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Emergency Medicine Research: Opportunities for just about anything!

Emergency Medicine Research: Opportunities for just about anything!. Prof David Taylor Director of Emergency and General Medicine Research, Austin Health. What is Emergency Medicine?. the management of any medical condition presenting from the community breadth and depth multi-disciplinary

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Emergency Medicine Research: Opportunities for just about anything!

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  1. Emergency Medicine Research: Opportunities for just about anything! Prof David Taylor Director of Emergency and General Medicine Research, Austin Health

  2. What is Emergency Medicine? • the management of any medical condition presenting from the community • breadth and depth • multi-disciplinary • interface between the community and inpatient care

  3. What is Emergency Medicine? • the management of any medical condition presenting from the community • breadth and depth • multi-disciplinary • interface between the community and inpatient care

  4. The ED interface – inpatient care Emergency Department Community providers General Practice Nursing homes Ambulance Retrieval Diagnostics Education Inpatient services Outpatient services Admin

  5. The paradigm shift 1980: triage, quick fix or referral 2010: triage, extended management +/- referral 2012: triage, quick fix or referral

  6. Extended management • thrombolysis • procedural sedation • resuscitation • fracture/dislocation • point of care testing • multi-disciplinary triage • nurse practitioners • pharmacists • primary care physio • nurse analgesia • care coordination • short stay units • community outreach

  7. Opportunities for ED Research • lots of patients • lots of diseases • lots of potential collaborators • evolving paradigm, evolving research questions • considerable interest • students, ACEM training requirement • extra dimension to clinical work

  8. Collaborations: Austin Departments: • General Medicine • Clinical Pharmacology • Infectious Diseases • Respiratory Medicine • Microbiology • Physiotherapy • Intensive Care • Victorian Poisons Info Centre • Universities: • Melbourne • Monash • La Trobe • RMIT • Uni QLD • Uni WA • Diver Alert Network • (SE-Asia Pacific)

  9. Collaborations: Hospitals • Royal Melbourne • St Vincent’s • Box Hill • Alfred • Northern • Epworth • Royal Adelaide (SA) • Liverpool (NSW) • Royal Brisbane & Women’s (QLD) • Redcliffe (QLD) • Prince Charles (QLD) • et al……….

  10. Difficulties of ED Research • clinical service pressures • lack of track record and expertise • lack of infrastructure and resources • short patient interaction time • patients are ill, by definition • informed consent • incentive to follow up

  11. Funding • beg, borrow and steal……shoestrings • Competitive grants • NHMRC • ARC • RMIT • ACEM • Philanthropic organizations • AMS student supervision • Prizes & Awards

  12. What sort of studies do we undertake? • Observational • Process evaluation • Epidemiological • Clinical trials • RCTs • intervention

  13. Studies: Observational • ‘Procedural sedation practices and factors associated with adverse events’ • ‘Complementary and Alternative Medicine use among ED patients taking warfarin’ • ‘Mobile phone use by Melbourne drivers’

  14. Studies: Process Evaluation • ‘Primary Contact Physiotherapy Service in the Emergency Department’ • ‘Nurse-initiated Analgesia for Emergency Department patients’ • ‘Utility of abdominal Xrays among emergency department patients’

  15. Studies: Epidemiology • ‘Chemical eye injuries reported to the Victorian Poisons Information Centre’ • ‘Absenteeism among public hospital staff’ • ‘Paediatric dog bite injuries in the domestic setting’

  16. Studies: Clinical Trials • ‘IV droperidol and olanzapine as adjuncts to midazolam for the acutely agitated patient: a multi-centre, randomized, double blind controlled trial’ • ‘Tropisetron vs metoclopramide for nausea and vomiting: a randomised, double blind, clinical trial’ • ‘Fascia iliaca block versus femoral nerve block for femoral neck fractures: a randomized, clinical trial’

  17. Studies: the past • Scuba diving • Surfing • Mobile phone use • Weather and the ED • Animal bites • Marine animal injuries • Obesity • Health Smart cards • Fungi • Alcohol use • Complementary meds • Complaints • Psych health • Advance directives • Self harm • Facsimile

  18. The Problem • Wide range of: • topics • presentation venues • publication options • funding sources • Master of nothing !! • funding • career

  19. The Future: Infrastructure • Personnel • Research assistant/nurse • Research fellowship • MD, PhD, BMedSci (AMS) scholars • Facilities • Dedicated office space • Computing, statistical software etc • Collaboration • within the Austin • other EDs, universities, institutions

  20. ED Research: The next frontier? • relatively new frontier • one of a number • immunology • genetics • imaging • oncology • ED collaborations • ACEM clinical trials group • NHMRC track record

  21. Your research: • interesting • useful • themed for track record • publish or perish • fun!!

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