ASSESSMENT OF BREATH SOUNDS DURING AMBULANCE TRANSPORT

Study objective: To determine whether the environment of a moving ambu lance affects the ability of out-of-hospital care providers to auscult ate breath sounds. Methods: Out-of-hospital care providers assessed br eath sounds with a previously described breath-sounds model in a quiet environment (control) and in a moving ambulance. The setting was a no nurban emergency medical services system and an interhospital transpor t agency based at a 600-plus-bed tertiary care center. The participant s were physicians, transport nurses, and advanced life support EMS pro viders routinely involved in the emergency out-of-hospital treatment a nd transportation of the ill and injured. The accuracy with which part icipants identified the presence or absence of breath sounds in the tw o environments was compared with the use of the chi(2) test, with the alpha-value set at .05. Results: The accuracy of breath-sounds assessm ent in the control environment was 96% (251 of 260); the sensitivity w as 96% and the specificity 97%. The accuracy of breath-sounds assessme nt in the experimental environment was 54% (140 of 260); the sensitivi ty was .09% and the specificity 98%. Participants were significantly l ess likely to hear breath sounds in the moving ambulance than in the q uiet room (P<.001). Conclusion: Assessment of breath sounds is hampere d by the environment of a moving ambulance.