• Introducing the Prehospital Evidence Based Practice Project

    by Guest Author. Last modified: 04/12/14



    In the past, EMS has been criticized for their relative lack of randomized controlled studies supporting prehospital treatment.  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. Because of this demand, Dalhousie University: Division of EMS created The Prehospital Evidence Based Practice Project (PEP) in 1998.

    The purposes of the Prehospital Evidence Based Practice Project are:

    1. to catalogue EMS studies
    2. to stimulate debate and growth towards evidence-based protocols
    3. to be a resource for the development of local EMS protocols; perhaps with a movement towards “best practice” paramedic protocols.
    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.

    Over the years, the project has grown immensely. It now operates with an evidence appraisal team of 65 doctors/paramedics/nurses from all over the world. The project has cataloged and graded nearly 1600 studies addressing interventions practiced in the EMS setting. PEP has been published in 4 peer reviewed journals and has been proudly presented 9 times at international conferences. PEP has also been cited as a source for many Canadian provincial practice guidelines.


    This project obtains studies via a semi-systematic PubMed search and hand searching. These studies are then appraised by a member of the primary appraisal team. The appraisal is based on Level of Evidence, Direction of Evidence and primary outcome. Once returned, the studies are reviewed a second time by a member of the senior appraiser team. As a group, the 3×3 PEP recommendations are compiled based off the sum of the evidence for each intervention.

    The hope is that this project can serve as a freely available knowledge translation source for paramedics, medical directors and decision makers. PEP is always evolving to suit the needs of the end user. If you would like to learn more or have any suggestions please visit: http://www.paramedicresearch.com or email EMS@Dal.ca

    This post was written by Jennifer Greene, Advanced Care Paramedic and Paramedic Knowledge Translation Coordinator at Dalhousie University Division of EMS.

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    Guest Author

    Guest posts are written by various organisations and authors with an interest in EMS, prehospital care, research and other relevant topics.

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