Show me the evidence! Engaging with science in the pre-hospital environment

Scientific insightAs a natural consequence of increased demand for clinical excellence and improved outcomes for patients, there is a related increase in demand for sound academic foundations for pre-hospital treatment. While current guidelines are based on best available evidence, there is a desire to fill gaps in knowledge through further investigation including during clinical trials.Paramedics should be encouraged to engage with the concept of evidence-based practice, and challenge the available evidence base in terms of its quality, source and level. Rather than continuing to blindly use protocols based on limited evidence, the entire pre-hospital community ought to design ways to put these protocols under increased scrutiny and determine the gaps requiring further investigation.Recent trials in the pre-hospital environment such as PARAMEDIC (Perkins et al, 2015), PARAMEDIC2 (Warwick Clinical Trials Unit, 2015), Airways-2 (Clinical Trials and Evaluation Unit Bristol, 2014) and Golden Hour (National Institute for Health Research Surgical Reconstruction and Microbiological Research Centre, 2014) have done precisely that: they have aimed to establish a better evidence-base where one was lacking. The new generation of paramedics ought to say: ‘Show me the evidence!’ when following common procedures based on expert opinion rather than science.

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