%0 Journal Article
%T A cross-sectional study of Victorian mobile intensive care ambulance paramedics knowledge of the Valsalva manoeuvre
%A Gavin Smith
%A Malcolm J Boyle
%J BMC Emergency Medicine
%D 2009
%I BioMed Central
%R 10.1186/1471-227x-9-23
%X A cross-sectional study in the form of a face-to-face interview was used to determine Melbourne MICA Paramedic understanding of VM instruction between January and February, 2008. The results were then compared with an evidence-based model of VM performance to ascertain compliance with the three criteria of position, pressure and duration. Ethics approval was granted.There were 28 participants (60.9%) who elected a form of supine posturing, some 23 participants (50%) selected the syringe method of pressure generation, with 16 participants (34.8%) selecting the "as long as you can" option for duration. On comparison, one out of 46 MICA Paramedics correctly identified the three evidence-based criteria.The formal education of Melbourne's MICA Paramedics would benefit from the introduction of an evidence based model of VM performance, which would impact positively on patient care and may improve reversion success in the prehospital setting. The results of this study also demonstrate that an opportunity exists to promote the evidence-based VM criteria across the primary emergency care field.The management of haemodynamically stable supraventricular tachycardia (SVT) in the form of atrioventricular nodal re-entry tachycardia (AVNRT) or atrioventricular re-entry tachycardia (AVRT) by Melbourne Mobile Intensive Care Ambulance (MICA) Paramedics has traditionally involved the use of vagal manoeuvres as a primary intervention, followed by pharmacological interventions. Recent changes to Victorian Ambulance clinical practice guidelines, which effectively inhibit pharmacological interventions (unless greater than 30 minutes from hospital), have created reliance upon the Valsalva Manoeuvre (VM) as the sole management method for these patients in the prehospital setting. Historically, VM education within the MICA paramedic course has been somewhat informal, and ongoing education relies heavily on cultural practice and individual learning.A comprehensive literature review revealed n
%U http://www.biomedcentral.com/1471-227X/9/23