Can emergency medical services personnel identify pneumothorax on focused ultrasound examinations?

Background Ultrasound is of proven accuracy in the diagnosis of pneumothorax. In certain locations, pre-hospital providers are adopting its use for the management of critically ill patients. Objectives To determine the sensitivity and specificity of emergency medical service (EMS) providers in identifying pneumothorax on ultrasound examinations. Methods This was an educational study evaluating 33 EMS providers. Each subject went through a brief didactic session covering the use of ultrasound in diagnosis of pneumothorax. They were then given an examination consisting of 20 individual ultrasound real-time video cases depicting either a pneumothorax or normal lung sliding. Sensitivities and specificities with 95% confidence intervals (95% CIs) were calculated for recognition of pneumothorax. Results The 33 study participants were able to identify pneumothorax with a sensitivity of 82% (95% CI 77–86%), specificity of 94% (95% CI 90–96%), positive predictive value of 93% (95% CI 89–95%), and negative predictive value of 84% (95% CI 80–87%). Conclusions Emergency medical service providers were able to identify pneumothorax at a relatively high rate. Real-time scanning by the study subjects might lead to even better results.