Snelling, P.J., 2018. A low‐cost ultrasound model for simulation of paediatric distal forearm fractures. Australasian Journal of Ultrasound in Medicine, 21(2), pp.70-74.
Snelling, P., 2019. BUCKLED: Bedside ultrasound conducted in kids with distal upper limb fractures in the emergency department (observational trial). Ultrasound in Medicine and Biology, 45, pp.S64-S65.
Dr Peter Snelling is a dual qualified Emergency Physician and Paediatrician with a special interest in Paediatric Emergency Medicine Point-of-care Ultrasound (PEM POCUS). He has undertaken an international traineeship in PEM POCUS at the Toronto Hospital for Sick Children and is a member of the international P2 Network. He holds a Certificate in Clinician Performed Ultrasound through ASUM. He is currently a PhD candidate through Griffith University with the theme of the use of ultrasound for paediatric forearm injuries. His portfolios within the Emergency Department include paediatrics and ultrasound.
Dr Stuart Watkins is an Emergency Physician at the Gold Coast University Hospital where he is the supervisor for the ED focused ultrasound program.
Main portfolio interests are focused ultrasound, improving procedural safety and ED Systems. He is a regular faculty member for ultrasound training workshops local, national and internationally.
Dr Watkins is a member of ASUM and the ACEM ultrasound subcommittee. He leads the ED program to improve intravenous cannulation practice and the use of ultrasound guidance to improve success and patient care. To support the training of ultrasound to clinicians we need to develop strong governance systems and proof of effect through research, audit and peer support.
Inserting a cannula (plastic tube) into a child's vein is a common procedure performed in the Emergency Department. This can be challenging and can cause considerable distress for the child and caregiver. The use of ultrasound is well established for guiding cannulas into veins of adults who are recognised as having difficult access. However, it is less commonly used in children for this purpose. By conducting this trial, we aim to identify factors that influence the success of cannula insertion into veins of children, particularly the early identification of patients with potentially difficult access, and any factors that influence the longevity of cannulas.
Zoneff, E.R., Baker, K., Sweeny, A., Keijzers, G., Sanderson, J. and Watkins, S., 2019. Response to the letter to the editor regarding “Ultrasound lung surface: Basic considerations of ultrasound physics”. Australasian Journal of Ultrasound in Medicine, 22(3), pp.227-227. h
Williams, G., Rotering, L., Samuel, A., Du, J.P. and Crilly, J., 2019. Zoneff, E.R., Baker, K., Sweeny, A., Keijzers, G., Sanderson, J. and Watkins, S., 2019. The prevalence of lung surface abnormalities in a healthy population as detected by a screening lung ultrasound protocol: Comparison between young and older volunteers. Australasian Journal of Ultrasound in Medicine.
Children frequently present to the emergency department with forearm injuries and often have an x-ray to assess if there is a fracture. Bedside ultrasound is a test that emergency practitioners can use to rapidly diagnose a fracture at the time of examination, without exposing children to ionising radiation. This trial will assess whether an x-ray is unnecessary when there is either a buckle fracture or no fracture seen on a portable ultrasound machine. We will also determine the time and cost implications of this new approach, which could enable families to go home earlier and could be more cost-effective, with less x-rays being ordered.
Most patients need intravenous cannula (a small plastic tube, inserted into the vein) in the emergency department, but many suffer multiple attempts before the health provider is successful. This can cause patient distress and delays the time to diagnose and to carry out potentially life-saving treatments. The study examines current practices of inserting intravenous (IV) cannulas in the Emergency Department at the Gold Coast University Hospital.
From this research, an ultrasound-guided cannulation training program, and other visual and written materials have been suggested. This will enable better recognition of patients with difficult intravenous access and increase ultrasound use during cannulation.
“We are well practiced in placing cannulas under ultrasound guidance with good success; however, many ED team members have not received this training. This is an easy skill to learn and can have great improvements for patient outcomes and experience.”
—Dr Amy-Archer Jones
