A Pilot Study on the Effect of Hospitalbased Emergency Medical Technician Training on Improving the Quality of Prehospital Assessment and Intervention

ABSTRACT

PURPOSE: This study was conducted to evaluate the short term effect of hospital-based clinical training for emergency medical technicians (EMTs) on improving the quality of prehospital assessment and intervention. METHODS: Three EMTs-level 1 were assigned to a regional emergency medical center and trained as to a designed program with three months. Three EMTs alternatively ran to the scene during later two months. In order to compare the completeness and the appropriateness of prehospital assessment and intervention between trained and nontrained EMTs, we collected pre-hospital records and divided the subjects into a study group who were managed by trained EMTs and a control group who were managed by non-trained EMTs-level 1 (level-1 control) or EMT-level 2 (level-2 control). The completeness and the appropriateness were evaluated by three expert panel groups, each consisting of three emergency physicians, on the basis of the guidelines and professional opinion. In assessing intergroup agreement, weighted kappa values for inter-panel agreement were all above 0.4 except on one factor (k=0.28). RESULTS: No significant difference existed in demographic findings between the study group (N=129) and the control (N=469). The study group showed significantly higher completeness (78.9%) than the level-1 (14.9%, p<0.001) or level-2 control group (9.8%, p<0.001) in their assessment of vital signs. The study group also scored significantly better for appropriateness than did the two control groups, both in evaluation of chief complaints and in prehospital management (p<0.001). CONCLUSION: The quality of pre-hospital assessment and intervention could be significantly improved through hospital-based EMT training, especially in the assessment of vital signs, appropriate evaluation of chief complaints, and prehospital intervention.