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Area of clinical uncertainty?


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I need some help. I have to begin working on my "Capstone Project" as a graduation requirement and I have no idea where to start. I can not for the life of me come up with an area of clinical uncertainty to formulate a question that can be answered by evaluating evidence based medicine. Any one have any ideas that could get me started? I have complete writer's block.

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What have you come across during rotations? Have any of your preceptors mentioned topics or procedures that are either new or they don't know much about? Have you heard something like this: "I heard there is a newer treatment coming out" or "I think they are developing a new test for this" or "I've heard THIS is a better approach/treatment/diagnostic study than THAT, but I'm not sure why". Dig through your experiences from clinical year, or if you are still in your clinicals then start asking your preceptors about interesting topics.

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We are in our last quarter of didactic so that is why this is a tough place to start as far as clinical experiences. My background is EMS and most of that is evidence based, or not appropriate for this Capstone. I believe I have found a topic however and have started working to narrow it. Thanks everyone for your help and direction.

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One thing I would consider (given your EMS history) is the use of NS or LR in fluid resuscitation for trauma patients with blood loss/hypovolemia. The new reports coming back from the wars in Iraq/Afghanistan are that LR and NS are among the worst things you can do for a person who is bleeding out. The research is playing catch up, from what I understand. If you can find some data and put together a meta-analysis, this is a topic that will upend most of our thought on the subject over the past several decades. Just a thought.

 

Andrew

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