This study will collect information from the records of 3000 children from 30 hospitals presenting after a head injury in 2016 and will interview staff to look at different factors influencing the care provided. APHIRST-Gap is expected to provide crucial information on scan rates and inform strategies, including national guideline development to standardise and improve the care of children with head injury across Australia and New Zealand.
Head injury is a common reason children present to Emergency Departments in Australia and New Zealand. While most are minor the important issue for emergency clinicians is to determine whether a particular child is at risk of a serious head injury such as a bleed on the brain. A computerised tomography(CT) scan is the investigation of choice to look for these injuries. Its presents risks though, including the risk of sedation, and radiation induced cancer.
Several “rules” have been designed to guide doctors in the decision, by weighing up the risk of injury with the risks associated with the scan. The published Australasian APHIRST study examined three of these rules. It found that all three rules performed well, clinicians made sound judgements, and the overall rate of CT scan use was low (10%). APHIRST was limited to 10 large metropolitan, and predominately paediatric hospitals. Most children in Australia are not seen in these hospitals. Further research is required to determine whether there is a large variation in scan use between different hospitals and how best to apply these findings to a broader range of hospitals.
This trial is being run by the PREDICT network and the Principal Investigator is Prof Franz Babl.READ MORE
Convulsive status epilepticus (CSE) occurs when seizures do not stop spontaneously. It is the most severe form of epilepsy, and can result in long-term disabilities and rarely death. It can affect both adults and children, although the causes and outcomes are different in these groups of patients. Treatments of patients with CSE are largely based on expert opinion rather than strong evidence, due to the difficult nature of conducting quality trials in patients with this relatively infrequent condition in the emergency setting. We will determine the incidence and causes of CSE in children in Australia and New Zealand and collect information on the type of seizure, duration, treatment and outcome to determine ways to improve the management of children with CSE.READ MORE