ASSESSMENT OF LUNG AUSCULTATION BY PARAMEDICS

Study objective: To determine how accurately paramedics interpret comm on lung sounds on an audiotape in comparison with emergency physicians . Methods: We carried out a prospective comparison of blinded lung sou nd interpretation using a standard teaching tape. Our subjects were 67 experienced paramedics and 22 new paramedics from urban and suburban emergency medical services systems comprising municipal and private am bulance providers; acid 18 emergency physicians. Five common lung soun ds were played three times, in different sequences, and with additiona l patient history provided for each repetition. The members of each gr oup listened to the same tape and were asked to identify the lung soun ds. Results: Emergency physicians had a median score of five of five p ossible correct responses in each of the three trials. This score was significantly higher than those of experienced acid new paramedics. Ex perienced paramedics (P=.001) and new paramedics (P=.002) significantl y increased their median scores over the three trials with additional medical history. We found no significant difference between experience d and new paramedics in any of the three trials. Conclusion: In our st udy, paramedics did not assess lung sounds as accurately as emergency physicians, and experienced paramedics did not interpret sounds more a ccurately than new paramedics. Correct identification of lung sounds i mproved significantly for paramedics when medical history was known.