Introduction

During 2022 over 53,000 emergency calls for chest pain were made to the Scottish Ambulance Service (SAS). One differential of chest pain is Acute Coronary Syndrome (ACS) whereby fissuring of atheromatous plaque causes a narrowing or occlusion of the coronary arteries leading to myocardial injury or death. It is a leading cause of mortality and morbidity worldwide. Paramedics seek specific ECG changes to support ACS diagnosis, specifically ST-segment elevation; this triggers the ACS pathway and emergency conveyance to definitive care (Primary Percutaneous Coronary Intervention). However, the cardiac electrophysiology of an ECG is an intangible and complex system with clinical indicators commonly deemed difficult to comprehend. Interpretation remains an ongoing challenge for new and experienced paramedics and novel ways to support interpretation are needed.

Methods

An interactive Augmented Reality mobile application which conveys a 3D anatomical heart model alongside varying clinical ECG presentations to enhance user knowledge of cardiac electrophysiology, was developed. The usability and effectiveness of the application was tested on a cohort of newly qualified paramedics (NQP’s) in the SAS, using the System Usability Scale, and comparing initial and post intervention knowledge of ECG interpretation.

Results

Ten NQP’s agreed to particpate. Knowledge significantly increased an average of 22% from pre- (M = 4.8 ± 1.62) to post-test (M = 7.0 ± 1.49) scoring. The application received an average usability score of 82.8, 24.8 points higher than the SUS standardised reference benchmark of 68.

Discussion/Conclusion

Improving interpretation of ECG within the context of pathophysiology of ACS may improve paramedics’ diagnostic accuracy of ST elevation and therefore impact positively on patient outcome. Our experimental findings suggest the current efficacy of the application in facilitating user knowledge and support recommendations for future research. Though, further testing is needed to confirm the current trends and validate the application in a medical context.