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Acquisition and interpretation of focused diagnostic ultrasound images by ultrasound-naive advanced paramedics: trialling a PHUS education programme
  1. Mike Brooke1,
  2. Julie Walton2,
  3. Diane Scutt2,
  4. Jim Connolly3,
  5. Bob Jarman4
  1. 1North West Ambulance Service NHS Trust, Bolton, UK
  2. 2University of Liverpool, School of Health Sciences, Liverpool, UK
  3. 3The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
  4. 4Gateshead Health NHS Foundation Trust, Gateshead, UK
  1. Correspondence to Mike Brooke, North West Ambulance Service NHS Trust, c/o, Broughton House, Cumbria and Lancashire HQ, Garstang Rd, Preston PR3 5LN, UK; michael.brooke{at}


Objective This trial investigated whether advanced paramedics from a UK regional ambulance service have the ability to acquire and interpret diagnostic quality ultrasound images following a 2-day programme of education and training covering the fundamental aspects of lung ultrasound.

Method The participants were tested using a two-part examination; assessing both their theoretical understanding of image interpretation and their practical ability to acquire diagnostic quality ultrasound images. The results obtained were subsequently compared with those obtained from expert physician sonographers.

Results The advanced paramedics demonstrated an overall accuracy in identifying the presence or absence of pneumothorax in M-mode clips of 0.94 (CI 0.86 to 0.99), compared with the experts who achieved 0.93 (CI 0.67 to 1.0). In two-dimensional mode, the advanced paramedics demonstrated an overall accuracy of 0.78 (CI 0.72 to 0.83), compared with the experts who achieved 0.76 (CI 0.62 to 0.86). In total, the advanced paramedics demonstrated an overall accuracy at identifying the presence or absence of pneumothorax in prerecorded video clip images of 0.82 (CI 0.77 to 0.86), in comparison with the expert users of 0.80 (CI 0.68 to 0.88). All of the advanced paramedics passed the objective structured clinical examination and achieved a practical standard considered by the examiners to be equivalent to that which would be expected from candidates enrolled on the thoracic module of the College of Emergency Medicine level 2 ultrasound programme.

Conclusion This trial demonstrated that ultrasound-naive practitioners can achieve an acceptable standard of competency in a simulated environment in a relatively short period of time.

  • Education
  • focused ultrasound
  • imaging
  • paramedic
  • pneumothorax
  • prehospital
  • respiratory
  • ultrasound

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  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the North West 1 Research Ethics Committee, Cheshire.

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

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