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Prehospital Evidence Based Practice   
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Introduction Fran├žais
The Prehospital Evidence Based Practice Program 1, 2 was started in 1998, and physicians from Dalhousie University, the QEII Health Sciences Center and the IWK Children's & Women's Hospital in Halifax have served as Appraisers. In an effort to broaden input, we have recently sought interest from EMS physicians and paramedics from across Canada.
In the past, EMS has been criticized for their relative lack of randomized controlled studies supporting prehospital treatment.3, 4, 5 Despite this (or because of this) criticism, research for prehospital care is improving and some evidence does exist to support the treatment/interventions provided in the prehospital environment. The volume and quality of research conducted in the prehospital setting is increasing, along with the demand to base paramedic/prehospital interventions on evidence. 6
Evidence Based Medicine (EBM) is a process used by clinicians which incorporates the best evidence available from research into the clinical decision-making process. 7
The purposes of the Prehospital Evidence Based Practice Program are:
  1. to catalogue EMS studies
  2. to stimulate debate and growth towards evidence-based clinical presentations
  3. to be a resource for the development of local EMS clinical presentations; perhaps with a movement towards "best practice" paramedic clinical presentations.
  4. to be a guide to help recognize opportunities for prehospital research.
  5. to develop a process of using evidence to evaluate practice change suggestions made by paramedics.
  1. Petrie DA, Cain E, Tallon J, Ross J, Kovacs G, Taylor B, Murray T, Urquhart D. Internet Use in The Development of An Evidence-Based Pre-Hospital Protocol Database. Emerg Med J 2002;19(supp11):A17-18.

  2. Jensen JL, Petrie DA, Travers AH, PEP Project Team. The prehospital evidence-based protocols project: knowledge translation in emergency medical services care. Acad Emerg Med 2009 July;16(7):668-73. Medline

  3. Maio RF, Garrison HG, Spaite DW, Desmond JS, Gregor MA, Cayten CG et al. Emergency medical services outcomes project I (EMSOP I): prioritizing conditions for outcomes research. Ann Emerg Med 1999; 33(4):423-432. Medline

  4. Callaham M (1997). Quantifying the scanty science of prehospital emergency care. Ann Emerg Med 30 : 791-796. Medline

  5. Brazier H, Murphy AW, Lynch C, et al (1999). Searching for the evidence in pre-hospital care: A review of randomized controlled trials. J Accid Emerg Med; 16: 18-23 Medline

  6. Smith E, et al (2007). The Cochrane Library as a Resource for Evidence on Out-of-Hospital Health Care Interventions. Ann Emerg Med; 49: 344.350. Medline

  7. Sackett,D, Richardson W, Rosenberg W, Haynes, R (1997). Evidence-based medicine. How to practice and teach EBM. London: Churchill Livingstone.