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Paramedic Electrocardiogram and Rhythm Identification: A Convenient Training Device
- Peggy Hale, Robert Lowe, Jason P. Seamon, James J. Jenkins
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- Journal:
- Prehospital and Disaster Medicine / Volume 26 / Issue 5 / October 2011
- Published online by Cambridge University Press:
- 10 November 2011, pp. 342-345
- Print publication:
- October 2011
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- Article
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Introduction: A common reason for utilizing local paramedics and the emergency medical services is for the recognition and immediate treatment of chest pain, a complaint that has multiple possible etiologies. While many of those complaining of disease processes responsible for chest pain are benign, some will be life-threatening and will require immediate identification and treatment. The ability of paramedics to not only perform field electrocardiograms (ECGs), but to accurately diagnose various unstable cardiac rhythms has shown significant reduction in time to specific treatments. Increasing the overall accuracy of ECG interpretation by paramedics has the potential to facilitate early and appropriate treatment and decrease patient morbidity and mortality.
Methods: A convenient training device (flip book) on ambulances and in common areas in the fire station could improve field interpretation of certain cardiac rhythms. This training device consists of illustrated sample ECG tracings and their associated diagnostic criteria. The goal was to enhance the recognition and interpretation of ECGs, and thereby, reduce delays in the initiation of treatment and potential complications associated with misinterpretation.
This study was a prospective, observational study using a matched pre-test/post-test design. The study period was from November 2008 to December 2008. A total of 136 paramedics were approached to participate in this study. A pre-test consisting of 15 12-lead ECGs was given to all paramedics who agreed to participate in the study. Once the pre-tests were completed, the flip books were placed in common areas. Approximately one month after the flip books were made available to the paramedics, a post-test was administered.
Statistical comparisons were made between the pre- and post-test scores for both the global test and each type of rhythm.
Results: Using these data, there were no statistically significant improvements in the global ECG interpretation or on individual rhythm interpretations.
Conclusions: A flip book with multiple ECG rhythms and definitions without the benefit of any outside support was not effective in improving paramedic identification of ECG rhythms on a post-test. Suggestions for further research include repeating the study with a larger sample size; utilizing a lecturer to explain how to use the flip book in the most efficient manner; reiterating how to read and interpret ECGs; and answering questions. Comparing test scores of paramedic students, and newly certified paramedics as opposed to veteran paramedics also may indicate that the flip books are more suited for one group over another.
Identifying Victims of Elder Abuse and Neglect: A Training Video for Prehospital Personnel
- Jason P. Seamon, Jeffrey S. Jones, Eric Chun, Jon R. Krohmer
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- Journal:
- Prehospital and Disaster Medicine / Volume 12 / Issue 4 / December 1997
- Published online by Cambridge University Press:
- 28 June 2012, pp. 36-40
- Print publication:
- December 1997
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- Article
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Introduction:
The majority of prehospital emergency medical services (EMS) personnel lack specific training relating to elder abuse and neglect.
Objectives:To develop and test an audio visual training program that focuses on the identification and reporting of domestic violence in the elderly.
Methods:A videotape was designed to be used as a 45-minute training course for prehospital personnel using one-half inch, super-VHS recording. A convenience sample of 60 EMS personnel working in Kent County then were asked to evaluate the videotape program. Each volunteer completed a pre-test on elder abuse and neglect, watched the 45-minute videotape, and then answered 12 questions on a post-test.
Results:Participants had an average of 12.4 years (range: 1–30 years) prehospita emergency-care experience. Only four (7%) could recall any previous training relating to elder abuse or neglect during their career. Although the prevalence of elder abuse in their community was described as “rather rare” by most (60%) of the subjects, 85% (51/60) had seen a suspected case of elder abuse or neglect during their careers; 47% (28/60) had seen a case during the past six months. Only 29% of these suspected cases were reported to county authorities. Approximately 40% of the questions on the pre-test were answered correctly (mean score, 4.8 ± 3.0). In comparison, 83% of the questions on the post-test were answered correctly (10.0 ± 3.0). Although participants had a number of suggestions to improve the video program, 78% (47/60) expected this material to change the way they will evaluate elderly patients in the future.
Conclusion:Prehospital personnel do not feel confident identifying or reporting victims of elder abuse or neglect. A videotape training program may be an effective way of presenting this information as a means of continuing education.