Sebastian Bjöhle

I am a prehospital emergency nurse and a clinical doctoral student at the Department of Clinical Science and Education at Södersjukhuset (KI SÖS). My clinical background includes several years in both cardiac intensive care and emergency medical service, two settings that have fostered my commitment to acute cardiac care and shaped my research interest in the early identification and management of patients suffering from myocardial infarction.

Chest pain, often strongly associated with myocardial infarction, is one of the most common symptoms among patients encountered in prehospital emergency care. Despite this, early and accurate identification of patients with acute myocardial infarction remains a significant challenge, particularly as many of these patients present without classical ECG changes. This clinical uncertainty, together with the risks associated with delayed treatment, has formed the foundation of my doctoral project, which focuses on early identification and clinical decision-making in patients with suspected myocardial infarction in the prehospital setting.

I also serve as a lecturer and course coordinator in the specialist nursing programme in ambulance care at Karolinska Institutet. Contributing to the education of future prehospital emergency nurses is, to me, both meaningful and inspiring. It allows me to integrate pedagogy, research, and clinical experience while also supporting the continued development of prehospital emergency care.

Research

My doctoral project investigates the prehospital management of patients with myocardial infarction, with a particular focus on early identification and clinical decision-making. A central component of my doctoral project is the randomized controlled trial TIGER (The effect of high-sensitivity Troponin I in addition to guideline-based care to identify myocardial infarction in prehospital emergency care – an open-label randomized controlled trial). The study investigates whether a novel point-of-care high-sensitivity troponin I test, used alongside standard prehospital care, can contribute to earlier identification, faster treatment, and improved outcomes. We are among the first in the world to evaluate the clinical utility of high-sensitivity troponin testing in a prehospital setting.

In addition to the TIGER study, my doctoral project includes two qualitative interview studies. The first, which has been completed and published, explored prehospital emergency nurses’ experiences of caring for patients with suspected myocardial infarction. The second qualitative study aims to explore patients’ experiences of suffering a suspected myocardial infarction and being cared for by emergency medical services when a point-of-care high-sensitivity troponin test is performed.

The fourth study is an epidemiological cohort study designed to examine how prehospital emergency nurses’ identification, management, and treatment of patients with suspected myocardial infarction influence patient outcomes. The study is based on seven years of retrospective prehospital medical data, supplemented with outcome data from the regional health care data warehouse (VAL) and the quality registry Swedeheart.

My principal supervisor is Jakob Lederman (PhD, Karolinska Institutet), and my co-supervisor is Veronica Vicente (Associate Professor, Karolinska Institutet). The project is conducted in collaboration with Ambulanssjukvården i Storstockholm AB (AISAB) and has received competitive research funding from Nätverkssjukvården (NSV) in Region Stockholm for the years 2024 and 2025.