Fibrinogen Early In Severe Trauma in children studY (FEISTY Junior)

Grant ID: EMPJ-371R27-2017

Project Summary

Traumatic injuries in children are a leading cause of death and disability in Australia. In high income countries, 40% of child deaths are because of traumatic injuries. Fibrinogen is one of the key clotting factors that need to be replaced in severe traumatic bleeding.

Currently, fibrinogen is replaced using cryoprecipitate; a blood product obtained from healthy volunteer donors. This is a precious resource that is stored frozen in the blood bank; it can take a long time to administer and place significant strain on blood banks. Fibrinogen concentrate (FC) is an alternative product used to assist in blood clotting. It is a product that is derived from blood plasma but stored in powder form and can be reconstituted at the bedside and given quickly. The study will investigate whether it is quicker to administer FC than cryoprecipitate, which may reduce haemorrhage and improve outcomes.

This study will enrol 30 children from three major paediatric trauma centres in Queensland admitted with severe traumatic bleeding. Time to administration of fibrinogen replacement and the effect of fibrinogen levels will be measured.



- George, S., Wake, E., Jansen, M., Roy, J., Maconachie, S., Paasilahti, A., Wiseman, G., Gibbons, K., Winearls, J., and FEISTY Investigators, 2022. Fibrinogen Early In Severe paediatric Trauma studY (FEISTY junior): protocol for a randomised controlled trial. BMJ open, 12(5), e057780.

- George, S., Wake, E., Sweeny, A., Campbell, D. and Winearls, J., 2022. Rotational thromboelastometry in children presenting to an Australian major trauma centre: A retrospective cohort study. Emergency Medicine Australasia, 34(4), pp.590-598. doi: 10.1111/1742-6723.13939


- Australia and New Zealand Trauma Society 2023, Melbourne, Australia, 12-15 October 2023.

- Australia and New Zealand Intensive Care Society 2023, Adelaide, Australia 29-31 March 2023

- FEISTY Junior - regional centres (Oral Presentation). 2022 Emergency Care Research Symposium, Gold Coast University Hospital, September 2022.

- World Trauma Congress 2020, Brisbane, Australia, 26-29 October 2020.

- Royal Brisbane and Women’s Hospital Trauma Symposium 2019 (Poster). Brisbane, Australia, 21-22 February 2019.

- Campbell, D., Wake, E., FEISTY Junior (oral presentation). Australian Trauma Society October 2018.

- SWAN Conference 2018, Sydney, Australia, 27-28 July 2018.

- George, S., Getting a Little FEISTY - Fibrinogen Replacement in Paediatric Trauma (oral presentation). ACEM ASM 2018. Perth, Australia.

- George, S., FEISTY Junior (oral and poster presentation). GCHHS Research Week 2018. Gold Coast, Australia.


Amount Awarded


Grant Scheme


Principal Investigator:
Dr Christa Bell

Co Investigators:
Dr Shane George
Dr James Winearls
Dr Melanie Jansen
Dr John Roy
Dr Andrew Blanch
Dr Christian Stocker

Associate Investigators:
Dr Emma Cottle
Ms Elizabeth Wake
Dr Glenn Ryan
Dr Catherine Hurn
Dr Greg Wiseman


Collaborating Institutions


  • Linked EMF grant: FEISTY trial in adults
  • Linked EMF grant: Fibrinogen Early In Severe Trauma studY II (FEISTY II)
  • FEISTY website

  • CONTACT US +61 7 3720 5700 Suite 1B, Terraces, 19 Lang Parade, Milton Qld 4064