NAEMSP Sessions Examine Putting Evidence Into Practice

As a young field, EMS has lacked much of its own specific evidence base. But as more is developed and the overall body grows, providers and their medical directors could benefit from a way to access that EMS-specific data, rather than relying on consensus, best guess, or findings from other fields.

The Canadian Prehospital Evidence-Based Practice Project (PEP) offers a way to do that. Born in Nova Scotia and housed at Dalhousie University, PEP is an effort to collect relevant studies specific to EMS for the easy reference of all.

The goals, its architects explained at the NAEMSP annual meeting Friday, are to help patients; help EMS systems make the best use of their limited resources; identify gaps and help steer future research; and become internationally recognized as a resource for evidence-based decision-making. PEP’s database is free and open to all. 

In assembling PEP, project leaders combed PubMed for EMS-specific literature with no date or outcome parameters (though they excluded animal studies and opinion pieces). Appraisers evaluated the strength and quality of each study, considering aspects like setting, methods, and primary outcomes; then a second team of senior appraisers vetted them further. On each issue, the body of evidence is summarized in a quick-reference matrix for easy use. Now project leaders are enhancing the database into what they call PEP 2.0, adding details like secondary outcomes and where studies were conducted. 

Find PEP at https://emspep.cdha.nshealth.ca, and for more information contact Jennifer Greene at EMS@dal.ca. 

Meanwhile, in the States, the National Association of State EMS Officials recently released an update to its National EMS Model Clinical Guidelines. Version 2, out since September, contains new and updated guidelines compatible with EMS Compass performance measures and NEMSIS v.3 protocols, as well as a universal documentation guideline. Ohio is incorporating the contents into its statewide EMS guidance.

The guidelines are intended to be patient-centric, evidence- and consensus-based, and reflect input from the broad EMS community. First released in 2014, they’ve been downloaded more than 15,000 times by local, regional, military and international bodies. 

An interim update in 2015 accommodated that year’s update to AHA guidelines before the full update last year. For more: https://nasemso.org/Projects/ModelEMSClinicalGuidelines/index.asp.