One hour, one-to-one semistructured interviews were conducted using a general interview guide (online supplemental file 1). The internet carriage service Skype was used, which is a Voice over Internet Protocol (VoIP).18 VoIP was beneficial in the COVID-19 pandemic context as paramedics are a scattered workforce, practising social distancing during the study and this approach minimised time needed away from clinical duties to participate. Interviews were video recorded with memos taken, transcribed verbatim and checked for accuracy against the recordings.


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