillation, atrial fibrillation, 3rd degree heart block, and ventricular tachycardia were identified by 52.8%, 60.2%, 42.0%, 40.7%, and 49.4% of the participants, respectively. The strip with an AMI was identified by 41.1%, while a pathological Q wave and ventricular extrasystole were identified by 19.1% and 24.7%, respectively. Paramedics with higher qualifications were as 28.0%-61.0% more likely to correctly interpret the 12 ECG strips compared to those with an associate degree (p-value across all variables was ≤ 0.001).
Conclusion
While the majority of participants in our region were unable to correctly answer the 12 ECG questionnaire, paramedics with higher qualifications were. Our study indicates that there is a need for evidenced-based ECG curricula targeting different levels of EMS professionals.

背景：院前环境下急性心肌梗死（acute myocardial infarction, AMI）与心律失常的管理，主要由能够熟练解读心电图（electrocardiography, ECG）的急诊医疗服务（Emergency Medical Services, EMS）从业者主导。本研究旨在评估沙特阿拉伯境内急诊医疗服务从业者的心电图解读能力。
方法：2022年8月至9月期间，我们邀请了在麦加、利雅得及东部地区服务于沙特红新月会（Saudi Red Crescent Authority）的所有急诊医疗服务从业者参与一项横断面调查。该调查用于评估急诊医疗服务从业者解读12份心电图条带的能力。采用描述性统计方法总结研究对象的特征及心电图解读能力，并对比了低学历与高学历急救医护人员之间的心电图解读能力差异。
结果：本研究周期内，共有231名参与者完成调查且全部纳入分析。研究对象的平均年龄为33.4岁，绝大多数为男性（占比94.8%）。近半数参与者为持有大专学历的急救医护人员，另有46.4%的参与者拥有高等学历。12份心电图条带的平均正确率为43.3%（95%置信区间：35.4%~51.3%）。分别有52.8%、60.2%、42.0%、40.7%及49.4%的参与者正确识别了心房扑动（atrial flutter）、心室颤动（ventricular fibrillation）、心房颤动（atrial fibrillation）、三度房室传导阻滞（3rd degree heart block）及室性心动过速（ventricular tachycardia）。41.1%的参与者正确识别了提示急性心肌梗死的心电图条带，而仅19.1%与24.7%的参与者分别识别出病理性Q波（pathological Q wave）与室性期前收缩（ventricular extrasystole）。与大专学历的急救医护人员相比，高等学历者正确解读12份心电图条带的概率高出28.0%~61.0%（所有变量的P值均≤0.001）。
结论：尽管本研究纳入地区的多数参与者无法正确完成12份心电图问卷，但高等学历的急救医护人员可做到这一点。本研究表明，亟需针对不同层级急诊医疗服务专业人员制定基于循证医学的心电图培训课程。