Evaluating the Impact That a Lung Ultrasound Training Program to Detect Acute Heart Failure Has on Paramedic Behavior

Area of Science:

• Emergency Medicine
• Point-of-Care Ultrasound
• Cardiology

Background:

• Paramedic-performed lung ultrasound (LUS) for pulmonary edema and acute heart failure is feasible.
• Limited data exists on the clinical application of LUS by paramedics post-training.

Purpose of the Study:

• To evaluate the behavioral impact of implementing a lung ultrasound (LUS) training program for paramedics.
• To assess the clinical application and effectiveness of LUS performed by paramedics in a prehospital setting.

Main Methods:

• Prospective observational cohort study involving 26 paramedics from a single agency.
• Paramedics underwent 1 hour of LUS training, including didactic and hands-on sessions.
• Independent LUS performance and interpretation by paramedics for 15 months in patients with shortness of breath.

Main Results:

• 22 of 26 paramedics (85%) performed 109 LUS examinations over 15 months.
• Paramedic-performed LUS demonstrated high specificity (91.0%) for pulmonary edema.
• Median image quality was rated 4 out of 5; prehospital treatment changes based on LUS findings were moderate (64.5% of true positives).

Conclusions:

• A LUS training program enabled most paramedics to utilize LUS in clinical practice with high image quality.
• Paramedic-performed LUS showed high specificity in identifying pulmonary edema in the prehospital setting.
• Prehospital management guided by LUS findings for heart failure requires further optimization.