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FollowingonfromJasonMerrillsexcellenttwopartpieceonIntroductiontoEvidenceBased
EMS(Part1&Part2)herewewillreviewthetopicofevidencebasedmedicine(EBM)and
evidencebasedpractice(EBP)ingeneral,andprovidelinkstosomereadingsdealingwith
Categories evidencebasedpracticeandthechallengesofevidencebasedprehospitalcareprovision.

Blogs(40)
Whatisevidencebased
AParamedic'sJourneyintoResearch(4)
Klint'sCorner(3)
medicine?
RapidReviews(8) Sackettatal.(1997)describeevidencebasedmedicineastheconscientious,explicitand
Textbooks,Tears&Trauma(13) judicioususeofcurrentbestevidenceinmakingdecisionsaboutthecareofindividualpatients.
BroaderimplementationsofEBMinhealthcarearealsoknownasEvidenceBasedPractice
TheGuidetoGuidelines(7)
(EBP)andEvidenceBasedHealthcare.
UnderstandingResearch(5)
CaseStudies(8)
EBPevolvedfromtheneedtobridgeacademicprogresswitheverydayclinicalpractice.EBPhas
FeaturedArticle(23)
ledtomorestructured,objectivedecision
HowTo(47) makinginhealthcare,andprovisionof
FOAM(8) interventionsbasedonscientific
News(117) researchratherthanonpractitioneropinion.
ConferenceTweets(31) Clinicalpracticehasbeencompletely
Pharmacology(1) transformedbyevidencebasedthinking,
Adrenaline(1) andprehospitalcareprovisionisno
exception.
Research(180)
AdvancedPractice(2)
AirwayManagement(6) Howisevidencebased
Anaphylaxis(2) practiceimplemented?
Cardiac(15)
Broadlyspeaking,therearefivesteps,
CommunityParamedic(2) whicharesimilartostepsinthescientific
CriticalCareParamedic(4) method.
Diagnostics(3)
Dispatch(1) 1.Definitionofproblem
ECG(4) 2.Systematicretrievalofthebestevidenceavailable
 Education(10) 3.Criticalappraisalofevidenceavailable
EMSOperations(2) 4.Applicationofresultsinclinicalpractice
EndofLifeCare(3) 5.Evaluationofperformance
Geriatrics(9)
Guidelines(22) HowdoIfindtheevidence?
HEMS(4) Thebestsourceofevidencebased
MassCasualty(2) recommendationsarerigoroussystematic
MedicalConditions(5) reviewsthatarebasedonmultisite
MentalHealth(7) randomised,doubleblinded,controlled
Military&Tactical(2) trialsinhumans.

Neonatal(1)
TheCochraneCollaborationisoneofthe
Neuro(11)
bestknowndatabasesofsystematic
Obstetrics(1)
reviews.Likeotherdatabasesofsystematic
Paediatrics(4) reviewssuchasUpToDate,Tripand
PainManagement(4) DynaMed,itrequiresauthorstoprovidea
PosterPresentations(5) detailedandrepeatableplanoftheir
Professionalism(5) literaturesearchandevaluationsofthe
Remote,Industrial&Austere(6) evidence.Uponreviewingalltheevidence,
Respiratory(5) treatmentiscategorizedas(1)likelytobe
Resuscitation(27) beneficial,(2)likelytobeharmful,or(3)evidencedidnotsupporteitherbenefitorharm.

Rural(3)
However,theknowledgegainedfromclinicalresearchdoesnotdirectlyanswertheprimary
Safety(3)
clinicalquestionofwhatisbestfortheindividualpatientathandandmanyauthorsbelievethat
Sepsis(7)
evidencebasedpracticeshouldnotdiscountthevalueofclinicalexperience.
Shock(2)
Simulation(7) Indeed,Hess(2004)considersevidencebasedpractice/evidencebasedmedicinetobea
SportsMedicine(1) combinationofexternalresearchevidence,clinicalexperienceandpatientvalues&expectations.
Trauma(20) MoredetailedexplanationsforgradingofevidencelevelscanbefoundinPart1&Part2of
Reviews(6) IntroductiontoEvidenceBasedEMS.
Conferences(5)
Courses(1) WhyshouldIcareaboutEBP?
YoushouldcareaboutEBPbecauseithasthepotentialtochangewhatyoudoandhowyou
doit!Moreimportantly,itcanhelpyoutodeliverbettercaretoyourpatients!
UpcomingEvents

Therearenoupcomingeventsatthistime.

News

Freeaccess:ResuscitationTodayVol3
Issue2(27/06/16)
FreeCPDattheEmergencyServicesShow
(23/05/16)
CanadianParamedicineFeb/Mar2016
OpenAccessIssue(11/04/16)
Freeaccess:ResuscitationTodayVolume
3Issue1(01/04/16) Forinstance,howmanyofuswereuntilrecently(andsomestillare)routinelyapplyingcollars
IntroducingtheIrishJournalof andlongboardstoextricatepatientsfromvehicles?Comeon,handsup!Didyouknowthat
Paramedicine(22/11/15) thispracticeislargelybasedontwopapersbyJDFarringtonentitledDeathinaDitch&
Extricationofvictimssurgicalprinciplespublishedin1967&1968!Noevidenceisassociated
withthesepapers,merelyobservationswell,EBPispotentiallyabouttochangethisarchaic
FeaturedArticle practiceforgood!

Eat,sleepandbehealthyaparamedics
guidetohealthiershiftwork
LatestHowToArticles
Paramedicstudentswritesomething!
(28/04/16)
Understandingdiagnostictests2:
likelihoodratios,preandposttest
probabilitiesandtheiruseinclinical
practice(30/01/15)
Understandingdiagnostictests1:
sensitivity,specificityandpredictive
values(11/12/14)
GRADEguidelinesbestpracticesusing
theGRADEframework(22/11/14)
RecentstudiesbyDixonetal.,Engsbergetal.,Shafer&Naunheim,haveallindicatedthatin
roadtrafficcollisionsettings,selfextricationresultsintheleastamountofcervicalspine
movement,andisasafermethodofextricationforthemajorityofpatients*.Theuseforor
againstapplicationofacervicalcollarisalsobeinginvestigated.Dixonetal.havenowreceived
fundingtofurtherinvestigatethebiomechanicsofextrication,andthisstudyisongoingatthe
timepublication.
FarringtonJD.DeathinaDitch.1967.BullAmCollSurg.2013Jun98(6):44
53discussion43.PMID:23789199.
Freefulltext
FarringtonJD.Extricationofvictimssurgical
principles.JTrauma.1968Jul8(4):493512.PMID:
5658633.
ShaferJS1,NaunheimRS.Cervicalspinemotionduringextrication:apilotstudy.WestJ
EmergMed.2009May10(2):748.PMID:19561822.
HowtogetstartedwithEMSresearch DixonM1,O'HalloranJ,CumminsNM.Biomechanical
JEMS(16/05/14) analysisofspinalimmobilisationduringprehospital
extrication:aproofofconceptstudy.EmergMedJ.
2013Jun28.PMID:23811859.
RecentComments
EngsbergJR1,StandevenJW,ShurtleffTL,EggarsJL,ShaferJS,Naunheim
alanbattonNotjustaloadofB.S. RS.Cervicalspinemotionduringextrication.JEmergMed.2013
DegreesforParamedics Jan44(1):1227.PMID:23079144.
alanbattonNotjustaloadofB.S.
DegreesforParamedics
Sowhatnext?
alanbattonNotjustaloadofB.S.
DegreesforParamedics
alanbattonNotjustaloadofB.S.
DegreesforParamedics

ReSEARCH

Go

Go

Firstly,weveagreatarticleonhowtoreadapaper.Onceyoucancomfortablyreadapaper,
youshouldbegintodevelopyourcriticalanalysisskills.Learnaboutthedifferentlevelsof
Title,Abstract,Keywords evidence,takeacourseorworkshopincriticalappraisalskills,andbeginsearchingthrough
Go someoftheevidencebaseddatabaseslistedattheendofthisarticle.

Systematicreviewsareliteraturereviewsfocusedonaresearchquestionthattrytoidentify,
appraise,selectandsynthesizeallhighqualityresearchevidencerelevanttothatquestion.
Tags
Theseareanessentialpartofevidencebasedpractice.Goodsourcesofsystematicreviews
includetheCochraneLibraryandBestEvidenceTopics(BestBETS).
Academic ACS AirwayManagement Ambulance AMI
Australia Canada Cardiac CardiacArrest Case
YourinstitutionmaybeabletogiveyouaccesstopaiddatabasessuchasUpToDateand
Study ClinicalManagement Computer
DynaMed.FreeresourcesincludetheCochraneDatabase,theDalhousieCPEBPProject,
ConferenceConsensusCPGCPRCPRUL
EvidenceSearchandtheTRIPDatabaseamedicalsearchenginewithemphasisonevidence
CriticalCare CVA Database ECG Education Elderly
basedmedicine(EBM)andclinicalguidelinesandqueries,includingcontentfromCochraneand
Emergency EMSEvidenceBasedFOAMFPHC
Bandolier.
Geriatric Guide Guideline Guidelines Haemorrhage

HEMS Ireland Journal Medication MentalHealth

Onceyoudelveintotheworldofevidencebasedpractice,youwillfindyourselfbeginningto
Neurology News OHCA Online Paediatric Pain
continuallyassesstheevidenceuponwhichyoubaseyourclinicaldecisions.Youwillfind
Management ParamedicPrehospital yourselfwillingtoseekoutqualityappraisedsourcesofevidencefromthemillionsofpotential
sourcesoutthereandyouwillbeginchoosingthosethatarerelevanttoyourpractice.
PTSD Reference Research
ResuscitationReviewSafetySepsisSeptic Onceyouhavefoundtheevidenceyouneedtoask
Shock Simulation SocialMedia Software Spinal STEMI

Stress Stroke StudentParamedic Study TBI Training

TranslationalHealthSciences
USA
yourself3keyquestions:
TraumaTwitterUK 1.CanItrustthisinformation?
2.Iftheinformationistrue,willtheuseofthisinformationmakeanimportantdifference?
3.CanIusetheinformationinthisinstance?

Archives EvidenceBasedPracticeinEMSsomereading
SelectMonth JensenJL1,PetrieDA,TraversAHPEPProjectTeam.TheCanadian
prehospitalevidencebasedprotocolsproject:knowledgetranslationin
emergencymedicalservicescare.AcadEmergMed.2009Jul16(7):66873.
PMID:19691810.

LangES1,SpaiteDW,OliverZJ,GotschallCS,SworRA,DawsonDE,Hunt
RC.Anationalmodelfordeveloping,implementing,andevaluating
evidencebasedguidelinesforprehospitalcare.AcadEmergMed.2012
Feb19(2):2019.PMID:22320372.

MyersJB1,SlovisCM,EcksteinM,GoodloeJM,IsaacsSM,LoflinJR,
MechemCC,RichmondNJ,PepePEU.S.MetropolitanMunicipalities'EMS
MedicalDirectors.Evidencebasedperformancemeasuresforemergency
medicalservicessystems:amodelforexpandedEMSbenchmarking.
PrehospEmergCare.2008AprJun12(2):14151.PMID:18379908.

CallahamM.Quantifyingthescantyscienceofprehospitalemergency
care.AnnEmergMed.1997Dec30(6):78590.PMID:9398774.

ElSayedMJ.Measuringqualityinemergencymedical
services:areviewofclinicalperformanceindicators.
EmergMedInt.20122012:161630.PMID:22046554.

WheredoIfindtheevidence?
Ourhintsoneffectivesearchingstrategies
ACPSmartMedicine
BestEvidenceTopics(BestBETS)
BMJClinicalEvidence
CanadianPrehospitalEvidenceBasedPractice
ClinicalKey
CochraneLibraryourguidetousingtheCochraneLibrary
DynaMed
EvidenceSearch
JAMAEvidence
JoannaBriggsInstitute
Lenus.ie
NationalGuidelineClearingHouse
NICEClinicalKnowledgeSummaries
PubMedClinicalQueries
TripDatabaseEvidenceSearch
UpToDateourguidetousingUpToDate

EvidenceBasedPracticeResources
DalhousieUniversityCanadianPrehospitalEvidenceBasedPracticesite
DalhousieUniversityPrehospitalCochraneCorner
UniversityofLimerickPrehospitalEvidenceBasedClinicalPracticeGuidelines(EBCPG)
Project
UniversityofOxfordCentreforEvidenceBasedMedicine

*Researchfindingsandconclusionsdisplayedonthissitearenotarecommendationtochange
yourscopeofpracticeordisregardyourserviceprovidersguidelines.Alwaysfollowlocal
protocols/guidelines.

References
1. SackettDL,RosenbergWM,GrayJA,HaynesRB,RichardsonWS.
Evidencebasedmedicine:whatitisandwhatitisnt.BMJ.1996Jan
13312(7023):712.PMID:8555924.

2. HessDR.WhatisevidencebasedmedicineandwhyshouldIcare?
RespirCare.2004Jul49(7):73041.PMID:15222906.

3. JensenJL1,PetrieDA,TraversAHPEPProjectTeam.TheCanadian
prehospitalevidencebasedprotocolsproject:knowledgetranslationin
emergencymedicalservicescare.AcadEmergMed.2009Jul16(7):66873.
PMID:19691810.

4. LangES1,SpaiteDW,OliverZJ,GotschallCS,SworRA,DawsonDE,
HuntRC.Anationalmodelfordeveloping,implementing,andevaluating
evidencebasedguidelinesforprehospitalcare.AcadEmergMed.2012
Feb19(2):2019.PMID:22320372.
5. MyersJB1,SlovisCM,EcksteinM,GoodloeJM,IsaacsSM,LoflinJR,
MechemCC,RichmondNJ,PepePEU.S.MetropolitanMunicipalitiesEMS
MedicalDirectors.Evidencebasedperformancemeasuresforemergency
medicalservicessystems:amodelforexpandedEMSbenchmarking.
PrehospEmergCare.2008AprJun12(2):14151.PMID:18379908.

6. CallahamM.Quantifyingthescantyscienceofprehospitalemergency
care.AnnEmergMed.1997Dec30(6):78590.PMID:9398774.

7. ElSayedMJ.Measuringqualityinemergencymedicalservices:a
reviewofclinicalperformanceindicators.EmergMedInt.
20122012:161630.PMID:22046554.

8. ShaferJS1,NaunheimRS.Cervicalspinemotionduringextrication:a
pilotstudy.WestJEmergMed.2009May10(2):748.PMID:19561822.

9. DixonM1,OHalloranJ,CumminsNM.Biomechanicalanalysisofspinal
immobilisationduringprehospitalextrication:aproofofconceptstudy.
EmergMedJ.2013Jun28.PMID:23811859.

10. EngsbergJR1,StandevenJW,ShurtleffTL,EggarsJL,ShaferJS,
NaunheimRS.Cervicalspinemotionduringextrication.JEmergMed.
2013Jan44(1):1227.PMID:23079144.

11. FarringtonJD.Extricationofvictimssurgicalprinciples.JTrauma.
1968Jul8(4):493512.PMID:5658633.

12. FarringtonJD.DeathinaDitch.1967.BullAmColl
Surg.2013Jun98(6):4453discussion43.PMID:
23789199.

Bio LatestPosts

AlanBatt
Paramedic,educator,researcher

Alanisacriticalcareparamedic,paramediceducatorandprehospital
researcher,currentlyworkingaroundtheworldasaneducatorand
researcher.HehaspreviouslyworkedandstudiedacrossEurope,North
AmericaandtheMiddleEast.HeholdsaGraduateCertificateinIntensive
CareParamedicStudies,andanMScinCriticalCare.Hismaininterestsare
incareoftheelderly,endoflifecare,patientsafety,professionalism
(includingroleandidentity),andparamediceducation.

11

CriticalAppraisalSkills
Programme(CASP)
FREEeLearning&
Checklists
Honeyourknowledgeand
IntroductiontoEvidence IntroducingthePrehospital skillsincriticallyappraising
BasedEMSPart1 EvidenceBasedPractice evidencewiththisfree
In"HowTo" Project onlinelearningandfree
In"News" appraisalchecklist
resource.
 In"News"

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