Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

My Response to A Discussion on Evidence from EMS Expo

 

Last week I wrote A Discussion on Evidence from EMS Expo about one of the conversations that I had at EMS Expo about evidence and patient care.

What were the conditions for the treatment being discussed?
 

Everybody knows the treatment works.

If the treatment is not used, the patient dies.

If the treatment is used, the patient lives.

We should ignore demands for evidence, because evidence-based medicine does not exist in this primitive culture.

Who are we to question the ways of this culture?

Isn’t it arrogant to try to impose our values on this culture?

It works for them, so shouldn’t we accept that?

 

The primitive culture being discussed was not EMS, but everything about the discussion does apply to the primitive culture of EMS.

We are Emergency Medical Shamans.
 


Original source of edited image.
 

We choose to ignore evidence and use magic rituals that do not work.

We use these magic rituals to harm patients.

We claim that these magic rituals are so beneficial that we should not deprive patients of the magic, because that would be dangerous.

We insist that intubation saves lives and claim that evidence of improved survival should not be obtained, because it would deprive patients of the standard of care harm by EMS. Too many people would be harmed by not receiving the standard of care.

We insist that spinal immobilization saves lives and protects spines and claim that evidence of improved survival should not be obtained, because it would deprive patients of the standard of care harm by EMS. Too many people would be harmed by not receiving the standard of care.

We insist that ventilation in cardiac arrest saves lives and claim that evidence of improved survival should not be obtained, because it would deprive patients of the standard of care harm by EMS. Too many people would be harmed by not receiving the standard of care.

We insist that epinephrine in cardiac arrest saves lives and claim that evidence of improved survival should not be obtained, because it would deprive patients of the standard of care harm by EMS. Too many people would be harmed by not receiving the standard of care.

We insist that IV fluid for uncontrolled hemorrhage saves lives and claim that evidence of improved survival should not be obtained, because it would deprive patients of the standard of care harm by EMS. Too many people would be harmed by not receiving the standard of care.

If the treatment is not used, the patient dies.

If the treatment is used, the patient lives.

Ask for the evidence and the absence of evidence becomes Everybody knows that . . .
 


 

Why do we believe the people who tell those EMS lies?

We are reckless and refuse to look at the evidence that shows how dangerous we are.

We are primitives who pretend that science does not work, because science does not support our biases.

When will we stop killing our patients with this ignorance?

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