The Importance Of Evidence Based Medicine

[BushyFromOz]

the answers to select from were extrapolated from several research papers into GP's, Nurses, Midwives, and Physiotherapists attitudes towards EBP.

I took the common attitudes towards EBP in all the papers and posted them here, i was just seeing if the PHC answers would be similar to the others

[kevkei]

Agree with both of the above.

Although, in the US, it really isn't very common for it to be applicable to a Paramedic, who work primarily from written protocols that they are not allowed to stray from. One of the most satisfying things about my current position is that I am given a great deal of latitude with my clinical decision making and can choose from a variety of medications for any given condition, based upon what I feel is best for this particular patient. But yes, that is an extremely dangerous way to go if you are not basing your decisions upon sound, research based evidence.

Dust, wouldn't you say though that more EMS protocols are being driven by evidence based medicine these days? If they aren't, they damn well should be.

Argee with Rid, tniuqs and Dust that evidence based medicine is the ONLY way to go otherwise it's all Voodoo.

[Dustdevil]

Dust, wouldn't you say though that more EMS protocols are being driven by evidence based medicine these days? If they aren't, they damn well should be.

I do agree that better systems base their protocols on current literature and evidence. But even in those systems, there is commonly a "one size fits all" approach that keeps medics within a rigid protocol framework, and does not allow for clinical decision making that may yield better therapeutics for a given patient.

We see it here on EMT City all the time. Medics quoting their protocol as if it were the Holy Grail of medicine, when in fact it is inappropriate for the situation at hand, yet that medic remains blissfully ignorant of that fact and smugly satisfied with himself because he successfully, yet mindlessly, followed the recipe in his little cookbook.

Protocol is not evidence, even if it is evidence based.

[kevkei]

That's why here, we don't have 'protocols' they are called Medical Control Guidelines because they recognize no call or guideline is black and white, it's all grey.

For example, we are encouraged (read, you are stupid not to) to do a 12 lead prior to administering nitro to rule out RVI and to also do a 15 lead in the presence of inferior changes and/or if elevation is present in V1.