26

Evidence Based Medicine in EMS

Embed Size (px)

DESCRIPTION

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

Citation preview

Page 1: Evidence Based Medicine in EMS
Page 2: Evidence Based Medicine in EMS

What is Evidence Based Medicine?

Page 3: Evidence Based Medicine in EMS

Where do I find the evidence?

Page 4: Evidence Based Medicine in EMS

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?

Page 5: Evidence Based Medicine in EMS

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

Page 6: Evidence Based Medicine in EMS
Page 7: Evidence Based Medicine in EMS
Page 8: Evidence Based Medicine in EMS

CPR & ECC Guidelines

Page 9: Evidence Based Medicine in EMS

CPR - 1916

Page 10: Evidence Based Medicine in EMS

What about?• Back Blows• Chest Thrusts• Cricothyrotomy• Direct Laryngoscopy• Heimlich Maneuver• Oxygen

Page 11: Evidence Based Medicine in EMS

What about?

Page 12: Evidence Based Medicine in EMS

What about?

Page 13: Evidence Based Medicine in EMS
Page 14: Evidence Based Medicine in EMS

Evaluating Evidence Quality• Sample size• Single centre v Multi centre• Blinded• Randomised• Controlled• Study subjects

Page 15: Evidence Based Medicine in EMS

Sample Size• The more patients we examine, the more certain

we can be of our results

Page 16: Evidence Based Medicine in EMS

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 study’s results

Page 17: Evidence Based Medicine in EMS

Double-blind

Page 18: Evidence Based Medicine in EMS

Randomised

Page 19: Evidence Based Medicine in EMS

Study Subjects

Page 20: Evidence Based Medicine in EMS

Evaluating Evidence QualityThe gold standard of all scientific studies in EMS and

medicine are large, multi-centre, double-blind, randomized controlled trials performed on human

subjects.

Page 21: Evidence Based Medicine in EMS
Page 22: Evidence Based Medicine in EMS

• 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!”

Page 23: Evidence Based Medicine in EMS

• The second tourist says, “No, no, no! Only some Scottish sheep are black.”

Page 24: Evidence Based Medicine in EMS

• 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.”

Page 25: Evidence Based Medicine in EMS

Not all evidence is as it seems

Page 26: Evidence Based Medicine in EMS

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 isn’t. 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.