This multicenter study has two primary aims; (1) we will assess Emergency Department-level variation in the use of CT scanning of the brain (CTB) in the diagnosis of children with mild head injury in tertiary, urban, and rural/regional hospitals in Australia and NZ, and identify potential hospital and/or patient level factors associated with CTB use; (2) we will identify and explore the clinician and organisational related factors influencing the use of CTB at participating Emergency Departments in children with head injuries and determine resource availability and need.

Each site will conduct a medical record audit to extract data relating to children who have presented with a head injury to the emergency department in 2016. Data will be extracted using a case report and entered into a web-based database.  Qualitative semistructured interviews will be conducted with invited doctors and nurses who treat children in the participating EDs, via telephone using a semi-structured interview proforma based on the Theoretical Domains Framework.

Alcohol misuse is a major health issue and can cause many diseases and injury conditions. The extent of alcohol related presentations to the emergency department is likely underestimated.

This research project aims to provide an overview of alcohol-related presentations to understand their prevalence as well as the group’s demographic profile, clinical characteristics, care delivery and outcomes.

The anticipated knowledge from this study can be used to inform future research, especially related to the implementation and evaluation of evidence-based interventions in the emergency department.

Shortness of breath (dyspnoea) is a common reason for presentation to Emergency Departments. The causes can include flare up due to chronic conditions such as asthma, heart failure, or chronic lung disease.

Significant knowledge about patients admitted to hospital with common causes is available. However, information about dyspnoea as a symptom is inconclusive. Cause distribution, the proportion of patients requiring admission and whether treatment complies with evidence-based guidelines is also unclear.

With reliable data on this symptom across several hospitals in different countries, the study results can highlight care improvement opportunities.

When patients have a serious infection, it can lead to sepsis, which means the infection can affect vital organs. If the blood pressure is low due to sepsis, traditionally doctors would give intravenous fluids. However, evidence suggests that too much fluid may be harmful. What the best amount of fluid is and when medications that support the blood pressure (also called vasopressors) should start is unknown.

This study showed that a restricted fluid and early vasopressor schedule in emergency department patients with suspected sepsis and hypotension appears practical. A future trial is necessary with high-risk patient recruitment to determine effects on clinical outcomes in this setting.

The emergency department is one of the most stressful places to work in health care, with clinician burnout featuring more often in the lay medial and peer-review literature. It is imperative we understand and work with emergency clinicians and hospital health service managers to assist with implementing appropriate strategies designed to effectively help our front line staff. This research project aims to provide a baseline understanding as to what factors of their working environment emergency department staff find most stressful, and what strategies they use to cope with these stressors. The knowledge gained from this study will inform future research, such as longitudinal studies to determine changes over time, as well as the development, implementation and evaluation of targeted strategies designed to assist staff work in busy emergency departments, both in Australia and internationally.

People who present to the emergency department by police are a vulnerable population. Limited evidence exists as to what and how health care is best delivered to these people. This research aims to understand if the demographic, clinical profile and outcomes of people arriving to the emergency department by police differ to those for people arriving by other means. The study also aims to evaluate the structures, processes and outcomes of a trial where emergency department nurses worked in the local police watch house.

Primary spontaneous pneumothorax (PSP) is a collapsed lung with air in the pleural cavity that occurs without a clinically apparent underlying lung disease. Over time this condition has been treated more often with interventional approaches such as a chest drain. The reasons for this are unclear and this approach has recently been questioned in scientific literature.

The research was a multi-site randomised trial of more than 300 patients in over 25 hospitals in Australia and New Zealand, which compared intervention with observation alone.

The study results will largely impact on current medical practice and international consensus guidelines. It will also be of large economic interest for admissions and associated procedures.

Read more about the project.

A small proportion of patients with a headache are diagnosed with serious conditions such as subarachnoid haemorrhage (SAH).

About one in three of these patients die and another one in three survive with a disability. Early diagnosis and treatment is essential.

Diagnosis involves a Computed Tomography (CT) scan and a spinal puncture. However, these tests are not 100% accurate, and doctors and patients are concerned about complications from these tests. As a result, variability exists in tests ordered and why they are ordered.

This study looked at how Queensland emergency departments investigated headaches, with a focus on diagnosing SAH. An understanding of this variability can assist doctors to develop guidelines and streamline diagnosis of patients with suspected SAH.