Prolonged Field Care Podcast 52: Walking The Fence Of Evidence, Environment, And Experience

After a few discussions with JJ who has also appeared in several Element  Rescue podcasts, Doug and Dennis talk about using evidence based  medicine whenever possible and what to do when no prospective randomized  controlled trials exist for a specific problem you face. What do you do  when no evidence exists for a specific problem you face? With such a  wide scope of practice while deployed and a lack of protocols SF medics  are often faced with unique situations in which they must actually weigh  the evidence, best practice, guidelines and expert consensus against  the given situation. This is a great responsibility not entrusted to  many other combat arms troops. In order to weigh the evidence you must  first be aware it exists and how to interpret what you are reading. This  will help get you on the right path in making informed decisions.

Check out the Discussion:  https://oembed.libsyn.com/embed?item_id=10109669  

Prolonged Prone Positioning Article NEJM 2013 

 Protocols and algorithms likely drive the majority of decisions a medic  will ever make. If you find yourself in a situation, such as a prolonged  field care situation, that outlasts all of those you should know some  of the current best practices and data to back up your decisions you may  be forced to make. Dogma is believing something to be true without  knowing if it actually is, or why. Don’t rely on dogma, question things  and have your own opinions. Know why you believe what you believe. When  you make a telemedicine consult call you should have a fairly good idea  of the decision you are leaning toward and why. You will sound much more  like the medical professional you claim to be and less like the knuckle  dragger they may be expecting. Medicine is a separate language and you  are expected to be somewhat fluent. Data and research are intellectual  and professional currency and which can add to your credibility. Read an  article, understand who the authors are, their specialty, where they  work and who funded or sponsored it as well as the references at the  end. You will run across words you aren’t familiar with. Put them in the  Google machine and expand your medical vocabulary. You may even want to  read those references and the references to those in order to really  dig deeper. (Three deep, right Scott?) Podcasts are a great way to hear  opinions on some of these studies and how others have incorporated them  into their practice. Podcasts and blogs (even this one) are not journal  articles and studies. They are meant to raise discussions and spark  debate and make you aware of new techniques or practices. If a study is  mentioned find the article and read it yourself. Does it apply to your  environment, experience and training? Don’t be the guy quoting a podcast  or Facebook post in a scholarly discussion, at that point it will just  be entertainment, for the other guy. Know where it originated.