A comparison of paramedic didactic training hours and NREMT-P examination performance.

OBJECTIVE: The didactic hours required by paramedic training programs differ tremendously throughout the country. The authors hypothesized that a correlation exists between paramedic didactic training hours and pass/fail performance on the National Registry Examination. METHODS: The authors retrospectively examined the performance of every applicant for the National Registry Paramedic Examination in June 1996. Applicants were identified by their National Registry Identification Number. A database was established linking the applicants to whether they passed or failed the NREMT-P exam. The authors then searched through the National Registry's archives and pulled each applicant's original application papers. On each application is a space to indicate the number of didactic hours of training that the particular applicant underwent. This information was also included in the database. The numbers of didactic hours of training and pass/fail performance on the NREMT-P exam were compared by point biserial correlation. RESULTS: One thousand six hundred applicants applied for the National Registry Examination in June 1996. For the 1,553 applicants included in the study, the mean number of didactic training hours was 377.5, with a standard deviation of 167.0 and a range of 63 to 1,594. The correlation between paramedic didactic training hours and pass/fail performance on the National Registry Examination was rpb = 0.0493, p = 0.0522. CONCLUSION: There is no correlation between paramedic didactic training hours and pass/fail performance on the NREMT-P examination.

The efficacy of a standard training program for transillumination-guided endotracheal intubation.

OBJECTIVE: To evaluate the success rate, intubation time, and complication rate of transillumination-guided intubation following two hours of instruction in the use of the Trachlight (TL) device. METHODS: A prospective, randomized crossover laboratory trial was conducted at an emergency medical service training site with 30 nonpaid volunteer paramedic students, one month prior to their graduation. The students were instructed in the use of the TL in a standardized curriculum consisting of didactic, video, and demonstration sessions. Each student was required to successfully intubate a training manikin with the TL five times. Approximately three weeks later, the students were asked to intubate the manikin 20 times, alternating between direct laryngoscopy (DL) and TL. RESULTS: The success rates were 94% for DL and 63% for TL (p < 0.0001). The mean intubation times were 14.6 seconds for DL and 16.8 seconds for TL (p < 0.001). The incidences of trauma were 7.3% for DL and 1.4% for TL (p < 0.001). CONCLUSION: A two-hour training session, including five successful light-guided intubations using the TL, was inadequate for producing acceptable success rates during manikin intubations by paramedic students. While TL intubation intervals were shorter when successful, the 2.2-second difference was not clinically meaningful. The incidence of trauma in our manikin model during TL intubations was significantly lower than that with DL.