Evidence Based Medicine in EMS

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Education forum presentation on Evidence Based Medicine / Evidence Based Practice.

Transcript of Evidence Based Medicine in EMS

  • What is Evidence Based Medicine?
  • Where do I find the evidence?
  • Questions to ask Can I trust this information? If the information is true, will the use of this information make an important difference? Can I use the information in this instance?
  • Why should I care? Potential to change what you do Potential to change how you do it Ultimately, can help you to deliver better care to your patients
  • CPR & ECC Guidelines
  • CPR - 1916
  • What about? Back Blows Chest Thrusts Cricothyrotomy Direct Laryngoscopy Heimlich Maneuver Oxygen
  • What about?
  • What about?
  • Evaluating Evidence Quality Sample size Single centre v Multi centre Blinded Randomised Controlled Study subjects
  • Sample Size The more patients we examine, the more certain we can be of our results
  • Multi-centre Multiple teams from multiple institutions each duplicating the same study procedure Reduces the chances that a systematic error by any one team will skew the studys results
  • Double-blind
  • Randomised
  • Study Subjects
  • Evaluating Evidence Quality The gold standard of all scientific studies in EMS and medicine are large, multi-centre, double-blind, randomized controlled trials performed on human subjects.
  • Three tourists are riding together on a train in Scotland. They look out the window, and see a black sheep. One tourist says, Fascinating! All Scottish sheep are black!
  • The second tourist says, No, no, no! Only some Scottish sheep are black.
  • The third tourist rolls his eyes at his two companions and says, Gentlemen, all we can say for sure is that there is one sheep in Scotland that appeared to be black on one side to the three of us while this train car was passing by it.
  • Not all evidence is as it seems
  • More reading http://prehospitalresearch.eu/?p=772 http://prehospitalresearch.eu/?p=1176 Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isnt. BMJ. 1996 Jan 13;312(7023):71-2. PMID: 8555924. Hess DR. What is evidence-based medicine and why should I care? Respir Care. 2004 Jul;49(7):730-41. PMID: 15222906.