Biomarkers for rapid diagnosis of paediatric sepsis

Sepsis is a time critical medical emergency that arises when the body starts to attack its own tissues and organs in response to an infection. Sepsis can result in organ dysfunction, multi-organ failure and death if not treated promptly, and is a leading cause of death in children worldwide. Sepsis often presents with non-specific signs common to many mild infections, making it difficult to detect early and accurately, leading to delaying appropriate treatments and resulting in severe sepsis. Therefore, it is vital to identify new approaches to rapidly identify the type of infection and predict the severity of the condition in patients presenting with suspected sepsis to enable early initiation of appropriate treatments.

Recent advances in genomic technologies have shown that gene expression based infection testing has the potential to provide much faster and more precise results. This results in more accurate diagnosis of infections and appropriate timely treatments. Our study will utilise an advanced gene expression analysis approach named single-cell RNA sequencing to identify new approaches for sepsis diagnosis. This could lead to development of a rapid testing method which can predict the type of infection (bacterial or viral) and the severity of the condition with a quick turnaround time for results, improving patient outcomes, reducing unnecessary antibiotic use, and shortening hospital length of stay.

Decimalate: Use of an on-line Smart Test and survey to determine whether comprehension of decimals is a barrier to interpretation of clinical chemistry results among Emergency Department staff.

Recognition of the extent of medication errors resulting from misinterpretation of instructions have resulted in a multitude of recommended practices to reduce the likelihood. One area which may contribute to error, but one which has received less attention, is that of accurate interpretation of clinical chemistry results. It is well recognised that numbers containing decimal places can lead to error in medications with decimals overlooked or misplaced. Anecdotal evidence from Emergency Physicians indicates difficulty in interpreting clinical chemistry results which are presented with leading decimals (e.g. 0.0095 g/l).

Misconceptions about decimals have been the subject of extensive study. Half of student teachers were unable to place 0.606, 0.0666, 0.6, 0.66 and 0.060 in correct sequence and 40 per cent of nurses demonstrated a lack of basic computational ability with, and incomplete or incorrect conceptual understanding of, decimals. No research has been found to-date with medical staff. Whilst remedial teaching is beneficial it may not be a practical solution to the identified problem within the Emergency Department. Rather a change in the presentation of results may provide a simple and practical solution; for example the presentation of Troponin 1 as 40 pg/ml rather than 0.04 ng/ml. Such change will not be effected however without evidence of need.

The goal of the research is to provide recommendations which ultimately could lead to improvements in patient safety. The more modest project objectives are to increase user friendliness of results and reduce the potential for errors.