3. 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?
4. 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
5. CPR & ECC Guidelines
6. CPR - 1916
7. What about?
• Back Blows
• Chest Thrusts
• Direct Laryngoscopy
• Heimlich Maneuver
8. What about?
9. What about?
10. Evaluating Evidence Quality
• Sample size
• Single centre v Multi centre
• Study subjects
11. Sample Size
• The more patients we examine, the more certain
we can be of our results
• 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
15. Study Subjects
16. Evaluating Evidence Quality
The gold standard of all scientific studies in EMS and
medicine are large, multi-centre, double-blind,
randomized controlled trials performed on human
17. • 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!”
18. • The second tourist says, “No, no, no! Only some
Scottish sheep are black.”
19. • 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.”
20. Not all evidence is as it seems
21. More reading
• 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.
• Hess DR. What is evidence-based medicine and why
should I care? Respir Care. 2004 Jul;49(7):730-41.