Project Snapshot – Head Injury Co-design

Co-designing discharge communication strategies for paediatric minor head injuries.

Co-ordinating PI:

Emma Tavender/Franz Babl

Study Co-ordinator ANZ

Emma Tavender/Cate Wilson

Study aim/s:

To improve discharge communication currently provided to children presenting to the ED with mild to moderate head injuries (concussion). Specifically, adolescents who have an increased risk of post-concussion symptoms (PCS).

Study design:

Mixed Methods:  stepped co-design method to engage consumers (parents and youths) and clinicians in the development of head injury discharge communication strategies.

Primary outcome:

Co-designed discharge communication strategies for adolescents with mild to moderate head injuries (concussion) with parents, youths and clinicians.

Additional outcomes:
  • Training materials that can be used for future co-design efforts
  • Advancement in the science of implementation and contribution to future discharge communication strategy development for other common paediatric ED presentations.
Current status:
  • Ethics received from RCH and Western Health.
  • Recruited four parents, four clinicians and three youths to participate.
  • Orientation/training session plus three meetings held.
  • Priorities for improvement have been determined.
  • List of priorities reduced to two key areas for improvement: Head injury: what to expect in the ED and Concussion discharge information.
  • Prototype to address the two key priorities that have been developed and updated in response to new International Sports-related Concussion guidance (Amsterdam 2023)
  • Plan to start usability testing end 2023/early 2024.

 

 

 

BREAKING NEWS – NHMRC Centre of Research Excellence grant application successful!

We are very excited to announce that we have received NHMRC (National Health and Medical Research Council) CRE funding ($2.5m) for the next 5 years which will support us to continue our PREDICT research plans.

The new CRE will continue to target conditions including sepsis and acute respiratory conditions like asthma, bronchiolitis and pneumonia. Additionally there will be a focus on improving family input at all stages of the trial design and execution and improved translation plus tracking of changes in care.

Over the next five years, the grant will also fund the creation of a family-facing smartphone app for families for certain high-risk conditions and an emergency department-focused implementation toolkit that can be adapted for hospitals across Australia and New Zealand.

The NHMRC funding will also develop Australia’s future workforce, training emerging leaders in emergency care through the creation of higher degree scholarships and postdoctoral opportunities. Through research and the implementation of best evidence, students and researchers within the CRE in Paediatric Emergency Medicine will be mentored across specialties and disciplines to become independent researchers who can improve the lives of all children who visit emergency departments.

The application was a massive collaborative effort from many people across many sites and thanks goes to all involved in this successful application.

We will discuss the CRE at the next PREDICT members meeting in November and look forward to an exciting and productive future for PREDICT!

Project Snapshot – BIPED

BI-PED Study

A Randomised Controlled Trial Comparing Epinephrine and Dexamethasone to Placebo in the Treatment of Infants with Bronchiolitis

Co-ordinating PI:

Amy Plint (Canada), Ed Oakley (Australia), Stuart Dalziel (New Zealand)

Study Co-ordinator ANZ

Sharon O’Brien

Study design:

International, multicentre, Phase 111, double-blind, randomised controlled trial

For further details about the study please see: https://www.predict.org.au/new-projects/bi-ped-study/

Current status:

The research team are pleased to announce that the 5th season of the BIPED trial has been the most successful yet, reaching 598/864 participants recruited! The yearly recruitment was 28% of our total sample size; almost 100 more participants were enrolled in season 5 than were enrolled in season 4.

We have just over 30% (266) of our sample size left to recruit!
Please see below a number of charts which show study progress both locally and internationally.

CountrySiteTotal RecruitmentSeason 5 recruiment
CanadaChildren's Hospital of Eastern Ontario (CHE)
14236
CanadaCHU Sainte Justine (STJ)4712
CanadaAlberta Children's Hospital (ACH)449
CanadaStollery Children's Hospital (SCH)217
CanadaChildren's Hospital of Winnepeg (WPG)183
CanadaLondon Health Sciences (LHC)111
AustraliaPerth Children's Hospital (PCH)14360
AustraliaWomen's and Children's Hospital (WCH)4831
AustraliaMonash Medical Center (MMC)3626
New ZealandStarship Children's Hospital (SSH)5233
New ZealandKidz First Middlemore Hospital (KFH)2117
New ZealandWaikato Hospital) (WHH)155
TOTAL598239

Getting to know you – meet Lara Caruso

Our “Getting to Know You” segment ensures PREDICT members are aware of new members, their interests and areas of expertise and where they are located.

This month we introduce Lara Caruso.

“I work in the Paediatric Emergency Department at the Womens & Childrens Hospital, Adelaide both on the floor as a Clinical Nurse and under Dr Amit Kochar as a Research assistant. Although I have a general interest in all paediatric emergency research, mental health would be my favourite.”

Welcome to PREDICT Lara!

 

 

 

 

 

New PREDICT publications

Congratulations to the following PREDICT authors:

Parr M, Wilson CL, Jones B, Crawford NW, Ferguson S, Ramesh S, Eapen N, Craig S, Hearps S, Babl FE.
“Emergency Department Presentations for Chest Complaints after Mrna Covid-19 Vaccinations in Children and Adolescents.” Emerg Med Australas  (Accepted Sept. 2023, in press).

PhD Opportunity – UTAS – IMPACT project

An exciting PhD opportunity to join the MRFF-funded Implementing clinical Pathways for Acute Care in Tasmania (IMPACT) project team, led by Dr Viet Tran (Royal Hobart Hospital and Statewide Director of Emergency Medicine Research).

The aims of the PhD are to improve care in Tasmanian EDs by embedding implementation science principles in health care systems and developing strategies to increase uptake of acute clinical pathways and reduce variations in care. The target acute care clinical improvement area will be co-developed with the candidate, dependent on clinical research interest.

Further details can be found here: Implementation Science improving ED care | University of Tasmania (utas.edu.au)) or contact Emma Tavender (emma.tavender@mcri.edu.au) if you have any specific questions.

Amit Kochar wins Research Award!

Congratulations to Dr Amit Kochar who was awarded the Research and Innovation Award at the Women’s and Children’s Health Network Excellence Awards ceremony held on Friday, August 11th, 2023.

Amit has been a strong leader, motivating the team at WCHN to continuously strive for improvement and reach goals. Undoubtedly, achieving success in  research trials within the Paediatric Emergency Department is a collaborative effort involving a vast array of hospital personnel, nursing and medical staff.

Congratulations to Amit and the WCH team from PREDICT! 

 

 

Project Snapshot – PEACHY O & M

PEAChY – O: Pharmacological Emergency management of Agitation in Children and Young people – A randomised controlled trial of Oral medication

Co-ordinating PI:  Elyssia Bourke

Study Co-ordinator: Kate Klein
Study design:

Randomised, controlled, open-label, multi-centre, phase III superiority effectiveness trial of: ORAL olanzapine vs ORAL diazepam.

For further background information see: https://www.predict.org.au/projects/peachy-o-and-peachy-m-studies/

Current status:

  • Study target sample size of 348 participants currently at 94% (N = 325 recruited). Nearing completion, over 12 months ahead of schedule!
  • PEAChY-O is on track to be complete by mid-September 2023.
  • Data cleaning is set to be finalised at all participating sites by late October, ready for final analysis.
  • An abstract is planned for presentation at the PAS in January 2024.

 

PEAChY- M: Pharmacological Emergency management of Agitation in Children and Young people – A randomised controlled trial of IntraMuscular medication

Study design:

Randomised, controlled, open-label, multi-centre, phase III superiority effectiveness trial of: INTRAMUSCULAR olanzapine vs INTRAMUSCULAR droperidol.

For further background information see: https://www.predict.org.au/projects/peachy-o-and-peachy-m-studies/

Current status:

  • Currently, 36% of the total number of participants required to meet the target sample size of 348 have been recruited.
  • Low recruitment across all sites due to several reasons. For example, management of ASBD events in the ED environment can be challenging and, commonly, many enrolled participants subsequently de-escalate (in behaviour) and no longer require IM medication (i.e. they either accept oral medication or no longer require any medication).
  • Education of clinical staff related to PEAChY-M continues at all sites to improve recruitment rates.

New PREDICT publications

Congratulations to the following PREDICT authors:

Borland ML, O’Brien S, Tavender E, Haskell L, Babl FE, Schembri R, Smedley B, Mitenko H, Robertson T, Mukherjee A, Dalziel SR. Evaluation of targeted implementation interventions for reducing investigations and therapies in infants with bronchiolitis. Acta Paediatr. 2023 Apr 6. doi: 10.1111/apa.16786. Epub ahead of print. PMID: 37026175.

O’Brien SL, Haskell L, Tavender EJ, Wilson S, Borland ML, Oakley E, Dalziel SR, Gill FJ. Factors influencing health professionals’ use of high-flow nasal cannula therapy for infants with bronchiolitis – A qualitative study. Frontiers in Pediatrics. 2023; 11: 1098577. 

Bourke EM, Douglas N, Wilson CL, Anderson D, Nehme Z, Babl FE; Paediatric Research in Emergency Departments International Collaborative (PREDICT). Acute Severe Behavioral Disturbance Requiring Parenteral Sedation in Pediatric Mental Health Presentations to Emergency Medical Services: A Retrospective Chart Review. Ann Emerg Med. 2023 Jun 30:S0196-0644(23)00355-4. doi: 10.1016/j.annemergmed.2023.04.028. Epub ahead of print. PMID: 37389492.

Craig S, Delardes B, Nehme Z, Wilson C, Dalziel S, Nixon GM, Powell C, Graudins A, Babl FE; PREDICT Network. Acute paediatric asthma treatment in the prehospital setting: a retrospective observational study. BMJ Open. 2023 Jun 22;13(6):e073029. doi: 10.1136/bmjopen-2023-073029. PMID: 37349099; PMCID: PMC10314617.

Getting to know you – meet Rebecca Gridley

Our “Getting to Know You” segment ensures PREDICT members are aware of new members, their interests and areas of expertise and where they are located.

This month we introduce Rebecca Gridley from the Queensland Children’s Hospital.

“I am currently an Advanced Trainee in Emergency Medicine and have been working at Queensland Children’s Hospital for the past 12 months. I have been very lucky to be involved in the data collection for some current studies within paediatric care, fostering an interest in research. I will be moving hospitals as part of my training but would like to stay linked in with research projects and remain up to date with evidence to provide the best possible care to all patients that I see. I hope to be able to contribute to research and continue to support advances in health care as my career progresses.”

Welcome to PREDICT Rebecca!