- © 2008 Canadian Medical Association or its licensors
The recent article by Ian Stiell and colleagues on prehospital care was excellent.1 However, as we question the value of prehospital advanced life-support we also need to determine whether in-hospital emergency advanced life-support makes a difference in patient outcomes. Those of us who have provided advanced cardiac life-support and listened to unsubstantiated claims about its benefits over the years must be aware that the use of bicarbonate, bretylium, calcium, vasopressin, amiodarone and many other drugs has probably done more harm than good.
It is important to practise evidence-based medicine and thus the use of prehospital advanced life-support should be validated, but we must also recognize that the role of emergency physicians in both advanced trauma life-support and advanced cardiac life-support has never been validated in an outcome study either.
Footnotes
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Competing interests: None declared.
REFERENCE
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