title: Assessment of lung auscultation by paramedics.
abstract: OBJECTIVE
  To determine how accurately paramedics interpret common lung sounds on an audiotape in comparison with emergency physicians.
  
  
  METHODS
  We carried out a prospective comparison of blinded lung sound interpretation using a standard teaching tape. Our subjects were 67 experienced paramedics and 22 new paramedics from urban and suburban emergency medical services systems comprising municipal and private ambulance providers; and 18 emergency physicians. Five common lung sounds were played three times, in different sequences, and with additional patient history provided for each repetition. The members of each group listened to the same tape and were asked to identify the lung sounds.
  
  
  RESULTS
  Emergency physicians had a median score of five of five possible correct responses in each of the three trials. This score was significantly higher than those of experienced and new paramedics. Experienced paramedics (P = .001) and new paramedics (P = .002) significantly increased their median scores over the three trials with additional medical history. We found no significant difference between experienced and new paramedics in any of the three trials.
  
  
  CONCLUSIONS
  In our study, paramedics did not assess lung sounds as accurately as emergency physicians, and experienced paramedics did not interpret sounds more accurately than new paramedics. Correct identification of lung sounds improved significantly for paramedics when medical history was known.
authors.affiliation: Department of Emergency Medicine, Lutheran General Hospital, Park Ridge, Illinois, USA.
authors.forename: H N
authors.initials: HN
authors.lastname: Wigder
authors.forename: D R
authors.initials: DR
authors.lastname: Johnson
authors.forename: S
authors.initials: S
authors.lastname: Cohan
authors.forename: R
authors.initials: R
authors.lastname: Felde
authors.forename: R
authors.initials: R
authors.lastname: Colella
mesh_terms: D001314:Auscultation; D002983:Clinical Competence; D004634:Emergency Medical Technicians; D004635:Emergency Medicine; D006801:Humans; D011446:Prospective Studies; D012135:Respiratory Sounds / Q000175:diagnosis*