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Gold Coast knowledge powering remote health improvements

Paediatric Research Fellow Dr Donna Franklin, based at Gold Coast Health, is leading a study to help children with acute respiratory failure in remote parts of Queensland.

A Gold Coast Health paediatric critical care nurse is taking her research project from the coast to country in remote Queensland courtesy of a $1.6 million grant from the Medical Research Future Fund.

Paediatric Research Fellow Dr Donna Franklin is chief investigator in PARIS on Country which is investigating empowering local clinicians to use new oxygen therapies for children who present to Emergency Departments with acute respiratory failure to limit the need for transferring the patient to an urban hospital. Gold Coast Health's Dr Shane George is also part of the project.

The Paediatric Acute Respiratory Intervention Studies (PARIS) began in 2013 across 17 centres including regional and tertiary hospitals in Queensland investigating use of nasal high flow in bronchiolitis and was published in the prestigious New England Journal of Medicine in 2018.

The next stage of PARIS recruited more than 2200 children in both the pilot study and multicentre international randomised controlled trial which involved 14 hospitals and investigated the use of nasal high flow in children with acute respiratory failure. Dr Franklin then turned her attention to remote Queensland.    

“PARIS studies over the past five years have resulted in a major shift in the paradigm of respiratory support for an acutely unwell child with breathing distress,” Dr Franklin said.

“Intensive Care Units are intimidating and terrifying for children and their parents, but paramount and necessary for those of us who need the help of skilled intensive care teams. Only a few studies in critically ill children have addressed the potential of an early intervention to prevent the progression of acute respiratory disease.”

The latest funding of $1,630,153 comes from the Federal Government’s Medical Research Future Fund grant round for 2022 Models of Care to Improve the Efficiency and Effectiveness of Acute Care. 

“PARIS on Country is addressing the inequality between urban and rural hospitals, of clinicians caring for a child presenting to a rural and remove emergency department in respiratory distress,” Dr Franklin said.

“In Far North Queensland, 50 per cent mostly indigenous children with acute respiratory failure require transfer to a higher level of care in Cairns or Townsville, whereas in South East Queensland up to 12 per cent of these children require inter-hospital transfer for a higher level of care. 

“This imposes significant emotional stress on families and children – the transfer is expensive and perceived by many parents as unnecessary. 

“The aim of PARIS on Country is ultimately to keep indigenous community members in their community because this has positive psychological and social-emotional impacts, but it also has significant cost benefits for health care.” 

Dr Franklin leads a collaborative team working on the study, including academics from Griffith University and James Cook University, as well as health services in Torres and Cape, Cairns, Townsville and Northwest Queensland.

Dr Franklin is a member of the Gold Coast Health Children’s Critical Care and Emergency Department Collaborative Research Group which contributes to more than 60 research projects and publishes dozens of articles in peer-reviewed journals each year. 

Last updated 18 May 2022