2022 Systematic Review of Evidence-Based Guidelines for Prehospital Care

Abstract

Special Patient Populations 2.0 MEDICAL OVERSIGHT OF EMS 2.1 Medical Oversight 2.1.1 Medical Oversight of EMS Systems 2.1.2 Legal Issues 2.2 EMS Systems 2.2.1 Public Safety Answering Points 2.2.2 Design of System Components 2.2.3 Delivery Systems with Special Considerations Thomas 2014 2.3 EMS Personnel 2.3.1 Scope of Practice Models 2.3.2 Education Bhanji 2015 Miller 2004 Powers 2018 2.3.3 EMS Provider Health and Wellness Patterson 2018 2.4 System Management 2.4.1 System Finance 2.4.2 Legislation and Government 2.4.3 Public Health 2.4.4 System Status Management 3.0 QUALITY MANGEMENT AND RESEARCH 3.1 Quality Improvement Principles and Programs 3.1.1 Data Collection, Management, and Analysis 3.1.2 Quality Improvement Programs Kronick 2015 3.1.3 Evidence-based Practice 3.2 Research 3.2.1 Data Collection, Management, and Analysis 3.2.2 Fundamental Knowledge of Biostatistics and Epidemiology 3.2.3 EMS Research Design 4.0 SPECIAL OPERATIONS 4.1 Mass Casualty Management 4.1.1 Incident Command System (ICS) 4.1.2 Triage 4.1.3 Patient Care in Mass Casualty Events / Scene Management 4.2 Chemical / Biological / Radiological / Nuclear / Explosive (CBRNE) 4.2.1 Toxic Exposure / Poisoning / Hazardous Materials (HAZMAT) 4.2.2 Explosive Incidents 4.2.3 Weapons of Mass Destruction and Related Injury 4.3 Mass Gathering 4.3.1 Planning and Operations 4.3.2 Personnel Needs 4.3.3 Training and Drills 4.3.4 Design of Temporary Treatment Facilities 4.3.5 Equipment 4.3.6 Communications 4.4 Disaster Management 4.4.1 National Incident Management System (NIMS) & National Response Framework 4.4.2 Catastrophic Events 4.4.3 Health and Medical Resources 4.4.4 Special Response Considerations 4.5 EMS Operations 4.5.1 Tactical 4.5.2 Technical Rescue 4.5.

Consensus Standard for Evidence Integration into EMS Education and High-Stakes Testing

“…The NAM criteria describe concrete recommendations that define high-quality, EBGs and are provided in Appendix (available online only). 4 , 6 , 7 , 13 , 15 – 17 All other sources were categorized as medium or low levels of evidence. Since the medium-quality of evidence category was noted to have significant internal heterogeneity in the quality of evidence, the panel recommended a subdivision and ranking (I, II, and III) within this category to allow for more accurate stratification (Table 1 ).…”

“…For prehospital EBGs, the PGC has curated a repository of EBGs and has reviewed the quality of evidence evaluation and development of recommendations for prehospital care within these guidelines. 4 – 6 , 25 The PGC has also defined gaps in the content of prehospital guidelines that could improve patient outcomes. 4 Applying structured approaches to primary source material can help identify high-quality evidence and prioritize implementing new knowledge by applying the Table of Evidence.…”

“…3 – 5 Yet, significant gaps exist among available prehospital guidelines, 5 which do not address all aspects of EMS medicine. 4 , 6 Therefore, knowledge from primary scientific literature and other available educational materials must be integrated into prehospital care while identifying knowledge gaps for future evaluation.…”

Prehospital Stroke Care Part 2: On-Scene Evaluation and Management by Emergency Medical Services Practitioners

“…Highest-quality EBGs provide recommendations based on a systematic review of the literature and use a structured approach to evidence evaluation to grade the quality of included evidence and strength of individual care recommendations. 80,81 Furthermore, following the National Model for Prehospital EBGs, sample protocols, and other implementation tools should be created in tandem with EBG publication to facilitate timely dissemination and implementation into individual EMS systems. 82 Multiple EBGs have been published addressing the prehospital evaluation and management of patients with suspected stroke.…”

Clinical Research in Prehospital Care: Current and Future Challenges

“…The use of evidence-based guidelines and protocols can help to improve the quality of care provided in the prehospital environment, reduce the risk of adverse events, and improve patient outcomes [6]. With an acceleration over the past decade, prehospital care has become increasingly sophisticated, with advances in technology and medical treatments allowing EMS personnel to deliver more advanced care in the field.…”