EBM Reviews | Myth Busters

by Louell L. Sala, MD

How sound are current practices on maternal and child care? In this section we take a look at some of these expert practices and recommendations comparing their evidences vis a vis methods used and conclusions drawn from related research and clinical observations.

NPO

Fasting in labor is common practice among our attending physicians as we always see the word NPO (short for nil per os) among patients going through labor. But is there really evidence to suggest that if fasting is not done during labor, patients will aspirate gastric contents during induction of anesthesia?

The evidence does not support this common belief. In a systematic review done by Singata et al. at the University of Fort Hare/East London Complex, East London South Africa, and using the Cochrane Pregnancy and Childbirth Group Trials Register of 2009, the authors found that there was no benefit or harm done to these patients. Using randomized controlled trials (RCT) and quasi-RCTs, they identified 5 studies with a total population of 3130 women. All studies looked at women in active labor and at low risk of potentially requiring a general anaesthetic.

EBM Reviews | Enemas During Labor & Perineal Shaving

by Louell L. Sala, MD


What is Evidence Based Medicine?
In a world where information can be achieved with a click of a button and yet can be disorganized and unvalidated, Dr. David Sackett in 1996 introduced the concept of Evidence Based Medicine. Defined as a conscientious, explicit, judicious use of current best evidence in making decisions about the care of individual patient, Dr. Sackett described it as a means of integrating individual clinical expertise with the best available external clinical evidence from systematic research. It was created so that as physicians, we can be up to date with the latest modalities, whether diagnostic, treatment or clinical practice guidelines, but more importantly for better quality of care and utilization of resources. 

Dr. Jessamine Sareno giving our GenSan audience a crash course in evidence based medicine

In their book “Painless Evidence-Based Medicine”, Drs. Antonio Dans, Leonila Dans and Maria Asuncion Silvestre set forth this definition "EBM is a systematic approach to the acquisition, appraisal and application of research evidence to guide healthcare decisions." [1]

The EINC Bulletin will look at the respective studies behind the EINC practices, dissect them and provide a short assessment that are sound and evidence - based. But in the end we should always emphasize that you are still the attending physician. After all it is the triad of individual clinical expertise, best external evidence and patient values and expectations that forms the backbone of evidence based medicine.