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| By Daniel Batsie, EMT-P Joseph J. Mistovich, MEd, NREMT-P & Daniel Limmer, AS, EMT-P , , Transition Topics for the Paramedic PART 1: T Brady is pleased to share with you a preview of its EMS Transition Series. Transition Series: Topics for the Paramedic provides both an overview of new information contained within the Education Standards at the paramedic level and a source of continuing education for practicing paramedics. During 2013, EMS World Magazine will feature exclusive excerpts from this new textbook. Visit www. bradybooks.com for more information. 58 Research: Evidence-Based Decision Making in EMS hroughout healthcare, medicine is moving to a more evidence-based approach. This means that outcomes of therapies and interventions are carefully measured to ensure that they have the intended results. When changes are made, decisions are based on clear indications and outcomes that point to meaningful improvements in patient care. As healthcare matures, more and more progress is based on an evidence-based approach. This means that the interventions we perform and the therapies we deliver must be meaningful and should be measurable. To assess the value of our care, we must turn to research. Quality studies and experimentation will separate important, relevant strategies from frivolous, wasteful endeavors. Consider the following situation: You work as a paramedic for an ambulance could pay for the addition of another paramedic. service that has 20 ambulances. Staffing is tight— How could your service make the correct and the budget is tighter. Tomorrow a new device decision? The answer is quality EMS research. If used to treat cardiac arrest will be released, at a there existed unbiased scientific experimentation cost of $1,500 each. The company that created the that this device really did double survival rates of device claims that it is the most important device the cardiac arrest, then this decision would be easy to company has ever released, and that it will signifimake. Similarly, if a quality study demonstrated that cantly increase cardiac arrest survival rates. the device did not improve cardiac arrest survival, As your company decides whether to buy the then the service could invest its money in more device, it must weigh the idea of improving survival meaningful areas. rates against the high cost of the device. Of course This example is hypothetical, of course, but every everyone would like to see patient care improve, day EMS agencies are faced with similar dilemmas. In but there is a significant cost to implementing this addition to spending money, consider the dilemmas new device. If your company chooses to outfit its EMS leaders and providers are faced with developing entire fleet, it will have to spend $30,000. If the protocols, adopting new medications and devices, device truly works, it makes a great deal of sense allotting staffing resources, and addressing myriad to purchase it, but if it does not work, the $30,000 questions that desperately need thoughtful answers. MARCH 2013 | EMSWORLD.com