Emerg Med J 30:334-338 doi:10.1136/emermed-2011-200839
  • Prehospital care

The impact of intense airway management training on paramedic knowledge and confidence measured before, immediately after and at 6 and 12 months after training

  1. Alix E Carter5
  1. 1Emergency Health Services, Halifax, Nova Scotia, Canada
  2. 2Emergency Health Services, Division of EMS, Faculty of Health Professions, Dalhousie University, Halifax, Nova Scotia, Canada
  3. 3Emergency Health Services, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
  4. 4Emergency Health Services, Department of Emergency Medicine, Division of EMS, Dalhousie University, Halifax, Nova Scotia, Canada
  5. 5Emergency Health Services, Department of Emergency Medicine, Dalhousie University, Division of EMS, Halifax, Nova Scotia, Canada
  1. Correspondence to Jan L Jensen, Emergency Health Services, 239 Brownlow Avenue, Dartmouth, Nova Scotia B2B3B3, Canada; jan.jensen{at}
  1. Contributors All members of the study group took part in the study design. MW and YL collected the data. YL undertook the data entry process. AC completed the statistical analysis. All members took part in the analysis of the results, writing and editing of the manuscript.

  • Accepted 24 April 2012
  • Published Online First 23 May 2012


Introduction Airway management is a core component in the practice of advanced life support (ALS) paramedics.

Objective To determine if an intense airway management course would improve ALS paramedic knowledge and confidence and if knowledge was retained over time.

Methods An identical written survey (measuring demographics and confidence) and multiple-choice examination (measuring knowledge) was administered at the start and end of a 10 h airway course. At 6 and 12 months after the course, paramedics took the knowledge examination. Paired confidence and written knowledge examination scores before and immediately after the course were compared. Differences between knowledge examination scores at all four time points (before, immediately after and at 6 and 12 months) were tested using analysis of variance and Tukey's test.

Results 299 ALS paramedics were enrolled in the study. 209 (69%) reported 6 or more years of ALS experience. The mean pre-course confidence score was 2.74/4 and the mean post-course confidence score was 3.39/4; a difference of 0.7 points (95% CI 0.61 to 0.71). Post-course examination scores improved by 4.9 points (95% CI 4.58 to 5.20), from 7.7 to 12.6/20. At 6 months the mean score was 10.3/20, and at 12 months 10.2/20. Post-course scores were significantly better than pre-course scores. Scores at 6 and 12 months did not differ significantly and remained significantly improved from pre-course scores.

Conclusion Significant improvement in confidence and knowledge was found after paramedics completed an intense airway management course. Knowledge at 6 and 12 months remained significantly better compared with pre-course.


  • Funding YL was briefly funded (the first 2 months of the study in 2009) by the Dalhousie University Medical Research Foundation through a grant for medical students undertaking summer research projects. Otherwise, this was an unfunded study, supported by Emergency Health Services and EHS Operations Management.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by Capital District Health Authority Research Ethics Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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Among patients with minor TBI (GCS 13-15) getting CT scans ≥ 24 hours after injury, what proportion have a traumatic finding?


0.5% - 43% response rate
3% - 41% response rate
10% - 16% response rate

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