Research Areas

EDNAV- Emerging Drugs Network of Australia VIC

The EDNAV project is an illicit drug monitoring project that is presently running in Victoria as part of a wider Australian network. It is a multisite project with over 11 Victorian EDs involved, conducting advanced analysis on blood taken as part of standard care from patients presenting to ED with suspected or reported illicit drug toxicity. Department of Health Victoria, Victorian Poisons Information Centre and the Forensic Institute are involved in coordination of elements of the study.

The project has led to the detection of more than 30 novel psychoactive substances and the release of multiple health department public health warnings. Locally the project has helped identify a run of serious overdoses of one illicit drug and identified potentially highly dangerous combinations of drugs in other series of overdoses. High-risk signals are escalated to key stakeholders to produce timely and proportionate public health alerts with a focus on harm minimisation in real time. Publications related to the study include:

Syrjanen R, Schumann J, Fitzgerald J, Gerostamoulos D, Abouchedid R, Rotella JA, Knott J, Maplesden J, Hollerer H, Hannon L, Bourke E, Hodgson SE, Greene SL. The Emerging Drugs Network of Australia - Victoria Clinical Registry: A state-wide illicit substance surveillance and alert network. Emerg Med Australas. 2023 Feb;35(1):82-88. doi: 10.1111/1742-6723.14059. Epub 2022 Aug 29. PMID: 36053993.

COVID-19 Research and the ED Data registry

The COVID-19 pandemic, social distancing and lockdown laws substantially changed the face of emergency care in the short term and potentially the longer term.

A number of collaborative projects around the COVID-19 pandemic have concluded including Traumatic Brain Injury presentations during COVID-19, the qualitative study examining reasons for under attendance in ED’s during COVID-19, paediatric COVID-19 presentations  and a number of collaborative projects nationally which were looking at the changing epidemiology of emergency department presentations. The largest project looking at the changing landscape of ED presentations and specific impacts on key types of presentations such as paediatric, Mental Health, STEMI and stroke patients is in the data analysis phase. This project has amassed a large quantity of data both before and after COVID-19 and will likely be the largest of its kind.

This last study serves as a spring board for an independent study aiming to establish an ED data registry for all participating ED’s as an ongoing concern. University Hospital ED has been involved with this from its inception. An NHMRC application for this is awaiting adjudication.

Netball Women’s’ Injury Study

UHG ED are collaborating with the BCORE, Deakin university and other partners including Epworth Health, St John of God Health Care and Southwest Health Care to investigate the injury patterns of Netball players presenting to Emergency Departments. Netball is ranked amongst the most popular sports to play in Australia and has a large supporter base.

The study builds on a previous project examining AFLW injury presentations to the ED. It aims to examine Netball related injury presentations to the ED, in particular the type and frequency of injuries netball players sustain. For perspective this will be compared to data regarding AFLW and male AFL injury presentations to the ED.

PREDICT network trials

We are participating in a number of PREDICT group trials and registries coordinated locally by Dr Jeremy Furyk.

The PREDICT group is a large international multisite collaborative program of research incorporating projects centred on paediatric and adolescent emergency care. Information on the PREDICT group can be found in the following link: https://www.predict.org.au/

The UHG ED is participating at a number of levels with PREDICT collaborations including participation in the Australian and New Zealand Emergency Department Airway Registry (ANZEDAR) – Multicentre, prospective observational study of paediatric intubations in in the emergency department.

Jeremy is one of the chief investigators on the PREDICT collaborative FEBCON trial, a multicentre stepped-wedge cluster randomised controlled clinical trial of usual care versus regular antipyretics for children presenting with a febrile convulsion to the emergency department. Febrile convulsions or seizures are the most common paediatric neurological presentation to emergency departments and very distressing for families involved. There is also a high rate (10-25%) of children having a further seizure within the same illness. A recent trial suggested regular fever reducing medication, antipyretics ie paracetamol, may reduce the risk of further early convulsions which differs from current practice and usual discharge advice. This study seeks to determine whether regular antipyretics reduce the risk of seizure recurrence and also aims to follow up long term outcomes for these children.

Paediatric cervical spine injury project

This project is a multisite collaborative that aims to examine the management of paediatric patients with possible cervical spine injury in a number of rural and regional emergency department sites. Though spinal neck injuries in children are rare they are potentially profoundly significant and life changing that careful assessment and management is critical in all paediatric trauma patients. This study aims to retrospectively evaluate the injury mechanisms, characteristics and management of these patients presenting to rural and regional Australian emergency departments. This trial was originally part funded through the Barwon Southwest Alliance.

ARISE Fluids in sepsis trial

The ED is a participating site in the ARISE Fluids study, coordinated by the Australian and New Zealand Intensive Care Research Centre. It is a large multicentre randomised controlled trial comparing treatment strategies for patients presenting to emergency with septic shock. The management of early septic shock is complex and evidence of the best approach is uncertain regarding whether to administer larger amounts of intravenous fluids or to favour early treatment with medication to maintain blood pressure. This study seeks to compare these treatment methods and follow up their long term outcomes. It has received NHMRC funding.