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Vasopressor Infusion via Peripheral vs Central Access in emergency department patients with shock – The VIPCA RCT

Quick facts

Principal investigator:

Dr Thomas Holland

Team members:
Project commenced:
2022

Shock is an umbrella description for poor blood supply to vital organs and can lead to multi-organ failure and death. Emergency department (ED) patients with shock are amongst the sickest, with 1/3 being admitted to an intensive care unit (ICU). Low blood pressure, a key feature of shock which causes the poor blood supply to vital organs, can be treated with medications called vasopressors. Vasopressors traditionally have been given through a so-called 'central line'. Central lines are invasive to insert and require skill, and the actual insertion can lead to complications. More evidence has emerged that so-called peripheral lines (aka 'drip') are safe for vasopressor infusion. Randomised controlled trials (RCT) to compare the two strategies will provide high quality data to inform clinicians as to which approach is best for patients, staff and the healthcare budget. We propose a feasibility RCT to test processes and inform a large phase-III RCT to definitively answer this question. We expect that the impacts of this RCT will include: *Potentially improved patient outcomes from avoiding risks of central lines * Improved patient experience from avoiding having central line insertion * Broad applicability to low-resource settings such as rural/regional/remote areas and low-income countries *Cost savings for healthcare services through reduced use of central lines

Grants Awarded

Emergency Medicine Foundation
$38,766


Composition, Quality and Delivery of Major Haemorrhage Protocols (MHP) and critical bleeding clinical practice guidelines in hospitals across Queensland Health

Quick facts

Principal investigator:
Dr Jessica Forbes
Team members:
Project commenced:
2022

Major bleeding is a leading cause of death in trauma patients. Blood product replacement is a key component of damage control resuscitation aimed at limiting coagulopathy until definitive control of bleeding is achieved. Although Major Haemorrhage Protocols (MHP) are now widely used in the initial resuscitation of traumatically injured patients (1), protocols can vary based upon individual institutions' capabilities and processes. Within Australia, the National Blood Authority 2011 Patient Blood Management Guideline Module 1: Critical Care/ Massive Transfusion (2) recommended institutions develop standardized MHP to guide clinicians regarding the dose, timing and ratio of blood component therapy for bleeding trauma patients. However, it is currently unknown if these guidelines are implemented and if so, what institutional variations occur. While the guidelines provide a robust review of the evidence base for MHP, there is little information about the logistics of MHP implementation. Our project aims are firstly to compare the available trauma bleeding protocols across Queensland for content and quality. Secondly, we wish to understand the institution's capabilities of delivering an MHP in terms of the structure and processes available to them. Thirdly we want to explore the experiences of clinicians involved in delivering an MHP for trauma patients in both tertiary, rural and remote hospitals within Queensland. Expected benefits are to identify potential disparity of care for trauma patients in terms of MHP content, availability of resources and access to blood products. This information can help guide improvements in education, blood products availability and cost-effective care across Queensland.

Grants Awarded

Emergency Medicine Foundation
$95,507


Clonal dynamics of SARS-CoV-2-specific T cells in children and adults with COVID-19.

Khoo, W.H., Jackson, K., Phetsouphanh, C., Zaunders, J.J., Alquicira-Hernandez, J., Yazar, S., Ruiz-Diaz, S., Singh, M., Dhenni, R., Kyaw, W., Merheb, V., Lee, F., Burrell, R., Howard-Jones, A., Koirala, A., Zhou, L., Yuksel, A., Catchpoole, D., Lai, C., Vitagliano, T., Rouet, R., Christ, D., Tang, B., West, N., George, S., Gerrard, J., Croucher, P., Kelleher, A., Goodnow, C., Sprent, J.D., Powell, J., Brilot, F., Nanan, R., Hsu, P., Deenick, E., Britton, P., Phan, G., and Tea, F., 2022.

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