Assessment of Electrocardiogram (ECG) Interpretation Proficiency Among Paramedics in a Tertiary Care Teaching Hospital.

Background Electrocardiogram (ECG) interpretation is a critical clinical skill essential for the rapid diagnosis of potentially life-threatening cardiac conditions, such as arrhythmias and myocardial infarctions. Accurate interpretation plays a pivotal role in clinical decision-making, particularly in emergency settings. Paramedics often acquire practical ECG experience during clinical rotations under the guidance of experienced clinicians. Familiarity with standardized guidelines, such as those from the American Heart Association, is fundamental for ensuring accurate and consistent ECG assessments. Aim This study aimed to evaluate the proficiency in ECG interpretation among paramedics at various training and professional levels in a tertiary care teaching hospital, with the goal of improving recognition and resuscitation outcomes in in-hospital cardiac arrests. Materials and methods A cross-sectional observational study was conducted using a validated, self-administered online questionnaire distributed via Google Forms. A total of 90 participants, including BSc Emergency Medical Technology (EMT) and BSc Intensive Care Technology (ICT) students, interns, emergency medical technician (EMT) staff, and emergency room (ER) nursing staff at Amrita Institute of Medical Sciences (AIMS), were surveyed. The questionnaire comprised 15 structured questions assessing ECG interpretation skills. Participants were categorized based on their scores: 0-5 (poor knowledge), 6-10 (average knowledge), and 11-15 (good knowledge). Statistical analysis was conducted using SPSS 20.0, with Kruskal-Wallis and Spearman's correlations applied. Results Among the 90 participants, 66 (73.3%) demonstrated good knowledge, while 24 (26.7%) showed average knowledge; no participant fell into the poor category. The mean total score was 11.86±2.33. Third-year students (mean: 13.21±1.87), interns (12.26±1.59), and staff (12.32±1.92) outperformed second-year students (9.57±2.34). The Kruskal-Wallis test revealed significant differences in the scores across training levels (χ²=26.024, p<0.001). While overall proficiency was high, second-year students and ER nurses scored comparatively lower on specific advanced ECG questions. Conclusion The findings indicate a generally high level of ECG interpretation knowledge among paramedics, especially among advanced-level students. However, there is a clear need for targeted educational interventions and structured training programs, particularly for early-stage students and ER nursing personnel, to strengthen foundational skills in ECG interpretation. The interpretation skills acquired by the personnel have helped them in recognizing ECG rhythms that result in cardiac arrest, which pave the way for early acknowledgment and management.