Document Type : Case Report
Malayer School of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Clinical Research Development Unit, Shahid Mostafa Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran
Department of Nursing, Malayer Branch, Islamic Azad University, Malayer, Iran
Department of Nursing, School of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
Cardiovascular emergencies have a high prevalence and are important among other pre-hospital emergencies. In such emergency situations, making decisions to provide the best care and transport to the hospital are brought with many challenges. The current study reports paramedics’ on-scene decision-making challenges in relation to a patient with the acute coronary syndrome. The case was an old woman who complained of sudden dizziness and weakness. The patient’s vital signs included a blood pressure of 100/70 mm Hg, heart rate of 58 beats per minute, respiratory rate of 17 breaths per minute, O2 sat of 96% and blood sugar of 145 mg/dL. The past medical history of the patient indicated that she had no previous disease or use of medications. In the hospital emergency unit, electrocardiography was recorded and ST-segment elevation myocardial infarction was observed.
Paramedics face many challenges in on-scene decision making, which affect the time, process, and consequences of their decisions. In low and middle-income countries, due to resource limitations, all ambulances are not equipped with diagnostic equipment including portable sonograph and electrocardiograms. In such contexts, decision-making protocols need to be designed and used at the emergency scenes to guide the paramedic and ensure their optimal performance.