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ECG Case Series ECG case series for paramedics: August 2024 Charles Bloe, Lead Nurse for Cardiology, Coronary Care Unit, Raigmore Hospital, Inverness, UK. Email: charles.bloe@nhs.scot This 58-year-old man lives in a remote and rural area and presents with central chest pain. He normally keeps fit and well and has no pertinent medical history. He was out for his usual morning jog. He had run for several miles when he became acutely unwell. He had developed a heavy, pressing central chest pain that radiated into his jaws and down both arms. The pain was severe and he rated it as 9 out of 10. He vomited several times. He managed to return to his car and drove himself home. However, he continued to feel very unwell and Figure 1. ECG of a 58-year-old man presenting with a heavy, pressing central chest pain called for an ambulance. He suspected he was having a heart attack. His vital signs were as follows: l Blood pressure: 120/78 mmHg l Pulse: 75 beats per minute l Respiratory rate: 16 breaths per minute l He was apyrexial l SpO2 on air: 97%. The 12-lead electrocardiogram (ECG) in Figure 1 was recorded. Interpretation of the ECG rhythm l The heart rhythm is regular l The heart rate is approximately 75 beats per minute l The rhythm is sinus rhythm l The cardiac axis is normal (positive QRS complexes in Lead I and aVF). There is ST segment elevation of approximately 5 mm across his chest leads V1–V5.There is no T wave inversion or pathological Q waves. This suggests a hyperacute anterior septal ST elevation myocardial infarction (STEMI). Coronary angiography revealed an occluded proximal left anterior descending coronary artery. A single stent was inserted. He went on to make an uneventful recovery. JPP Call for CPD Papers The Journal of Paramedic Practice is seeking articles in various topic areas across the four pillars of paramedic practice for its Continuing and Professional Development platform. Contact the editor to contribute articles in paramedic research, clinical practice, education and leadership management. CPD jpp@markallengroup.com Volume 12 Number 3 www.paramedicpractice.com Journal of PARAMEDICPRACTICEThe clinical monthly for emergency care professionals March 2020 EDITORIAL Quality in practice: raising the bar CLINICAL PRACTICE Triage system performance: consistency and accuracy in the emergency centre RESEARCH Point-of-care testing by paramedics using a portable laboratory: an evaluation LEADERSHIP AND MANAGEMENT Effective clinical feedback provision to ambulance clinicians: a literature review CLINICAL EXAMINATION SERIES Cranial nerves: part 2 SPOTLIGHT ON RESEARCH Quality improvement JPAR_2020_12_3_89_Cover March.indd 89 www.paramedicpractice.com lthcare Ltd Hea MA 2024 © 314 https://doi.org/10.12968/jpar.2024.0058 Vol 16 No 8 • Journal of Paramedic Practice
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Minds and Machines Innovation and integrity: AI in paramedic education Joe Frankland, Paramedic Lecturer, University of Bradford, UK. Email: j.frankland4@bradford.ac.uk lthcare Ltd Hea MA 2024 © The College of Paramedics (2024) recently released the updated version of its paramedic curriculum, which adheres to several crucial documents that ensure the highest quality of paramedic education in the UK and compliance with essential standards. This curriculum outlines the intended learning outcomes necessary for a student paramedic to register as a paramedic and practice safely and effectively. Learning outcomes are generally assessed through various methods in paramedic curricula to guarantee that students have gained the requisite knowledge, skills, and attitudes to become proficient paramedics. These assessment methods may include written assignments, practical demonstrations, simulations, clinical placements, multiple-choice examinations, and others. By employing diverse assessment strategies, educators can comprehensively evaluate students’ progress and readiness to enter the paramedic profession. However, the increasing sophistication and accessibility of artificial intelligence (AI) technologies pose significant challenges to the authenticity and integrity of certain assessments in paramedic curricula. An authentic assessment effectively evaluates a student’s true intellectual abilities and depth of understanding by requiring them to complete tasks that showcase their higher-order thinking skills and ability to solve complex problems (Koh, 2017). In written assessments, the process of researching, organising, and critically thinking through the topic is just as important as the essay itself. Effective essays demonstrate the student’s ability to engage with the subject matter, analyse information, and communicate effectively. This aligns with authentic assessment principles, which seek to evaluate a student’s true intellectual abilities and depth of understanding. However, the rise of large language models (LLMs) poses significant challenges to the authenticity of written assessments. LLMs, such as GPT, can generate highly coherent and contextually relevant text, making it difficult to distinguish between human-written and AI-generated essays (Cotton et al, 2023; Perkins, 2023). This means that students could potentially use LLMs to complete their essay assignments, bypassing the crucial process of researching, organising, and critically engaging with the subject matter. The use of LLMs in essay assessments undermines the purpose of authentic assessment, as it becomes challenging to evaluate a student’s true intellectual abilities and depth of understanding when the task can be completed by an AI system (Perkins, 2023). This raises concerns about the validity and reliability of written assessments in the face of advanced language models (Kumar et al, 2023). Vol 16 No 8 • Journal of Paramedic Practice https://doi.org/10.12968/jpar.2024.0041 315

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ECG Case Series

ECG case series for paramedics: August 2024

Charles Bloe, Lead Nurse for Cardiology, Coronary Care Unit, Raigmore Hospital, Inverness, UK. Email: charles.bloe@nhs.scot

This 58-year-old man lives in a remote and rural area and presents with central chest pain. He normally keeps fit and well and has no pertinent medical history. He was out for his usual morning jog. He had run for several miles when he became acutely unwell. He had developed a heavy, pressing central chest pain that radiated into his jaws and down both arms. The pain was severe and he rated it as 9 out of 10. He vomited several times. He managed to return to his car and drove himself home. However, he continued to feel very unwell and

Figure 1. ECG of a 58-year-old man presenting with a heavy, pressing central chest pain called for an ambulance. He suspected he was having a heart attack.

His vital signs were as follows: l Blood pressure: 120/78 mmHg l Pulse: 75 beats per minute l Respiratory rate: 16 breaths per minute l He was apyrexial l SpO2 on air: 97%. The 12-lead electrocardiogram (ECG) in Figure 1 was recorded.

Interpretation of the ECG rhythm l The heart rhythm is regular l The heart rate is approximately 75 beats per minute l The rhythm is sinus rhythm l The cardiac axis is normal (positive QRS

complexes in Lead I and aVF). There is ST segment elevation of approximately 5 mm across his chest leads V1–V5.There is no T wave inversion or pathological Q waves. This suggests a hyperacute anterior septal ST elevation myocardial infarction (STEMI).

Coronary angiography revealed an occluded proximal left anterior descending coronary artery. A single stent was inserted. He went on to make an uneventful recovery. JPP

Call for CPD Papers

The Journal of Paramedic Practice is seeking articles in various topic areas across the four pillars of paramedic practice for its Continuing and Professional Development platform. Contact the editor to contribute articles in paramedic research, clinical practice, education and leadership management.

CPD

jpp@markallengroup.com

Volume 12 Number 3

www.paramedicpractice.com

Journal of

PARAMEDICPRACTICEThe clinical monthly for emergency care professionals

March 2020

EDITORIAL Quality in practice: raising the bar CLINICAL PRACTICE Triage system performance: consistency and accuracy in the emergency centre RESEARCH Point-of-care testing by paramedics using a portable laboratory: an evaluation LEADERSHIP AND MANAGEMENT Effective clinical feedback provision to ambulance clinicians: a literature review CLINICAL EXAMINATION SERIES Cranial nerves: part 2

SPOTLIGHT ON RESEARCH

Quality improvement

JPAR_2020_12_3_89_Cover March.indd 89

www.paramedicpractice.com lthcare Ltd

Hea

MA

2024

©

314 https://doi.org/10.12968/jpar.2024.0058

Vol 16 No 8 • Journal of Paramedic Practice

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