External Ventricular Devices in Aeromedical Retrieval- Are they Safe?

Nationally, 1-2 % of the population will sustain a significant bleed due to the rupture of an abnormal ballooning of the blood vessels within the brain. A complication of this, called hydrocephalus, requires a drain to be inserted into the brain to reduce excessive fluid build-up, until the definitive management is achieved. Advances in interventional radiology techniques such as endovascular coiling have become common practice in the management of these patients. In Queensland, endovascular coiling is mostly performed in Brisbane, and therefore patients outside of the Brisbane area are required to travel for this treatment. For critically unwell patients in North Queensland, the only option is aeromedical retrieval. This area of aeromedical retrieval has not been previously explored therefore this project will look at the safety of aeromedical transports of patients with an invasive drain in a patient’s brain to work towards statewide guidelines.

Implementation of Nasal High Flow: A Remote Context

In this study, the clinician-researchers are exploring whether nasal high flow (NHF) therapy can be safely and effectively used to improve health outcomes for infants with bronchiolitis in isolated remote communities, in particular for remote Indigenous Australians who have a higher incidence rate of bronchiolitis than non-Indigenous Australians. There is a desire by clinicians to implement NHF in remote areas, but this should undergo similar scientific scrutiny as previous published data.

NHF is a respiratory support system that provides support for people with respiratory conditions and is applied by high flow oxygen through nasal prongs. The therapy can avoid an escalation of care during hospitalisation. The safety of NHF has been widely studied in tertiary areas and regional hospitals, however, there is a lack of evidence to support safe use in remote settings.

In this study, the researchers are employing a two-phased approach: Firstly, an expert working party establishing agreed safe clinical boundaries for the NHF implementation and utilising expert viewpoints for implementation when managing infants with bronchiolitis. Secondly, a comparison of the outcomes before and after implementation to observe a reduction in escalation of care leading to reduced transfers. A community engagement process, with the focus to keep community members in their country/home environment, will be established to measure psychological, social-emotional and economic benefits of NHF.