• 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 (2012-04)
      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
    • GP perspectives of paramedic referrals to urgent and primary care

      Burns, John (2018-07)
      Abstract published with permission. Background: This article stemmed from a search for more understanding about how paramedics relate to urgent and primary care (U&PC). Methods: The current study is qualitative, involving interview with seven general practitioners (GPs) in Wirral, Merseyside. Their verbatim evidence was audiorecorded, transcribed and analysed. Findings: There were three superordinate themes established: variability of referrals; the value of referrals sometimes being overlooked; and the need for skills development to improve referrals. Conclusion: The paramedic skillset is essential for appropriate referrals as long as their limitations are considered by GPs, while future research should focus on how paramedic skill bases can evolve in the U&PC community.
    • The unique advantages of advanced paramedic practitioners

      Brown, Lucy; Hedgecock, Liz; Simm, Catherine; Swift, Juliette; Swinburn, Andy (2011-03-22)