ABSTRACT
I. RESEARCH PROBLEMS A. Introduction: Lack of Randomized Controlled Trials In 1991, Jones and Brenneis [1] concluded from an analysis of nine comparative studies that ‘‘In general the studies are limited by heterogeneous levels of service or approach to care. They often study a small specific subset of trauma population and are not randomized.’’ Most of the studies contain substandard levels of care with respect to on-scene time and performance of procedures. Spaite et al. [2] came to an almost identical conclusion. ‘‘Current methods for the evaluation of EMS (Emergency Medical Services) systems are fundamentally inadequate for answering important questions because they rely mainly on the traditional medical model.’’ Recently Spaite et al. [3] wrote in another article on the subject: ‘‘There is a desperate need for prospective, randomized controlled trials that compare ALS (Advanced Life Support) versus Basic Life Support prehospital care in victims of major trauma.’’ Pepe and Eckstein [4] emphasized in an article on prehospital care of the trauma patient that although for the ‘‘use of the PASG (Pneumatic Anti Shock Garments) prospective controlled trials have been recommended,’’ ‘‘statistical evidence is still lacking,’’ and ‘‘further studies are needed.’’
