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Training paramedics in focussed echo in life support

Booth, Katherine L.a; Reed, Matthew J.a,b,d; Brady, Shirind; Cranfield, Kristina R.d; Kishen, Ravind; Letham, Katyd; McAlpine, Graemed; Murray, Douglas B.d; Wilson, Emma-Bethd; Wilson, Miked; Short, Stevenc; Clegg, Gareth R.a,b,c,d

European Journal of Emergency Medicine: December 2015 - Volume 22 - Issue 6 - p 430–435
doi: 10.1097/MEJ.0000000000000246

Objectives The aim of this study was to determine whether paramedics can be trained to perform and interpret focussed Echo in Life Support (ELS) for the assessment of cardiac movement and the recognition of reversible causes of cardiac arrest.

Methods This study is a prospective observational pilot study. Data were collected during a 1-day course training 11 paramedics to perform ELS scans on healthy volunteers. The students were assessed on image acquisition skills and theoretical knowledge (including interpretation). Level 1 ultrasound-trained emergency medicine physicians undertook the training and assessment.

Results All paramedics could obtain images in the parasternal and subxiphoid views. When performing scans in the 10-s pulse check window, 88% of attempts in both views were successful (subxiphoid mean image quality 3.8 out of 5, parasternal 4.0). Theoretical knowledge improved (mean precourse score 54%, postcourse score 89%; P<0.001). There was no apparent association between theoretical and practical performances. At 10 weeks, theoretical knowledge was nonsignificantly reduced (82%; P=0.13) but less when compared with practical performance (75% subxiphoid success, mean quality 3.0; 25% parasternal success, mean quality 4.0).

Conclusion Paramedics can perform focused ELS, integrate attempts into simulated cardiac arrest scenarios and retain some of this knowledge. Further work is required to assess the feasibility of incorporating this into real-world cardiac arrest management.

aCollege of Medicine and Veterinary Medicine, University of Edinburgh

bEmergency Medicine Research Group Edinburgh (EMeRGE)

cResuscitation Research Group

dDepartment of Emergency Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK

Correspondence to Matthew J. Reed, MA, MBBChir, MD, MRCS, FCEM, Department of Emergency Medicine, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK Tel: +44 131 242 1448; fax: +44 131 242 1339;e-mail:

Received September 29, 2014

Accepted December 22, 2014

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