Qualitative evaluation of ambulance paramedic staff’s medication practices and awareness in cardiovascular emergency care

Ambulance paramedics are essential in the early management of cardiovascular emergencies, where timely and accurate medication administration can significantly influence patient outcomes. Despite their frontline role, limited research has explored paramedics’ medication practices and awareness in these high-pressure, prehospital settings. This study investigates the lived experiences and decision-making processes of paramedic staff in the UAE to identify challenges and opportunities for improving practice. A qualitative research design was employed using semi-structured, open-ended interviews with paramedics of varying scopes of practice across multiple ambulance coverage points in the UAE. Purposive sampling was used to recruit participants during their duty shifts, partly adopting convenience sampling. Interviews were audio-recorded using smartphone applications, and thematic analysis was conducted using ATLAS.ti Version 24.1.1. Of the fifteen paramedics interviewed, six met the inclusion criteria and were included in the final analysis. Data saturation was achieved with six participants, yielding 265 unique quotations and 25 recurring codes. Six core themes emerged and were grouped into two categories: Challenges in Cardiovascular Medication Use (Highly Demanding, High-Stake – High-Risk Medication, Tight Scope of Practice) and Strengths and Opportunities for Improvement in Practice (Value-Laden, Medicines Stewardship, Enhanced Scope of Practice). These themes formed a conceptual framework—the “Value-based Care Ladder”—illustrating a progressive path for improving paramedic medication practice. The findings underscore the need for continuous education, hands-on training, and expanded clinical exposure to emergency medications, alongside the development of interpersonal and ethical competencies. These efforts are vital for cultivating a confident, competent, and well-prepared paramedical workforce in prehospital cardiovascular care.