The aim of this study is to evaluate securement devices for peripheral intravenous catheters (PIVC) in the paediatric ED to determine which method is most effective for reducing PIVC failure, associated costs, acceptability and patient distress.
Infants and children depend on PIVCs for the provision of medical therapy within the emergency department and during hospitalisation. However, PIVC insertion and management is challenging and more than 25% of devices fail. PIVC failure is costly for both the patient and healthcare organisation. Failure may require the child to undergo traumatic reinsertion procedures, delay important medical treatment and prolong length of hospital stay. One way to reduce PIVC failure is with effective PIVC dressing and securement, by ensuring correct catheter position in the vein.
Our trial aims to test if new advances in catheter securement, medical grade superglue (Histoacryl) and an integrated dressing securement product (SorbaView SHIELD), are effective at preventing cannula failure and complications in paediatric patients. Using a three arm, randomised controlled trial, this study will recruit 460 paediatric patients at two regional emergency departments (Logan Hospital, Ipswich Hospital). Children will be randomised to receive PIVC securement by i) standard care, ii) advanced dressing or iii) medical grade superglue and advanced dressing. The main outcome of this trial is PIVC failure, with other important questions surrounding cost effectiveness and patient comfort also to be explored.
It is important for effective, improved cannula security to be explored as this is frequently a first line device choice for treatment, being highly effective in rapid treatment situations. A result in improved treatment delivery will benefit with cost savings in not only product but clinician time spent re-inserting, and a reduction in unnecessary, painful procedures for children.READ MORE
Patient health records contain a significant amount of information through each episode of care provided at a healthcare facility. However, due to the unstructured nature of the clinical information in each record, the clinical data is not readily accessible for research or administrative use unless an expensive and time-consuming manual process is used. Methods of data extraction through various algorithms are available but require training and testing a dataset of annotated health records.
To address this issue, my key aim is to generate structured clinical data from previously inaccessible and unstructured electronic records. I am attempting to develop a process of automatically extracting clinical data from electronic records of patients who present with chest pain to emergency departments in Queensland. The clinical data extracted will be composed of the documented cardiac risk stratification for each patient and major adverse cardiac events.
To develop this data extraction process, an annotation scheme was designed using a widely accepted standardized reporting guideline. Using the annotation scheme, emergency clinicians annotate patient records to produce an annotated dataset for both training and testing machine learning algorithms.READ MORE
Most children with asthma presenting to an emergency department (ED) are managed with inhaled medications and oral steroids. Infrequently, some children are very unwell, and require assistance with their breathing, or intravenous medication Currently, there is minimal information to guide clinicians on which treatment to choose for severe acute asthma. All have side-effects, and we do not know which is most effective. Studies from the UK and Australasia demonstrate significant variation in practice, although Australasian data is nearly 10 years out of date. When comparing treatments, it is important to determine whether or not they can reduce the risk of severe complications, or whether they make a difference in important treatment outcomes.
This project will allow us to determine current management practices for children with severe acute asthma and/or wheeze; how common severe acute asthma is and also how frequently complications of severe asthma occur; and understand where differences in therapy exist between states/regions. We will be looking at sites across Australia and New Zealand. Once complete, this project will provide important data to allow us to design future research to establish the best treatments for severe asthma.
EMF is funding the Queensland sites taking part in this Australasian trial. This study is being run by the PREDICT network. The Chief Investigatory is A/Prof Simon Craig. The study will include 18,000 children aged 1 – 18 years treated for asthma in the ED.READ MORE
Emergency department physicians with no prior specialised ultrasound training can be taught to reliably identify bronchiolitis, pleural effusions, pneumothorax and pneumonia, in children presenting with cough, shortness of breath and hypoxia through the use of lung ultrasound after a brief training. In this study, we are assessing the effectiveness of trainees performing a lung ultrasound examination of children, capturing their images and recording their findings. No clinical decisions will be made based on these findings without consultation with the consultant on duty. We will consider to what extent the teaching was successful and try to determine whether the teaching resulted in a objectively verifiable benefit to the emergency department. We anticipate a reduction in the amount of time the child spends in the department. It is also anticipated that there will be decline in x-rays relative to the number of presenting patients.READ MORE