title: Assessment of breath sounds during ambulance transport.
abstract: OBJECTIVE
  To determine whether the environment of a moving ambulance affects the ability of our-of-hospital care providers to auscultate breath sounds.
  
  
  METHODS
  Out-of-hospital care providers assessed breath sounds with a previously described breath-sounds model in a quiet environment (control) and in a moving ambulance. The setting was a nonurban emergency medical services system and an interhospital transport agency based at a 600-plus-bed tertiary care center. The participants were physicians, transport nurses, and advanced life support EMS providers routinely involved in the emergency out-of-hospital treatment and transportation of the ill and injured. The accuracy with which participants identified the presence or absence of breath sounds in the two environments was compared with the use of the chi 2 test, with the alpha-value set at .05.
  
  
  RESULTS
  The accuracy of breath-sounds assessment in the control environment was 96% (251 of 260); the sensitivity was 96% and the specificity 97%. The accuracy of breath-sounds assessment in the experimental environment was 54% (140 of 260); the sensitivity was .09% and the specificity 98%. Participants were significantly less likely to hear breath sounds in the moving ambulance than in the quiet room (P < .001).
  
  
  CONCLUSIONS
  Assessment of breath sounds is hampered by the environment of a moving ambulance.
authors.affiliation: Department of Emergency Medicine, East Carolina University School of Medicine, Greenville, North Carolina, USA.
authors.forename: L H
authors.initials: LH
authors.lastname: Brown
authors.forename: J E
authors.initials: JE
authors.lastname: Gough
authors.forename: D M
authors.initials: DM
authors.lastname: Bryan-Berg
authors.forename: R C
authors.initials: RC
authors.lastname: Hunt
mesh_terms: D000552:Ambulances; D001314:Auscultation; D006801:Humans; D009622:Noise; D012135:Respiratory Sounds; D012680:Sensitivity and Specificity; D014187:Transportation of Patients