Birmingham assessment of breathing study (BABS)

Area of Science:

• Emergency Medicine
• Cardiopulmonary Resuscitation
• Medical Education

Background:

• Current resuscitation guidelines for lay rescuers depend on recognizing "normal breathing."
• The accuracy of layperson assessment of breathing patterns is not well-established.
• This study evaluated the ability of medical students to differentiate breathing types and choose appropriate interventions.

Purpose of the Study:

• To assess medical students' ability to discriminate between simulated normal, abnormal, and absent breathing.
• To evaluate the appropriateness of treatment decisions based on breathing assessment by medical students.

Main Methods:

• Six video clips of simulated breathing (normal, shallow, rapid, agonal, absent) were presented to 48 second-year medical students.
• Students indicated if the patient was breathing (normal, abnormal, no) and selected an action (rescue breathing, recovery position).
• Breathing patterns were validated by experienced emergency practitioners prior to student assessment.

Main Results:

• Students misclassified normal breathing as abnormal in 33% of cases and absent in 6%.
• Abnormal breathing was misclassified as normal in 29% and absent in 10% of cases.
• Correct treatment selection occurred in 86% for normal breathing, 51% for abnormal, and 86% for absent breathing.

Conclusions:

• Medical students demonstrated unreliable discrimination between normal and abnormal breathing.
• Inaccurate breathing assessments led to a significant number of potentially harmful treatment choices.
• Re-evaluation of current methods for assessing breathing and circulation in resuscitation is necessary.