Acquisition and interpretation of focused diagnostic ultrasound images by ultrasound-naive advanced paramedics: trialling a PHUS education programme
Brooke, Mike Walton, Julie Scutt, Diane Connolly, Jim Jarman, Bob
Brooke, Mike
Walton, Julie
Scutt, Diane
Connolly, Jim
Jarman, Bob
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Abstract
Objective This trial investigated whether advanced
paramedics from a UK regional ambulance service have
the ability to acquire and interpret diagnostic quality
ultrasound images following a 2-day programme of
education and training covering the fundamental aspects
of lung ultrasound.
Method The participants were tested using a two-part
examination; assessing both their theoretical
understanding of image interpretation and their practical
ability to acquire diagnostic quality ultrasound images.
The results obtained were subsequently compared with
those obtained from expert physician sonographers.
Results The advanced paramedics demonstrated an
overall accuracy in identifying the presence or absence of
pneumothorax in M-mode clips of 0.94 (CI 0.86 to 0.99),
compared with the experts who achieved 0.93 (CI 0.67
to 1.0). In two-dimensional mode, the advanced
paramedics demonstrated an overall accuracy of 0.78 (CI
0.72 to 0.83), compared with the experts who achieved
0.76 (CI 0.62 to 0.86). In total, the advanced paramedics
demonstrated an overall accuracy at identifying the
presence or absence of pneumothorax in prerecorded
video clip images of 0.82 (CI 0.77 to 0.86), in comparison
with the expert users of 0.80 (CI 0.68 to 0.88). All of the
advanced paramedics passed the objective structured
clinical examination and achieved a practical standard
considered by the examiners to be equivalent to that
which would be expected from candidates enrolled on
the thoracic module of the College of Emergency
Medicine level 2 ultrasound programme.
Conclusion This trial demonstrated that ultrasoundnaive practitioners can achieve an acceptable standard
of competency in a simulated environment in a relatively
short period of time.
https://emj.bmj.com/content/emermed/29/4/322.full.pdf
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
http://dx.doi.org/10.1136/emj.2010.106484