Randomized Controlled Trial of Point-of-Care Ultrasound Education for the Recognition of Tension Pneumothorax by Paramedics in Prehospital Simulation

The primary goal of this study was to determine if ultrasound (US) use after brief point-of-care ultrasound (POCUS) training on cardiac and lung exams would result in more paramedics correctly identifying a tension pneumothorax (TPTX) during a simulation scenario. A randomized controlled, simulation...

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Bibliographic Details
Published in:Prehospital and disaster medicine 2021-02, Vol.36 (1), p.74-78
Main Authors: Khalil, Paul A., Merelman, Andrew, Riccio, John, Peterson, Jodi, Shelton, Ryan, Meyers, Jeff, Ketchmark, Tim, Garneau, Emily, Khalil, Stephanie, Roosevelt, Genie, Toney, Amanda
Format: Article
Language:English
Subjects:
Blood pressure
Education
Emergency medical care
Fires
Health technology assessment
Intervention
Original Research
Paramedics
Pneumothorax
Point of care testing
Simulation
Training
Ultrasonic imaging
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Summary:The primary goal of this study was to determine if ultrasound (US) use after brief point-of-care ultrasound (POCUS) training on cardiac and lung exams would result in more paramedics correctly identifying a tension pneumothorax (TPTX) during a simulation scenario. A randomized controlled, simulation-based trial of POCUS lung exam education investigating the ability of paramedics to correctly diagnose TPTX was performed. The US intervention group received a 30-minute cardiac and lung POCUS lecture followed by hands-on US training. The control group did not receive any POCUS training. Both groups participated in two scenarios: right unilateral TPTX and undifferentiated shock (no TPTX). In both scenarios, the patient continued to be hypoxemic after verified intubation with pulse oximetry of 86%-88% and hypotensive with a blood pressure of 70/50. Sirens were played at 65 decibels to mimic prehospital transport conditions. A simulation educator stated aloud the time diagnoses were made and procedures performed, which were recorded by the study investigator. Paramedics completed a pre-survey and post-survey. Thirty paramedics were randomized to the control group; 30 paramedics were randomized to the US intervention group. Most paramedics had not received prior US training, had not previously performed a POCUS exam, and were uncomfortable with POCUS. Point-of-care US use was significantly higher in the US intervention group for both simulation cases (P
ISSN:1049-023X
1945-1938
DOI:10.1017/S1049023X20001399