Appropriate Emergency and Critical Care pillar

Our overarching aim is to challenge established ideas and to investigate interventions that may lead to:

• better patient outcomes
• greater staff satisfaction
• better health economic outcomes.

Our key is to search for the most appropriate care. We research acute clinical conditions in the Emergency Department, where doing less may be better. The overarching theme aligns with the ‘Deliberate Clinical Inertia’ concept.

Some examples of this research focus are the following completed projects:

• conservative treatment for primary spontaneous pneumothorax (air leakage
  between the lungs and chest) rather than inserting a drain-
   https://www.nejm.org/doi/full/10.1056/NEJMoa1910775
• finding the best balance for fluid resuscitation in sepsis -https://doi.org/10.1111/1742-6723.13469
  https://link.springer.com/article/10.1007/s00134-018-5433-0
• treating boxers’ fractures with a buddy strap rather than plaster-
   https://doi.org/10.1016/j.annemergmed.2019.01.032
• avoiding unnecessary antibiotic prescriptions-
  https://doi.org/10.1093/jac/dky447
• treating intoxicated patients with observation alone, rather than intravenous
  fluids- https://onlinelibrary.wiley.com/doi/full/10.1111/1742-6723.12151

In the last 12 months until early 2020, our pillar had various successes. Specifically, we became involved in >15 active projects, with our grants totalling approximately AUD $4 Million AUD. The group was involved with > 20 peer reviewed papers, and we supported a research registrar, several junior medical staff and over 10 medical students to become involved in projects.

We encourage staff and students to challenge current practice and seek improvement areas, avoiding unnecessary treatments that are without evidence or may even cause harm.

These research questions aim to result in:

• Increased junior researcher numbers
• Multi-centre and multi-disciplinary collaborations.