ArticlePrehospital emergency care2025
A Qualitative Analysis of Barriers to Evidence-Based Care in the Prehospital Management of Patients with Suspected Acute Coronary Syndrome.
Article in Prehospital emergency care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
4 citing papers in PubMed.
- Self-reported adherence of ambulance nurses to acute chest pain guidelines in Southern Sweden: a cross-sectional study.BMJ open · 2026Article
- Prehospital 12-Lead ECG Use for Suspected Acute Coronary Syndrome Varies by Community Social Vulnerability.Prehospital emergency care · 2026Observational
- Navigating critical time: a qualitative exploration of the experiences of patients and companions in myocardial infarction management.BMC cardiovascular disorders · 2025Article
- Rural Emergency Medical Services Perspectives on Improving Acute Stroke Care: A Qualitative Study.Prehospital emergency care · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectivesPrehospital electrocardiogram (ECG) and administration of aspirin are evidence-based strategies for patients with acute coronary syndrome (ACS). However, emergency medical services (EMS) compliance in patients with suspected ACS varies widely. We sought to understand the barriers to prehospital ECG acquisition and aspirin administration for patients with suspected ACS.
methodsIn this qualitative study, we interviewed EMS clinicians at three geographically diverse United States (U.S.)-based EMS agencies. We interviewed practicing clinicians and quality and operations leaders at these agencies. Based on the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, interviews were recorded, transcribed, and analyzed using a grounded qualitative approach with open coding. The Systems Engineering Initiative for Patient Safety (SEIPS) framework and a constant comparison technique were used to identify and refine themes.
resultsTwenty-five paramedics and 20 additional agency personnel participated. Median age was 41 (IQR: 34-51) years and 13 (29%) were female. Themes were organized using SEIPS and longitudinally through four phases of an EMS call. During the
conclusionsMultiple, interrelated themes underscored the complexities of delivering evidence-based care to prehospital patients with ACS. Education in ECG interpretation, resource allocation, bias, and enhancing feedback may serve as strategies to address the identified barriers.
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