Research portfolio


Current studies                                             

Australia and New Zealand Collaborations

(click on map to see CCREM collaborators)

(1)    Coordinated by CCREM

Restricted Fluid Resuscitation in Sepsis-associated Hypotension Trial (REFRESH)
[Twitter account: @REFRESH_Trial]
A multicentre randomised trial of fluid restricted versus fluid liberal resuscitation in early management of sepsis.

Critical illness and shock study (CISS)

A prospective study of patients presenting to the Emergency Department with critical illness or injury that compromise the cardiovascular and/or respiratory systems. Currently focussing on the acute immune response to anaphylaxis, septic shock, traumatic brain injury and post-cardiac arrest.

Identification of biomarkers that correlate with clinical features and outcomes following concussion (Concussion)
Clinical data, imaging, neuropsychological testing and blood samples of patients with concussion will be correlated with outcomes. This may lead to the development of improved tools for diagnosis and prognosis.

Primary Spontaneous Pneumothorax Study
An Australasian randomised controlled trial of conservative management with observation only versus interventional (aspiration and/or insertion of chest drain) treatment of primary spontaneous pneumothorax (see details below).

Chest Pain Registry
The chest pain registry is a longitudinal study of patients presenting to the Emergency Department with chest pain and is looking at medium term outcomes of these patients. Coordinated by CCREM partner, Fremantle Hospital Emergency Medicine Research

Western Australian Illicit Substance Evaluation (WISE) [On hold]
A single centre observational study of patients with suspected intoxication with illicit stimulant drugs.

Nausea
A study to assess the effectiveness of current ED treatment in the reduction of symptoms of nausea and vomiting.

(2)   Collaborations - patient recruitment at CCREM sites, but coordinated by other centres or units

The FluCAN Surveillance System
FluCAN is the first system in Australia to collect high quality and reliable data on hospitalised acute respiratory disease and other influenza-related admissions in real time. Royal Perth Hospital participates as the sentinel site for WA. (Dr A Cheng, Infectious Diseases Unit, Alfred Hospital).

Australian Snakebite Project (ASP)
A national multicentre observational study investigating the appropriate use, dose and safety of snake antivenoms in Australia. (Dr G Isbister, University of Newcastle, Calvary Mater Hospital).

FOODS
A double blinded randomised control trial of drugs versus placebo in soft food bolus oesophageal impactions.

ARISE
Multi-centre observational descriptive study of current practice; 

The Australasian Resuscitation In Sepsis Evaluation: FLUid or Vasopressors In Emergency Department Sepsis. (ARISE FLUIDS observational study)



Pneumothorax study / Chief Investigators: Professor Simon Brown, Dr Emma Ball / ACTRN12611000184976 

Enrolment is complete. Follow up continues.

A randomised controlled trial of invasive versus conservative treatment of primary spontaneous pneumothorax (PSP)

The incidence of primary spontaneous pneumothorax (PSP) is around 18-28/100,000 per year for men and 1.2-6/100,000 per year for women. Current treatment guidelines emphasise the importance of intervention, which involves insertion of a chest drain, hospital admission, and thoracic surgery in some. This approach has been questioned and there is evidence to suggest that conservative management (doing nothing) may be just as effective and safe.

The main aim of this study is to determine whether conservative management of primary spontaneous pneumothorax is an acceptable and safe therapeutic option, and whether it has any specific advantages for patients, compared to a standard interventional approach.

We aim to recruit people presenting to Emergency Departments (ED) with a first primary spontaneous pneumothorax. Participants will be randomly allocated to either intervention or conservative treatment.

The main outcome of the study (the “primary outcome”) will be the proportion of participants with complete lung re-expansion by 8 weeks. We also compare the rate of complications, days in hospital or off work, and patient satisfaction.


Previous Research

Inflammation and acute stroke study
A study of patients presenting to the ED with acute stroke, investigating early immunological markers.

Microcirculation in Acute Atrial Fibrillation
An observational study of the effects of atrial fibrillation on the microcirculation using dynamic near infrared spectroscopy.

Target Pain Study
A multi-Emergency Department study testing if the adoption of a pain score target will increase patient satisfaction with their pain management in the ED. (Prof D Taylor, Austin Health)

Clinical Associations with Acute Decompensated Diastolic Heart Failure in the Elderly (DHF Study)
A multicentre, prospective observational study following elderly patients with established DHF over a period of time by comparing their baseline characteristics when they are well to when they present unwell to the Emergency Department.

Jack Jumper Ant Venom Immunotherapy (JJA VIT) Trials
A study of immunotherapy dosing and immune response (IgE, IgG4). First phase published in the Journal of Allergy and Clinical Immunology (2012). Completed in 2013.

Emergency Department Anaphylaxis Studies (EDA II and III)
A randomised controlled trial of intramuscular versus intravenous adrenaline during anaphylaxis (ii) A study of gene activation and biochemical mediators of anaphylaxis.

Australasian Resuscitation in Sepsis Evaluation (ARISE Study)
A multi-centre, randomised controlled trial of early goal-directed therapy in patients presenting to the emergency department with severe sepsis in Australasia (ANZICS Clinical Trials Group)

Australian Snakebite Project and Fresh Frozen Plasma Study (ASP-FFP)
A national multicentre prospective cohort study of snake envenoming in Australia (Dr G Isbister, University of Newcastle, Calvary Mater Hospital).

Redback Antivenom Evaluation (RAVE) II Study
Randomised controlled trial of intravenous antivenom versus placebo in the treatment of redback spider bite. Completed April 2013 (Dr G Isbister, University of Newcastle, Calvary Mater Hospital).

Quantifying alcohol-related harm presenting to Emergency Departments in Australasia
To determine the proportion of alcohol-related presentations to emergency departments in Australia and New Zealand, at a single time point on a weekend night shift (Dr Diana Egerton-Warburton, ACEM)

Evidence-based paramedic models of care to reduce unnecessary emergency department attendance: feasibility and safety
Development and validation of clinical protocols for extended care paramedics (Prof I Jacobs, Curtin University).

Functional status of survivors of out-of-hospital cardiac arrest (OCHA) in Perth
A retrospective observational study to determine the functional/neurological outcome of OHCA survivors discharged from hospital and to estimate the uptake of post-resuscitation practices such as therapeutic hypothermia and coronary reperfusion (Prof I Jacobs, Curtin University).

Emergency Department Complex Needs Coordination Team (ED CoNeCT)
A randomised trial of patient centred intervention to reduce re-presentations of older people at risk after discharge from the emergency department.

Preferences for the organisation of acute health services for older people (PROSpER)
Preferences for providing acute medical care for people living in residential aged care facilities (University of Sydney).

Assessing Risk in Sepsis using Tissue Oxygen Saturations (ARISTOS)
A clinical observational study examining the use of near infrared spectroscopy derived tissue oxygen saturation at the bedside in Emergency Department patients with sepsis to determine the utility of this measure to predict organ dysfunction.

Emergency Department Delirium Identification (EDDI) trial
A clinical trial of a new delirium identification tool and early warning system.

Sepsis/Saline Trial
A pilot randomised trial of hypertonic saline versus normal saline as the initial bolus fluid in patients with infectious systemic inflammatory response syndrome.

The prophylactic hypothermia trial to lessen traumatic brain injury (POLAR)
This trial will investigate whether early and sustained cooling of patients with severe traumatic brain injury is associated with better survival and less disability compared to standard care in which patients are maintained at normal temperature (ANZICS Clinical Trials Group).

Australian Snakebite Project and Fresh Frozen Plasma Study (ASP-FFP)
A national multicentre prospective cohort study of snake envenoming in Australia (Dr G
Isbister, University of Newcastle, Calvary Mater Hospital).

Improving quality of life in residential aged care
A randomised controlled trial to reduce emergency department transfers and improve quality of life in residential aged care facilities.

Emergency Department Anaphylaxis Studies (EDA II and III)
(i) A randomised controlled trial of intramuscular versus intravenous adrenaline during anaphylaxis (ii) A study of gene activation and biochemical mediators of anaphylaxis.

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